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Published Online: 10 October 2023

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Publication: Pharmacotherapy for Complex Substance Use Disorders: A Practical Guide
https://doi.org/10.1176/appi.books.9781615379989.index
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Page numbers printed in boldface type refer to figures and tables.
Abstinence syndrome,
184
Acamprosate
clinical case of,
91
for treatment of AUD,
75–76, 93
for treatment of AUD during pregnancy,
252, 253–254
Acetaminophen
for pain management,
346, 348
for treatment of OUD during pregnancy,
264, 266
Acamprosate, for treatment of AUD and CUD,
90
Addiction
.See also Adolescents; Substance use disorders
brain disease model of,
35, 36
case examples of AUD,
97–99
definition of,
1
neurobiology of
case example of,
31–32
circuits involved in,
32–34, 33
conditioned reinforcement and intoxication,
34–35
description of,
32–34
genetics and personality factors,
35–37
overview,
31
pharmacodynamics of,
39–41
pharmacogenomics and,
37–38
pharmacokinetics and,
38–39
psychological theories and,
37–38
stages of,
35, 36
in twins,
35
Addiction Severity Index,
215
ADHD (attention-deficit/hyperactivity disorder)
co-occurring addictive disorders in adolescents,
288–289
nonstimulants and,
126
stimulants and,
133, 211–212
TUD and,
220
Adolescent community reinforcement approach, for treatment of adolescents with SUDs,
308
Adolescents
addictive disorders in
alcohol and,
284, 291–292, 292
binge drinking among adults compared with,
292
consent to treatment,
281–282
co-occurring disorders,
288–290
ADHD,
288–289
cannabis and,
293
cocaine,
294–295
depression and anxiety,
289–290
hallucinogens and,
295, 296–299
inhalants,
300
opioids and,
293–294
over-the-counter drugs,
295, 300
overview,
288
psychosis,
290–291
trauma and PTSD,
290
diagnosis of,
300–301
drug testing for,
302–303
effects of substance on the adolescent brain,
285–288
adolescent brain development,
285–286
alcohol and,
286–287
cannabis,
287–288
nicotine and,
287
overview,
285
epidemiology,
282–283
marijuana,
284
microprocessor disorders and,
307, 309–310
nicotine and,
292–293
overdose and,
283
overview,
281
risk factors for substance use,
291
screening,
301–302
substances commonly used,
283, 284
TUD,
284
treatment,
303–307, 308
psychosocial interventions,
306–307, 308
of SUDs,
304–305
alcohol use in,
2
age at drinking onset,
286
cannabis use in,
220
co-occurring SUDs and psychiatric disorders in,
4
PTSD in,
215
risk factors for adolescent substance use in,
291, 291
risk factors for adolescent substance use with peers,
291, 291
suicide among,
4–5
Adverse Events in a Global Smoking Cessation Study (EAGLES) trial,
80–81
Affect regulation,
32
Agonist therapy, laboratory testing in,
55–57
AIDS-defining illnesses (ADIs),
236–237.See also HIV Alcohol
in adolescents,
291–292
binge drinking, among adults compared with adolescents,
292
cannabis with AUD and,
84–85
effects on the adolescent,
286–287
mechanisms of,
40
pain and,
344–346
plus cocaine, treatment for,
122–124
smoking with AUD and,
80–83
Alcohol use disorder (AUD)
.See also Adolescents; Substance use disorders
abstinence and,
76, 77
in adolescents,
2, 286–287
anxiety disorders and,
204
benzodiazepines and,
85–86
binging and,
2
biomarkers for,
64–65
bipolar disorder and,
202–203
blood biomarkers for use of,
59, 63, 64, 66
cannabis with,
84–85
care of patient with,
207
case example of,
223–225
clinical cases of,
91, 97–99
clinical trials of treatment among LGBTQ+ population,
323–324
cocaine and,
89–91
CUD and,
122–124
DSM-5 defined,
322
