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(p. 763) Psychopharmacological Treatments for Substance Use Disorders 

(p. 763) Psychopharmacological Treatments for Substance Use Disorders
Chapter:
(p. 763) Psychopharmacological Treatments for Substance Use Disorders
Author(s):

James R. McKay

, Henry R. Kranzler

, Kyle M. Kampman

, Rebecca L. Ashare

, and Robert A. Schnoll

DOI:
10.1093/med:psych/9780199342211.003.0024
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date: 22 October 2020

The treatment of substance use disorders with medications is well established, although most experts agree that pharmacological interventions must be combined with psychosocial therapies. Many type 1 and type 2 controlled trials have shown that the use of nicotine replacement therapy significantly increases abstinence rates. Non-nicotine treatments, such as bupropion and varenicline, have been found in controlled trials to significantly increase abstinence rates. The treatment of alcohol use disorder can be enhanced by three approved medications with different mechanisms of action: disulfiram, naltrexone, and acamprosate. Methadone maintenance treatment has consistently shown efficacy in the treatment of opioid dependence, and buprenorphine has substantially expanded the options for treating the disorder. Although double-blind, placebo-controlled clinical trials of several medications have provided initial evidence of efficacy for cocaine use disorder, efficacy has not yet been shown in multisite trials.

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