Medications in the Treatment of Substance Use Disorder
There are types of medications that are often used in treatment settings that have been designed to work for the specific use disorders. From (SAMHSA, 2015) we can see the different types of medications. For alcohol use disorders, Acamprosate can be used to help reduce cravings and for general maintenance. Naltrexone, an opioid antagonist is used to reduce cravings. Disulfiram is used to change the way in which alcohol is metabolized which provides an upsetting experience if the user ingests alcohol. Medications for Tobacco use disorders can include nicotine replacement through nicotine gum, transdermal patches and lozenges which contain small amounts of nicotine to reduce withdrawal symptoms. There are also nicotine inhalants that are fact acting. There is Varenicline which is a nicotine agonist that helps in cessation and Bupropion, a type of antidepressant that has been found to be useful in this treatment. Drugs for opioid use disorder have been extensively. Methadone is a type of synthetic opiate which is used in maintenance of the disorder. Buprenorphine is another type of opiate that is also used but when combined with an opiate antagonist, the resultant medication known as suboxone has been shown to be effective in craving reduction. .
In addition to these components, many clinical settings offer case management services to address the social component of the disorder such as coordination of behavioral health services with housing, employment, and even education, This is provided because in most cases the person with the disorder is involved with multiple mental health care systems and it is preferable that they have one point of contact to assist in the recovery process (SAMHSA, 2015).
Many of the evidenced based treatment modalities that are used in today’s treatment are some form of cognitive behavior therapy or behavior therapy. The cognitive behavioral therapies address issues of irrational thinking through cognitive disputation, deal in psychoeducation about biological and non-biological aspects of the disease and teach a relapse prevention model (NIDA, 2012). Behavior therapies such as third-wave behavioral techniques including Dialectical Behavior Therapy (DBT) and Acceptance and Commitment Therapy (ACT) utilize mindfulness based techniques and values definition to help clients to change behaviors so that there is a decrease in pathological behaviors with a corresponding increase in healthy prosocial behaviors that move the person in the direction of the things they most value (Hayes, Strosahl, & Wilson, 2012; Koerner, 2012). These behavior models also assist the user with emotion dysregulation and help in dealing with cognitive distortions but do so in a way that is counter to the CBT models in that the irrational thoughts and feelings are not disputed directly.