Drug substitution treatments and addiction pharmacotherapies: Integrating pharmacotherapy into the addiction syndrome treatment paradigm

Abstract

(from the chapter) In this chapter, I explore how a treatment philosophy that is based on the addiction syndrome model can guide the use of pharmacotherapy during the care of a broad range of patients who are struggling with various expressions of addiction. I focus on four of the most common expressions of addiction (i.e., alcohol, opiate, and nicotine dependence and pathological gambling [PG]) because there are Food and Drug Administration (FDA)-approved medications or a substantial research literature that support the efficacy of drug substitution treatment and other addiction pharmacotherapies in these conditions. I have chosen not to cover other conditions, such as cocaine or marijuana dependence, because the current evidence of effective pharmacotherapies is insufficient to warrant inclusion in this chapter. My discussion highlights the degree to which clinical presentations support the addiction syndrome paradigm, how this concept informs a particular philosophy of clinical management, and how this approach is likely to improve treatment outcomes.

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