during pregnancy,
250–258
benzodiazepine withdrawal,
255, 256, 257
epidemiology,
250
pharmacological treatment,
25, 252, 253–258
risks of not treating,
250
effects of,
17
epidemiology of,
1–2, 200–201
MDD and,
202
methamphetamines and,
86–88
mood disorders and,
200
MSUD options for,
91, 95–96
opioids and,
155–158
overview,
73–74
pharmacotherapy for,
74–80, 93–94
combination treatment,
79–80
FDA-approved medications,
74–78
off-label, second-line interventions,
76–78
off-label, third-line interventions,
78–79
principles of,
157
psychotherapy and,
203
PTSD and,
205–207
smoking and alcohol with,
80–83
social anxiety and,
204–205
suicidality and,
201–202
treatment algorithm for,
91, 92
treatment for adolescents with,
304
withdrawal management from,
178, 179
Alcohol Use Disorder and Associated Disabilities Schedule–5 (AUDADIS-5),
156
Alcohol Use Disorders Identification Test (AUDIT),
156, 283, 284, 301–302
Alcohol Use Disorders Identification Test–Concise version (AUDIT-C),
301
Alcohol withdrawal syndrome (AWS), during pregnancy,
255
Alpha2-adrenergic agonists, for withdrawal from opioids,
146–147
Alprazolam, false negatives on urine testing,
53
American Academy of HIV Medicine (AAHIVM),
236
American Society of Addiction Medicine (ASAM) Patient Placement Criteria,
176, 238–239
Amiodarone, for management of effects of inhalants,
19
Amitriptyline, for pain management,
348
Amphetamines
in adolescents,
284
effects of,
17
false negatives on urine testing,
53
false positives on urine testing,
52
functional brain imaging studies in users of,
34
mechanisms of,
40
Amphetamine salts, extended-release, for treatment of CUD,
111, 113
Amphetamine use disorder
mortality outcome from,
127
overview,
124–125
treatment for,
124–127
Anhedonia,
212
Anticonvulsants
for treatment of amphetamine use disorder,
125
for treatment of CUD,
113
Antidepressants
for pain management,
348
for treatment of amphetamine use disorder,
125–127
for treatment of comorbid depression and OUD,
208
for treatment of comorbid PTSD and OUD,
210
for treatment of CUD,
113
Antiepileptic medications, for pain management,
348
Antipsychotics
for treatment of amphetamine use disorder,
125–126
for treatment of CUD,
113
for treatment of MUD,
130
in patients receiving OAT,
162
Antiviral therapy (ART)
drug interactions with,
240
for treatment of HIV,
235, 239–240
Anxiety disorders
AUD and,
204
CaUD and,
221
co-occurring addictive disorders in adolescents and,
289–290
overview,
208
prevalence of symptoms in adolescents,
290
stimulants and,
214
TUD and,
217–219
Apgar scores,
257
Aripiprazole
cravings for methamphetamine and,
214
for treatment of amphetamine use disorder,
125
for treatment of CUD,
113
ART. See Antiviral therapy
ASAM (American Society of Addiction Medicine) Patient Placement Criteria,
176, 238–239
Assertive continuing care, for treatment of adolescents with SUDs,
308
Atomoxetine
for treatment of amphetamine use disorder,
126
for treatment of methamphetamine and tobacco/nicotine,
128
for treatment of MUD,
129
in patients receiving OAT,
161
AUD. See Alcohol use disorder
AUDADIS-5. See Alcohol Use Disorder and Associated Disabilities Schedule–5
AUDIT. See Alcohol Use Disorders Identification Test
AUDIT-C. See Alcohol Use Disorders Identification Test–Concise version
AWS. See Alcohol withdrawal syndrome
Ayahuasca, effects of,
18
B12, for management of effects of neurotoxicity,
19
Baclofen
for pain management,
346
for treatment of amphetamine use disorder,
125
for treatment of AUD,
77–78, 93
for treatment of AUD and MUD,
88
trials for treatment of AUD and CUD,
90
BAL. See Blood alcohol level
Barbiturates
effects of,
