0
0

Chapter 58. Treatment of Substance-Related Disorders

Charles P. O'Brien, M.D., Ph.D.; Charles A. Dackis, M.D.
DOI: 10.1176/appi.books.9781585623860.434964

Sections

Excerpt

Drugs that produce substance use disorders all activate the brain reward system, but each class of drugs activates the system by a different pharmacological mechanism. Thus, this chapter is organized according to pharmacological class. The emphasis is on pharmacotherapy, but all treatment using medications should be accompanied by counseling or psychotherapy according to the patient's needs. Medication combines very well with psychotherapy, including self-help groups such as Alcoholics Anonymous (AA). The majority of patients also have an additional mental disorder (besides the addictive disorder) such as depression, anxiety, or bipolar disorder. These comorbidities require specific treatment including medication and psychotherapy. The best treatments for addiction complicated by additional psychiatric disorders are delivered in an integrated fashion, preferably from the same therapist. All psychiatrists should be able to manage substance use disorders, especially those that co-occur with other psychiatric diagnoses.

Your session has timed out. Please sign back in to continue.
Sign In Your Session has timed out. Please sign back in to continue.
Sign In to Access Full Content
 
Username
Password
Sign in via Athens (What is this?)
Athens is a service for single sign-on which enables access to all of an institution's subscriptions on- or off-site.
Not a subscriber?

Subscribe Now/Learn More

PsychiatryOnline subscription options offer access to the DSM-5 library, books, journals, CME, and patient resources. This all-in-one virtual library provides psychiatrists and mental health professionals with key resources for diagnosis, treatment, research, and professional development.

Need more help? PsychiatryOnline Customer Service may be reached by emailing PsychiatryOnline@psych.org or by calling 800-368-5777 (in the U.S.) or 703-907-7322 (outside the U.S.).

FIGURE 58–1. Percentages of youths ages 12–17 years reporting past-year marijuana use, by age group: 2000.Source. Reprinted from Substance Abuse and Mental Health Services Administration: 2000 National Household Survey on Drug Abuse Report: Marijuana Use Among Youth. Substance Abuse and Mental Health Services Administration, July 2002. Used with permission.

References

American Psychiatric Association: Diagnostic and Statistical Manual of Mental Disorders, 4th Edition, Text Revision. Washington, DC, American Psychiatric Association, 2000
 
Anton RF, O'Malley SS, Ciraulo DA, et al: Combined pharmacotherapies and behavioral interventions for alcohol dependence: the COMBINE study: a randomized controlled trial. JAMA 295:2003–2017, 2006
[PubMed]
 
Ball JC, Ross A: The Effectiveness of Methadone Maintenance Treatment. New York, Springer-Verlag, 1991
 
Beary MD, Christofides J, Fry D, et al: The benzodiazepines as substances of abuse. Practitioner 231:19–20, 1987
[PubMed]
 
Benowitz NL: Nicotine replacement therapy: what has been accomplished—can we do better? Drugs 45:157–170, 1993
[PubMed]
 
Benwell ME, Balfour DJ: The effects of nicotine administration on 5-HT uptake and biosynthesis in rat brain. Eur J Pharmacol 84:71–77, 1982
[PubMed]
 
Bickel WE, Stitzer ML, Bigelow GE, et al: A clinical trial of buprenorphine: comparison with methadone in the detoxification of heroin addicts. Clin Pharmacol Ther 43:72–78, 1988
[PubMed]
 
Bigelow G, Preston K, Schmittner J, et al: A randomized, single-dose, opioid challenge study of extended-release naltrexone in opioid-using adults. Neuropsychopharmacology 31:S199, 2006
 
Burling TA, Ziff DC: Tobacco smoking: a comparison between alcohol and drug abuse in patients. Addict Behav 13:185–190, 1988
[PubMed]
 
