Substance Abuse Treatment Strategies and FDA-Approved Medications

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Explore the various substance abuse treatment approaches, including psychological and pharmacological interventions, along with FDA-approved medications like disulfiram, naltrexone, and buprenorphine. Learn about the challenges in substance abuse treatment and the psychology of substance users. Discover primary care interventions and the transtheoretical model for behavioral change in addiction treatment.


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  1. Taking drugs if you have ___ is BAD

  2. Increased rates transmission Unprotected sex Anal intercourse Group sex or multiple partners Internet partners Injection drug users High or intoxicated during sex Sex work Sex with serodiscordant partner

  3. Substance Treatment in the USA Forty million Americans ages 12 and older (16 percent) only about 1 in 10 people receive treatment Addiction treatment programs are not adequately regulated

  4. Substance abuse treatments Psychological Pharmacological Combination Public Health

  5. FDA approved pharmacologic Alcohol disulfram (antabuse) Acamprosate naltrexone Nicotine Buproprion Varenicline nicotine replacement

  6. FDA approved pharmacologic Opioid Methadone maintenance Buprenorphine Naltrexone (PO/IM) Buprenorphine/naltrexone

  7. Psychology of Substance User Impulsive Fearless Incapable of delayed gratification Opposite of people who go into health care!!!

  8. Traditional counseling Immediate and Total Abstinence Provider set goals Confrontational Dichotomis Good (What I say) Bad (What you do) Nearly Completely Ineffective!!

  9. Transtheoretical Model Gradual Behavioral Change Conceptualized stages Identify patient s current stage Strategies to advance the stage Understanding of backward and forward progress of change Reduced provider frustration Increased patient acceptance

  10. Primary care Intervention

  11. Primary Care Intervention toxicological and questionnaire screening brief motivational interviews active referrals a list of treatment providers follow-up booster phone call.

  12. Risk Diagnosis Questionnaire Starting point for clinical interaction Simple self report instrument 13 questions Clinically validated Rapidly elicits risk behavior without appearing judgmental Callahan 2007

  13. http://www.motivationalinterview.org/ Project MATCH http://pubs.niaaa.nih.gov/publications/MATCHSeries3/

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