17
false negatives on urine testing,
53
false positives on urine testing,
52
Bath salts. See Cathinones
BAWS. See Brief Alcohol Withdrawal Scale
Beck Depression Inventory,
215
Behavioral inhibition,
32
Benzene, effects of,
19
Benzodiazepines
alcohol and,
85–86
avoidance of,
205
dosing,
180–181
effects of,
17
false negatives on urine testing,
53
false positives on urine testing,
52
for management of effects of inhalants,
19
for management of effects of opioids,
20
management of withdrawal from,
180–181
metabolism of,
54
plus alcohol, AUD and,
95
risks of,
210
for treatment of AUD,
85–86
withdrawal during pregnancy,
255, 256, 257
withdrawal management from,
178
Beta -blockers, for treatment of AUD and PTSD,
207
Biak. See Kratom
Binge drinking,
291, 292
Bioavailability, description of,
38
Bipolar disorder
AUD and,
202–203
treatment with ketamine,
203–204
Black-box warning, for varenicline,
218
Blood alcohol level (BAL),
201
Blood biomarkers, alcohol and,
59, 63, 64, 66
Blood testing,
49, 51
Blue silk. See Cathinones
Brain
adolescent development of,
285–286
circuits of,
32–34, 33
effects of substance use on the adolescent brain,
285–288
functional brain imaging studies in SUD users,
34
functional systems of,
32
getting a “high,”
32
Brain disease model of addiction (BDMA),
35, 36
Brief Alcohol Withdrawal Scale (BAWS),
178–179
Brief intervention, for treatment of adolescents with SUDs,
306
Brief Screener for Tobacco, Alcohol, and other Drugs (BSTAD),
5, 302
Brief strategic family therapy, for treatment of adolescents with SUDs,
308
Bromo. See Hallucinogens, synthetic
BSTAD. See Brief Screener for Tobacco, Alcohol, and other Drugs
Buprenorphine
case example of,
162–164
clinical case examples of,
68
clinical examples of,
59, 63
drug interactions with,
241, 242
evaluation and management of pain in patients taking,
334–338
to extended-release naltrexone, for management of effects of opioids,
148
factors in identifying discordant urine buprenorphine testing,
60–62
false negatives on urine testing,
53
identifying discordant urine buprenorphine testing,
60–61
for management of acute pain,
338, 341, 343–344
for management of effects of opioids,
20, 208, 144–145
to methadone, for management of effects of opioids,
147
treatment and OUD,
57–59
for treatment of comorbid PTSD and OUD,
210
for treatment of CUD,
113
in patients receiving OAT,
160
for treatment of HIV,
241–243
for treatment of OUD
during pregnancy,
259–260, 263, 265, 264
versus methadone,
260, 261, 262
Buprenorphine with naloxone (Subutex), for treatment of OUD during pregnancy,
262
Bupropion
as false-positive for amphetamines,
49
plus naltrexone
for treatment of amphetamine use disorder,
127
for treatment of AUD and MUD,
87–88
for treatment of methamphetamine and tobacco/nicotine,
128
for treatment of MUD,
129
plus NRT, for treatment of TUD,
118
plus varenicline, for treatment of TUD,
121
for smoking cessation,
218
for treatment of AUD,
82–83, 95
for treatment of AUD and MUD,
86
for treatment of cocaine,
183
for treatment of comorbid CUD and MUD,
213
for treatment of CUD,
111, 114
in patients receiving OAT,
161
for treatment of HIV,
243
for treatment of MSUDs,
182
for treatment of TUD,
115, 117, 120, 121
for treatment of TUD during pregnancy,
269–270
for treatment of TUD with OUD,
150
Bupropion monotherapy, for treatment of AUD,
96
Bupropion XL (extended release), for treatment of TUD,
120
Caffeine,
216.See also Tobacco use disorder
Cannabidiol (CBD), for treatment of CaUD,
152
Cannabinoid-like substances, description of,
189–190
Cannabinoid receptors (CB1),
288
Cannabinoids
effects of,
16