Carroll KM, Fenton LR, Ball SA, et al: Efficacy of disulfiram and cognitive behavior therapy in cocaine-dependent outpatients: a randomized placebo-controlled trial. Arch Gen Psychiatry 61:264–272, 2004
[PubMed]
 
Collins ED, Kleber HD, Whittington RA, et al: Anesthesia-assisted vs buprenorphine- or clonidine-assisted heroin detoxification and naltrexone induction: a randomized trial. JAMA 294:903–913, 2005
[PubMed]
 
Comer SD, Sullivan MA, Yu E, et al: Injectable, sustained-release naltrexone for the treatment of opioid dependence: a randomized, placebo-controlled trial. Arch Gen Psychiatry 63:210–218, 2006
[PubMed]
 
Compton W, Thomas Y, Stinson F, et al: Prevalence, correlates, disability, and comorbidity of DSM-IV drug abuse and dependence in the United States. Arch Gen Psychiatry 64:566–576, 2007
[PubMed]
 
Covey LS, Glassman AH, Stetner F: Depression and depressive symptoms in smoking cessation. Compr Psychiatry 31:350–354, 1990
[PubMed]
 
Covey LS, Sullivan MA, Johnston J, et al: Advances in non-nicotine pharmacotherapy for smoking cessation. Drugs 59:17–31, 2000
[PubMed]
 
Cowan A, Lewis JW, Macfarlane IR: Agonist and antagonist properties of buprenorphine, a new antinociceptive agent. Br J Pharmacol 60:537–545, 1977
[PubMed]
 
Crane M, Sereny G, Gordis E: Drug use among alcoholism detoxification patients: prevalence and impact on alcoholism treatment. Drug Alcohol Depend 22:33–36, 1988
[PubMed]
 
Dackis CA: New treatments for cocaine abuse. Drug Discovery Today 2:79–86, 2005
 
Dackis C, O'Brien C: Glutamatergic agents for cocaine dependence. Ann N Y Acad Sci 1003:328–345, 2003
[PubMed]
 
Dackis CA, Lynch KG, Yu E, et al: Modafinil and cocaine: a double-blind, placebo-controlled drug interaction study. Drug Alcohol Depend 70:29–37, 2003
[PubMed]
 
Dackis CA, Kampman KM, Lynch K, et al: A double-blind, placebo-controlled trial of modafinil for cocaine dependence. Neuropsychopharmacology 30:205–211, 2005
[PubMed]
 
Daughton DM, Heatley SA, Pendergast JJ, et al: Effect of transdermal nicotine delivery as an adjunct to low-intervention smoking cessation therapy. Arch Intern Med 151:749–752, 1991
[PubMed]
 
Dole VP, Nyswander M: A medical treatment for diacetylmorphine (heroin) addiction: a clinical trial with methadone hydrochloride. JAMA 193:646–650, 1965
[PubMed]
 
Ferdinand RF, van der Ende J, Bongers I, et al: Cannabis-psychosis pathway independent of other types of psychopathology. Schizophr Res 79:289–295, 2005
[PubMed]
 
Ferry LH, Robbins AS, Scariati PD, et al: Enhancement of smoking cessation using the antidepressant bupropion hydrochloride: abstract from the 65th Scientific Sessions of the American Heart Association, New Orleans, LA. Circulation 86 (suppl 1):671, 1992
 
Finnegan LP: Treatment issues for opioid-dependent women during the perinatal period. J Psychoactive Drugs 23:191–201, 1991
[PubMed]
 
Finnegan LP, Kandall SR: Maternal and neonatal effects of alcohol and drugs, in Substance Abuse: A Comprehensive Textbook. Edited by Lowinson JH, Ruiz P, Millman RB, et al. Baltimore, MD, Williams & Wilkins, 1992, pp 628–656
 
Fox BS, Kantak KM, Edwards MA, et al: Efficacy of a therapeutic cocaine vaccine in rodent models. Nat Med 2:1129–1132, 1996
[PubMed]
 
Fram DH, Marmo J, Holden R: Naltrexone treatment—the problem of patient acceptance. J Subst Abuse Treat 6:119–122, 1989
[PubMed]
 
Fudala PJ, Jaffe JH, Dax EM, et al: Use of buprenorphine in the treatment of opiate addiction, II: physiologic and behavioral effects of daily and alternate-day administration and abrupt withdrawal. Clin Pharmacol Ther 47:525–534, 1990
[PubMed]
 
Fudala PJ, Bridge TP, Herbert S, et al: A multi-site efficacy evaluation of a buprenorphine/naloxone product for opiate dependence treatment. NIDA Res Monogr 179:105, 1999
 
Fuller RK, Branchey L, Brightwell DR, et al: Disulfiram treatment of alcoholism: a Veterans Administration cooperative study. JAMA 256:1449–1455, 1986
[PubMed]
 
Garbutt JC, Kranzler HR, O'Malley SS, et al: Efficacy and tolerability of long-acting injectable naltrexone for alcohol dependence: a randomized controlled trial. JAMA 293:1617–1625, 2005
[PubMed]
 
Gawin FH, Kleber HD: Abstinence symptomatology and psychiatric diagnosis in cocaine abusers. Arch Gen Psychiatry 43:107–113, 1986
[PubMed]
 
Gerra G, Zaimovic A, Giusti F, et al: Lofexidine versus clonidine in rapid opiate detoxification. J Subst Abuse Treat 21:11–17, 2001
[PubMed]
 
Gerstein DR: The effectiveness of drug treatment, in Addictive States, Vol 70. Edited by O'Brien CP, Jaffe JH. New York, Raven, 1992, pp 253–282
 
Glassman AH: Cigarette smoking: implications for psychiatric illness. Am J Psychiatry 150:546–553, 1993
[PubMed]
 
Glassman AH, Stetner F, Walsh Raizman PS, et al: Heavy smokers, smoking cessation, and clonidine: results of a double-blind, randomized trial. JAMA 259:2863–2866, 1988
[PubMed]
 
Goff DC, Henderson DC, Amico E: Cigarette smoking in schizophrenia: relationship to psychopathology and medication side effects. Am J Psychiatry 149:1189–1194, 1992
[PubMed]
 
Gold MS, Redmond DE, Kleber HD: Clonidine blocks acute opiate withdrawal symptoms. Lancet 2(8090):599–602, 1978
[PubMed]
 
Gold MS, Pottach AC, Sweeney DR, et al: Opiate withdrawal using clonidine. JAMA 243:343–346, 1980
[PubMed]
 
Gonzales RA, Weiss F: Suppression of ethanol-reinforced behavior by naltrexone is associated with attenuation of the ethanol-induced increase in dialysate dopamine levels in the nucleus accumbens. J Neurosci 18:10663–10671, 1998
[PubMed]
 
Goodwin DW: Alcohol: clinical aspects, in Substance Abuse—A Comprehensive Textbook. Edited by Lowinson JH, Ruiz P, Millman RB. Baltimore, MD, Williams & Wilkins, 1992, pp 144–151
 
Grabowski J, Rhoades H, Siverman P, et al: Risperidone for the treatment of cocaine dependence: randomized double-blind trial. J Clin Psychopharmacol 20:305–310, 2000
[PubMed]
 
Gross J, Stitzer ML: Nicotine replacement: ten-week effects on tobacco withdrawal symptoms. Psychopharmacology 93:334–341, 1989
 
Hart CL, Haney M, Ruben E, et al: Smoked cocaine self-administration decreased by modafinil maintenance: preliminary findings. Presented at International Study Group for the Investigation of Drug as Reinforcers Annual Meeting, Scottsdale, AZ, June 2006
 
Hubbard JR, Franco SE, Onaivi ES: Marijuana: medical implications. Am Fam Physician 60:2583–2588, 1999
[PubMed]
 