false negatives on urine testing,
53
mechanisms of,
41
synthetic,
194
Cannabis
.See also Opioid use disorder
alcohol with AUD and,
84–85
clinical case example of,
66–67
co-occurring addictive disorders in adolescents and,
293
effects on the adolescent brain,
287–288
efficacy in pain management,
342–344
epidemiology of,
2, 3
false positives on urine testing,
52
for insomnia,
84
“legal,”
194
for management of acute pain,
343–344
management of withdrawal,
184
OUD and,
152–155
plus alcohol, AUD and,
95
plus methamphetamine, treatment for,
128, 131
to relieve PTSD symptoms,
222
risk factor for development of psychotic symptoms,
223
synthetic,
189
for treatment of HIV,
244
treatment outcomes with co-use of opioids and,
153
use in adolescents,
220
withdrawal from,
84–85
withdrawal management from,
178, 179
Cannabis use disorder (CaUD),
2
anxiety disorders and,
221
case example of,
99
clinical practice and,
154–155
cravings with,
154
medications for OUD and,
154
mood disorders and,
220–221
overview,
220
psychotic disorders and,
223–225
PTSD and,
222
treatment for,
84–85, 131–132
treatment for adolescents with,
305
withdrawal from,
220
Capsaicin cream/gel, for pain management,
349
Carbamazepine
for treatment of AUD,
95
treatment of AUD withdrawal during pregnancy,
256, 257
Cariprazine
for treatment of methamphetamine and tobacco/nicotine,
128
for treatment of MUD,
130
in patients receiving OAT,
162
CASCADE. See Concerted Action on SeroConversion to AIDS and Death in Europe
Case examples
of AUD,
91, 97–99, 223–225
of intoxication,
31–32
of laboratory testing,
66–68
of MUD,
134
of OUD,
162–164
of PTSD,
162–164
of TUD,
97–98, 134
of UDS,
66–68
Catha edulis,
193.See also Cathinones
Cathinones
epidemiology of,
3
synthetic,
193–194
description of,
189
CaUD. See Cannabis use disorder
CB1. See Cannabinoid receptors
CBD. See Cannabidiol
CBT. See Cognitive-behavioral therapy
Centers for Medicare and Medicaid Services,
246
Charlson Comorbidity Index,
4
Chemsex
in the LGBTQ+ population,
319–320
for reduction of HIV transmission,
246
China White. See Fentanyl
Cigarette use,
2.See also Nicotine
CINA. See Clinical Institute Narcotic Assessment
Cisgender men,
125
Cisgender population,
322.See also LGBTQ+ population
CIWA-Ar. See Clinical Institute Withdrawal Assessment for Alcohol–Revised
CIWA-B. See Clinical Institute Withdrawal Assessment for Benzodiazepines
Clinical Institute Narcotic Assessment (CINA) Scale,
22
Clinical Institute Withdrawal Assessment for Alcohol–Revised (CIWA-Ar),
22, 174, 179–180, 17
Clinical Institute Withdrawal Assessment for Benzodiazepines (CIWA-B), withdrawal management from benzodiazepines,
180–181
Clinical Opiates Withdrawal Scale (COWS),
192
for management of effects of opioids,
20, 145, 146, 147
for treatment of OUD during pregnancy,
265
withdrawal management from MSUDs,
178–179
Clinical practice
CaUD and,
154–155
OAT and,
151
OUD and,
151, 154–155, 162–164
prescribing opioid agonists in,
263, 264, 265–266
SUD and,
133–134
for treatment of TUD,
270
during pregnancy,
272
Clonazepam
false negatives on urine testing,
53
for management of effects of inhalants,
19
Clonidine
for management of effects of opioids,
20
for treatment of comorbid PTSD and OUD,
210
for treatment of OUD during pregnancy,
266, 264
for withdrawal from opioids,
146
Club drugs,
295
Cocaine
alcohol and,
89–90
co-occurring addictive disorders in adolescents and,
294–295
false positives on urine testing,
52
mechanisms of,
40
metabolism of,
55
pharmacotherapy for management of,
183
plus alcohol
overview,
122
treatment for,
122–124
treatment of AUD and,
96
plus methamphetamine,
124