Hughes JR, Hatsukami D: Signs and symptoms of tobacco withdrawal. Arch Gen Psychiatry 43:289–294, 1986
[PubMed]
 
Hurt RD, Sachs DP, Glover ED, et al: A comparison of sustained-release bupropion and placebo for smoking cessation [see comments]. N Engl J Med 337:1195–1202, 1997
[PubMed]
 
Iversen LL: The Science of Marijuana. New York, Oxford University Press, 2000
 
Jasinski DR, Pevnick JS, Griffith JD: Human pharmacology and abuse potential of the analgesic buprenorphine. Arch Gen Psychiatry 35:501–516, 1978
[PubMed]
 
Jasinski DR, Fudala PJ, Johnson RE: Sublingual versus subcutaneous buprenorphine in opiate abusers. Clin Pharmacol Ther 45:513–519, 1989
[PubMed]
 
Johnson RE, Cone EJ, Henningfield JE, et al: Use of buprenorphine in the treatment of opiate addiction, I: physiologic and behavioral effects during a rapid dose induction. Clin Pharmacol Ther 46:335–343, 1989
[PubMed]
 
Johnson RE, Jaffe JH, Fudala PJ: A controlled trial of buprenorphine treatment for opioid dependence. JAMA 267:2750–2755, 1992
[PubMed]
 
Johnston L: Monitoring the Future 2005, in Monitoring the Future: National Survey Results on Drug Use, 1975–2005. Edited by Johnston L, O'Malley P, Bachman J, et al. Bethesda, MD, National Institute on Drug Abuse, 2006, pp 139–262
 
Jorenby DE, Leischow SJ, Nides MA, et al: A controlled trial of sustained-release bupropion, a nicotine patch, or both for smoking cessation [see comments]. N Engl J Med 340:685–691, 1999
[PubMed]
 
Jorenby DE, Hays JT, Rigotti NA, et al: Efficacy of varenicline, an alpha4beta2 nicotinic acetylcholine receptor partial agonist, vs placebo or sustained-release bupropion for smoking cessation: a randomized controlled trial. JAMA 296:56–63, 2006
[PubMed]
 
Kakko J, Gronbladh L, Svanborg KD, et al: A stepped care strategy using buprenorphine and methadone versus conventional methadone maintenance in heroin dependence: a randomized controlled trial. Am J Psychiatry 164:797–803, 2007
[PubMed]
 
Kampman KM, Pettinati H, Lynch KG, et al: A pilot trial of olanzapine for the treatment of cocaine dependence. Drug Alcohol Depend 70:265–273, 2003
[PubMed]
 
Kampman KM, Pettinati H, Lynch KG, et al: A pilot trial of topiramate for the treatment of cocaine dependence. Drug Alcohol Depend 75:233–240, 2004a
 
Kampman KM, Pettinati HM, Volpicelli JR, et al: Cocaine dependence severity predicts outcome in outpatient detoxification from cocaine and alcohol. Am J Addict 13:74–82, 2004b
 
Kantak KM, Collins SL, Lipman EG, et al: Evaluation of anti-cocaine antibodies and a cocaine vaccine in a rat self-administration model. Psychopharmacology 148:251–262, 2000
[PubMed]
 
Killen JD, Fortmann SP, Murphy GM, et al: Extended treatment with bupropion SR for cigarette smoking cessation. J Consult Clin Psychol 74:286–294, 2006
[PubMed]
 
Koob GF, Ahmed SH, Boutrel B, et al: Neurobiological mechanisms in the transition from drug use to drug dependence. Neurosci Biobehav Rev 27:739–749, 2004
[PubMed]
 
Kornetsky C, Porrino LJ: Brain mechanisms of drug-induced reinforcement, in Addictive States, Vol 70. Edited by O'Brien CP, Jaffe JH. New York, Raven, 1992, pp 59–78
 
Kosten TR, Kleber HD: Buprenorphine detoxification from opioid dependence: a pilot study. Life Sci 42:635–641, 1988
[PubMed]
 