Cocaine use disorder (CUD)
AUD and,
122–124
co-occurring psychiatric disorders and,
114–122
effects of,
17
epidemiology of,
2
medications for treatment of,
111–112
overview,
114–115
PTSD and,
215
toxicity and,
18
treatment of AUD and,
89–91
Cochrane reviews,
85, 153, 260–261, 268
Cognitive-behavioral therapy (CBT)
for treatment of abstinence from cannabis,
220
for treatment of adolescents with SUDs,
306
for treatment of AUD,
203
for treatment of CaUD and depressive symptoms,
213
COMBINE study,
76, 80
Concerted Action on Seroconversion to AIDS and Death in Europe (CASCADE),
247
Conditioned reinforcement, intoxication and,
34–35
Consent, for adolescent treatment for addictive disorders,
281–282
Contingency management
for reduction of HIV transmission,
246
for treatment of adolescents with SUDs,
306
Control circuit,
32, 33
Coronavirus SARS-CoV-2 disease (COVID-19)
opioid use during,
143
substance use during,
282
SUDs and,
8
COWS. See Clinical Opiates Withdrawal Scale
CRAFFT (Car, Relax, Alone, Forget, Friends, Trouble) 2.1 + N,
301
Creatinine, identifying discordant urine buprenorphine testing and,
61
“Croak,”
124
CUD. See Cocaine use disorder
Dance fever. See Fentanyl
DAST-A. See Drug Abuse Screening Test
DAST-10. See Drug Abuse Screening Test
Death
.See also Suicide
from opioid overdose,
46
Delta-8-Tetrahydrocannabinol (Δ8 THC),
194–195, 190
Delta-9-tetrahydrocannabinol (Δ9 THC),
48–49, 194
cannabis in adolescents and,
287–288
for management of cannabis-involved MSUDs,
184
for remission from PTSD,
222
Department of Health and Human Services Office of the Inspector General,
246
Depressants
effects of,
17
effects of combining with stimulants,
18
Depression, co-occurring addictive disorders in adolescents and,
289–290
Desipramine, for treatment of CUD,
112, 113
Dextromethorphan, description of,
295, 300
N,N-Dimethyltryptamine (DMT),
196
Diphenhydramine, for treatment of OUD during pregnancy,
264
Dipstick tests,
48, 50
Discrimination. See Stigma
Disulfiram
plus naltrexone, for treatment of AUD and CUD,
123–124
plus or minus naltrexone, for treatment of AUD,
96
for treatment of AUD,
75, 93, 96
during pregnancy,
251, 252
for treatment of AUD and CUD,
90, 123
for treatment of AUD and PTSD,
206
for treatment of CUD,
112, 114
in patients receiving OAT,
160
Divalproex, for treatment of comorbid depression and AUD,
203
DMT (N,N-Dimethyltryptamine),
196
Doxazosin
for treatment of AUD,
79, 94, 96
for treatment of AUD and PTSD,
207
for treatment of comorbid PTSD and CUD,
215
for treatment of CUD,
112, 114
in patients receiving OAT,
161
for treatment of HIV,
243
trials for treatment of AUD and CUD,
90–91
Dronabinol, for reduction of cannabis withdrawal symptoms,
220
Drug Abuse Screening Test (DAST-10; DAST-A),
302
Drugs
.See also Medications; individual drug names
absorption,
38
administration,
39
description of metabolism of,
38
distribution,
38
excretion,
38
DSM-IV
comparison to DSM-5
criteria for SUDs,
23–25, 26–27
criteria for MDD,
200
SUDs changes from,
x
DSM-5
comparison to DSM-IV criteria for SUDs,
23–25, 26–27
criteria for diagnosis of SUDs in adolescents,
300
defined AUD in,
322
SUDs in,
x
Duloxetine, for pain management,
348
EAGLES. See Evaluating Adverse Events in a Global Smoking Cessation Study
ECA. See Epidemiologic Catchment Area
E-cigarettes. See Electronic (e-) cigarettes
Ecstasy (MDMA), effects of,
17
Electronic (e-) cigarettes (electronic nicotine delivery system),
267
for treatment of TUD,
121–122
Electronic medical records, comprehensive review of,
13
Epidemiologic Catchment Area (ECA),
200
Euphoria, from intoxication,
294–295
Evaluating Adverse Events in a Global Smoking Cessation Study (EAGLES),
218
Family, risk factors for adolescent substance use within,
291, 291
Family therapy
for treatment of adolescents with SUDs,
307
types of,
308
FASD. See Fetal alcohol spectrum disorder
FDA, approved treatments for SUDs
acamprosate, for AUD,
75–76, 91, 251
baclofen, for spasticity in multiple sclerosis,
345
buprenorphine
for nicotine use disorder,
304
for OUD,
259
bupropion
for CaUD,
111
for smoking cessation,
82
disulfiram, for AUD,
75
epidiolex, for cannabis use,
343
gabapentin
for anxiety,
77
for AUD,
345
Marinol (dronabinol), for nausea,
343
methadone, for OUD,
259
naltrexone
for AUD,
74, 76, 83, 123, 251, 259
for OUD,
251, 259
NRT, for smoking cessation,
244, 269, 304
overview, ix,
73
paroxetine, for PTSD,
210
sertraline, for PTSD,
210
Syndros (dronabinol), for nausea,
343
topiramate
for AUD,
77
for migraine headaches,
345
varenicline
for smoking cessation,
218
for TUD,
80–81
Fetal alcohol spectrum disorder (FASD),
250
Fetus, adverse health outcomes from TUD,
267
Flumazenil, for treatment of AUD,
86
Flunitrazepam (Rohypnol), description of,
296
Folic acid, treatment of AUD withdrawal during pregnancy,
258
Functional family therapy, for treatment of adolescents with SUDs,
308
Functional MRI (fMRI), in adolescents,
287
GABAergic transmission,
35
Gabapentin
case example of,
97
for pain management,
345
plus naltrexone combination, for treatment of AUD,
80
for reduction of cannabis use,
220
for treatment of amphetamine use disorder,
125
for treatment of anxiety disorders,
204
for treatment of AUD,
77, 85, 93, 95
for treatment of AUD and MUD,
88
for treatment of AUD during pregnancy,
252, 254–255
for treatment of cannabis use,
132
for treatment of CaUD,
132
GAD. See Generalized anxiety disorder
Gamma-butyrolactone (GBL), use in the LGBTQ+ population,
320
Gamma-hydroxybutyrate (GHB),
295
description of,
296
use in the LGBTQ+ population,
320
Gas chromatography–mass spectrometry (GC-MS),
48
Gender identity. See LGBTQ+ population General Anxiety Disorder–7 (GAD-7),
6
Generalized anxiety disorder (GAD), AUD and,
204
Genetics
.See also Twins
development of addiction in twins,
35
neurobiology of addiction and,
35–37
risk of addiction and,
37
Genome-wide association studies (GWASs),
39
“Getting clean,”
183
“Goofball,”
158
Great Bear. See Fentanyl
Group therapy, for treatment of adolescents with SUDs,
307
GWASs. See Genome-wide association studies
HAART. See Highly active antiretroviral therapy
Hair testing,
49, 51
Haldol, for management of effects of inhalants,
19
Hallucinogens
co-occurring addictive disorders in adolescents and,
295, 296–299
effects of,
18
novel,
196–197
synthetic,
191
“Hanging in,”
180–181
Harm reduction,
6–7
Hashish. See Cannabis
Heroin, epidemiology of,
3
Heroin use disorder, epidemiology of,
3
Heteronormativity, description of,
317–318
Highly active antiretroviral therapy (HAART),
236–237.See also HIV
HIV
.See also AIDS-defining illnesses
approaches to reducing transmission of,
245–246
chemsex,
246
contingency management,
248
pre-exposure prophylaxis,
245
syringe services programs,
245
associated neurocognitive disorders with,
237
impact of substance use on HIV outcomes,
236–238
overview,
235–236
treatment
antiretroviral therapy,
239–240
with cannabis,
244
drug interactions with antiviral therapy,
240
general approach to,
238–239
HAART,
236–237
with methadone and buprenorphine,
241–243
with opioids,
240–241
with stimulants,
243
tobacco and,
244–245
Honey oil. See Cannabis
Hydrocodone, false negatives on urine testing,
53
Hydromorphone, false negatives on urine testing,
53