Kosten TR, Rosen M, Bond J, et al: Human therapeutic cocaine vaccine: safety and immunogenicity. Vaccine 20:1196–1204, 2002
[PubMed]
 
Lhuintre JP, Daoust M, Moore ND, et al: Ability of calcium bis acetyl homotaurine, a GABA agonist, to prevent relapse in weaned alcoholics. Lancet 1(8436):1014–1016, 1985
[PubMed]
 
Lhuintre JP, Moore N, Tran G, et al: Acamprosate appears to decrease alcohol intake in weaned alcoholics. Alcohol Alcohol 25:613–622, 1990
[PubMed]
 
Ling W, Charuvastra C, Collins JF, et al: Buprenorphine maintenance treatment of opiate dependence: a multicenter, randomized clinical trial. Addiction 93:475–486, 1998
[PubMed]
 
Ling W, Rawson R, Shoptaw S, et al: Management of methamphetamine abuse and dependence. Curr Psychiatry Rep 8:345–354, 2006
[PubMed]
 
Lipsedge MS, Cook CCH: Prescribing for drug addicts. Lancet 2(8556):451–452, 1987
[PubMed]
 
Maddux JF, Desmond DP: Methadone maintenance and recovery from opioid dependence. Am J Drug Alcohol Abuse 18:63–74, 1992
[PubMed]
 
Magura S, Goldsmith D, Casriel C, et al: The validity of methadone clients' self-reported drug use. Int J Addict 22:727–750, 1987
[PubMed]
 
Martell BA, Mitchell E, Poling J, et al: Vaccine pharmacotherapy for the treatment of cocaine dependence. Biol Psychiatry 58:158–164, 2005
[PubMed]
 
Martin WR, Jasinski DR: Physical parameters of morphine dependence in man: tolerance, early abstinence, protracted abstinence. J Psychiatry Res 7:9–17, 1969
[PubMed]
 
Martin WR, Jasinski D, Mansky P: Naltrexone, an antagonist for the treatment of heroin dependence. Arch Gen Psychiatry 28:784–791, 1973
[PubMed]
 
Mason BJ, Ownby RL: Acamprosate for the treatment of alcohol dependence: a review of double-blind, placebo-controlled trials. CNS Spectr 5:58–69, 2000
[PubMed]
 
Matherson E, O'Shea B: Smoking and malignancy in schizophrenia. Br J Psychiatry 145:429–432, 1984
 
McLellan AT, Arndt IO, Metzger DS, et al: The effects of psychosocial services on substance abuse treatment. JAMA 269:1953–1959, 1993
[PubMed]
 
Mendelson J, Jones RT, Welm S, et al: Buprenorphine and naloxone combinations: the effects of three dose ratios in morphine-stabilized, opiate-dependent volunteers. Psychopharmacology 141:37–46, 1999
[PubMed]
 
Metzger DS, Woody GE, McLellan AT, et al: Human immunodeficiency virus seroconversion among in- and out-of-treatment intravenous drug users: an 18-month prospective follow-up. J Acquir Immune Defic Syndr Hum Retrovirol 6:1049–1056, 1993
[PubMed]
 
Miller N, Summers G, Gold M: Cocaine dependence: alcohol and other drug dependence and withdrawal characteristics. J Addict Dis 12:1712–1716, 1993
 
Myrick H, Malcolm R, Taylor B, et al: Modafinil: preclinical, clinical, and post-marketing surveillance—a review of abuse liability issues. Ann Clin Psychiatry 16:101–109, 2004
[PubMed]
 
O'Brien CP: Benzodiazepine use, abuse, and dependence. J Clin Psychiatry 66 (suppl 2):28–33, 2005
 
O'Brien CP, Testa T, O'Brien TJ, et al: Conditioned narcotic withdrawal in humans. Science 195:1000–1002, 1977
[PubMed]
 
Ogborne AC, Kapur BM: Drug use among a sample of males admitted to an alcohol detoxification center. Alcohol Clin Exp Res 11:183–185, 1987
[PubMed]
 
O'Malley SS, Jaffe AJ, Chang G, et al: Naltrexone and coping skills therapy for alcohol dependence. Arch Gen Psychiatry 49:881–887, 1992
[PubMed]
 
O'Malley SS, Krishnan-Sarin S, Farren C, et al: Naltrexone decreases craving and alcohol self-administration in alcohol-dependent subjects and activates the hypothalamo-pituitary- adrenocortical axis. Psychopharmacology (Berl) 160:19–29, 2002
[PubMed]
 
Onaivi ES: Neuropsychobiological evidence for the functional presence and expression of cannabinoid CB2 receptors in the brain. Neuropsychobiology 54:231–246, 2006
[PubMed]
 
Paille FM, Guelfi JD, Perkins AC, et al: Double-blind randomized multicentre trial of acamprosate in maintaining abstinence from alcohol. Alcohol Alcohol 30:239–247, 1995
[PubMed]
 
Palmer KJ, Buckley MM, Faulds D: Transdermal nicotine: a review of its pharmacodynamic and pharmacokinetic properties and therapeutic efficacy as an aid to smoking cessation. Drugs 44:498–529, 1992
[PubMed]
 
Peachy JE, Naranjo CA: The role of drugs in the treatment of alcoholism. Drugs 27:171–182, 1984
 
Regier DA, Myers JK, Kramer M, et al: The NIMH Epidemiologic Catchment Area Program: historical context, major objectives, and study population characteristics. Arch Gen Psychiatry 41:934–941, 1984
[PubMed]
 
Revell AD, Warburton DM, Wesnes K: Smoking as a coping strategy. Addict Behav 10:209–224, 1985
[PubMed]
 
Sacco KA, Termine A, Seyal A, et al: Effects of cigarette smoking on spatial working memory and attentional deficits in schizophrenia: involvement of nicotinic receptor mechanisms. Arch Gen Psychiatry 62:649–659, 2005
[PubMed]
 
Sass H, Soyka M, Mann K, et al: Relapse prevention by acamprosate: results from a placebo-controlled study on alcohol dependence. Arch Gen Psychiatry 53:673–680, 1996
[PubMed]
 
Satel SL, Price LH, Palumbo JM, et al: Clinical phenomenology and neurobiology of cocaine abstinence: a prospective inpatient study. Am J Psychiatry 148:1712–1716, 1991
[PubMed]
 
Schneider NG, Olmstead R, Mody FV, et al: Efficacy of a nicotine nasal spray in smoking cessation: a placebo-controlled trial. Addiction 90:1671–1682, 1995
[PubMed]
 
Sellers EM, Sullivan JT, Somer G, et al: Clinical Institute Withdrawal Assessment for Alcohol (CIWA-AD), in Task Force for the Handbook of Psychiatric Measures, Washington, DC, American Psychiatric Association, 2000, pp 479–481
 
Sofuoglu M, Kosten TR: Novel approaches to the treatment of cocaine addiction. CNS Drugs 19:13–25, 2005
[PubMed]
 
Soyka M, Lutz W, Kauert G, et al: Epileptic seizures and alcohol withdrawal: significance of additional use (and misuse) of drugs and electroencephalographic findings. Epilepsy 2:109–113, 1989
 
Stitzer ML: Nicotine-delivery products: demonstrated and desirable effects, in New Developments in Nicotine-Delivery Systems. Edited by Henningfield JE, Stitzer ML. Ossining, NY, Cortland Communications, 1991, pp 35–45
 
Substance Abuse and Mental Health Services Administration: Summary of Findings From the 2000 National Household Survey on Drug Abuse. Rockville, MD, U.S. Government Printing Office, 2001
 
Substance Abuse and Mental Health Services Administration: Emergency Department Trends From the Drug Abuse Warning Network, Preliminary Estimates January–June 2001 With Revised Estimates 1994 to 2000. Rockville, MD, U.S. Government Printing Office, 2002
 
Sutherland G, Stapleton JA, Russell MAH, et al: Randomised controlled trial of nasal nicotine spray in smoking cessation. Lancet 340:324–329, 1992
[PubMed]
 
Tonnesen P, Norregaard J, Simonsen K, et al: A double-blind trial of a 16-hour transdermal nicotine patch in smoking cessation. N Engl J Med 325:311–315, 1991
[PubMed]
 
Tonnesen P, Norregaard J, Mikkelson K, et al: A double-blind trial of a nicotine inhaler for smoking cessation. JAMA 269:1268–1271, 1993
[PubMed]
 
Volpicelli JR, O'Brien CP, Alterman AI, et al: Naltrexone and the treatment of alcohol dependence: initial observations, in Opioids, Bulimia, Alcohol Abuse, and Alcoholism. Edited by Reid LB. New York, Springer-Verlag, 1990, pp 195–214
 
Volpicelli JR, Alterman AI, Hayashida M, et al: Naltrexone in the treatment of alcohol dependence. Arch Gen Psychiatry 49:876–880, 1992
[PubMed]
 
Volpicelli JR, Watson NT, King AC, et al: Effect of naltrexone on alcohol "high" in alcoholics. Am J Psychiatry 152:613–615, 1995
[PubMed]
 
Weddington WW, Brown BS, Haertzen CA, et al: Changes in mood, craving, and sleep during short-term abstinence reported by male cocaine addicts: a controlled, residential study. Arch Gen Psychiatry 47:861–868, 1990
[PubMed]
 
Whitworth AB, Fischer F, Lesch OM, et al: Comparison of acamprosate and placebo in long-term treatment of alcohol dependence [see comments]. Lancet 347:1438–1442, 1996
[PubMed]
 
Wikler A: Dynamics of drug dependence. Arch Gen Psychiatry 28:611–616, 1973
[PubMed]
 
+

CME Activity

Add a subscription to complete this activity and earn CME credit.
Sample questions:
1.
Among medications approved by the U.S. Food and Drug Administration (FDA) to treat alcohol dependence, which of the following has effects on the -aminobutyric acid (GABA)/N-methyl-d-aspartate (NMDA) complex?
2.
A patient who has been a pack-a-day smoker for over 20 years now wishes to quit. You initially recommend nicotine replacement therapy in the form of a nicotine patch. Research findings suggest that what percentage of patients treated with transdermal nicotine will be able to stop smoking and remain abstinent after 1 year?
3.
Which of the following statements concerning benzodiazepines is true?
NOTE:
Citing articles are presented as examples only. In non-demo SCM6 implementation, integration with CrossRef’s "Cited By" API will populate this tab (http://www.crossref.org/citedby.html).
Related Content
Articles
Books
Gabbard's Treatments of Psychiatric Disorders, 4th Edition > Chapter 19.  >
The American Psychiatric Publishing Textbook of Geriatric Psychiatry, 4th Edition > Chapter 23.  >
Dulcan's Textbook of Child and Adolescent Psychiatry > Chapter 17.  >
The American Psychiatric Publishing Textbook of Substance Abuse Treatment, 4th Edition > Chapter 1.  >
Topic Collections
Psychiatric News
PubMed Articles
"Eating addiction", rather than "food addiction", better captures addictive-like eating behavior. Neurosci Biobehav Rev 2014;():.doi:10.1016/j.neubiorev.2014.08.016.
Or08-4how craving fluctuates - preliminary results of a longitudinal study among gamblers. Alcohol Alcohol 2014;49 Suppl 1():i45-i46.doi:10.1093/alcalc/agu053.38.
 
  • Print
  • PDF
  • E-mail
  • Chapter Alerts
  • Get Citation