Hydroxyzine, for treatment of OUD during pregnancy,
264
Hyperalgesia, opioid-induced,
331–332
Hypnotics
description of,
190
for management of effects of opioids,
20
novel,
195–196
IDU. See Injection drug use
.See also HIV
IGDS. See Internet Gaming Disorder Scale
Incentive salience, intoxication and,
34
for management of cannabis-involved MSUDs,
184
for treatment of AUD,
85, 95
for treatment of cannabis,
132
for treatment of CaUD,
132
Inhalants
co-occurring addictive disorders in adolescents and,
300
effects of,
19
Inhibition, behavioral,
32
Injection drug use (IDU),
235.See also HIV
Insomnia, cannabis for,
84
Internet Gaming Disorder Scale (IGDS),
309
motivational,
306
preparation of location for MSUD patient,
13
Intoxication
case example of,
31–32
conditioned reinforcement and,
34–35
Intramuscular naltrexone plus bupropion, for treatment of MSUDs,
182
K2. See Cannabis; Synthetic marijuana
Kakuam. See Kratom
Kappa opioid receptor agents, for treatment depression and PTSD,
210
Ketum. See Kratom
Kratom
description of,
188, 192–193
epidemiology of,
3
false negatives on urine testing,
53
Kush. See Cannabis
Laboratory testing, for SUDs
.See also Urine drug screen
in agonist therapy,
55–57, 57
blood biomarkers for alcohol use,
59, 63, 64–65, 66
clinical cases of,
66–68
duration of detection,
55, 56
example of results for different substances when UDS is positive for amphetamines,
57
false negatives,
49, 50–51, 52–53s
false positives,
49, 52
interpreting positive screening results,
45–48, 47
metabolites of substances,
84, 85
overview,
45
for patients with MSUDs,
21
strengths, limitations, and types of drug testing,
50–51
types and sources of testing,
48–49
blood testing,
49, 51
dipstick tests,
48, 50
GC–MS,
48
hair testing,
49, 51
immunoassay, urine,
50
LC–MS,
48
saliva testing,
48, 50
Lamivudine, drug interactions with,
242
LC-MS. See Liquid chromatography–mass spectrometry
Legislation
for the sale of tobacco products,
2
Synthetic Drug Abuse Prevention Act of 2012,
187
Levomilnacipran, for pain management,
348
LGBTQ+ population
approach to treatment of SUDs
acknowledgement of intersectional identity,
320
assess history and current risk for participation in chemsex,
319–320
combining pharmacotherapy with motivational enhancement and skills-building,
320–321
discussing identity with patients,
318–319
discrimination in,
320
guiding principles for treatment of SUDs in,
322, 328
overview,
317–318
pharmacotherapy for SUDs,
321–322, 323–327
clinical trials for,
323–327
toxic masculinity/femininity,
318
Lidocaine
for management of effects of inhalants,
19
patch, for pain management,
349
Liquid chromatography–mass spectrometry (LC-MS),
48
Lisdexamfetamine
for treatment of amphetamine use disorder,
127
for treatment of CUD,
111, 113
for treatment of methamphetamine and tobacco/nicotine,
128
for treatment of MUD,
129
for treatment of OUD,
164
Lithium, for treatment of comorbid depression and AUD,
202
Lofexidine, for withdrawal from opioids,
147
Loperamide, for treatment of OUD during pregnancy,
264
Lorazepam, false negatives on urine testing,
53
LSD. See Lysergic acid diethylamide
Lysergic acid diethylamide (LSD),
196, 295
description of,
296
effects of,
18
Major depressive disorder (MDD)
AUD and,
202
DSM-IV criteria for,
200
treatment with ketamine,
203–204
Marijuana. See Cannabis
Maternal Opioid Treatment: Human Experimental Research (MOTHER) trial,
260
Matrix Model treatment,
271–272
for amphetamine use disorder,
126
MDD. See Major depressive disorder
MDMA (ecstasy). See 3,4-Methylenedioxymethamphetamine
Medicare,
156
Medications
.See also Drugs; individual drug names
for AUD, FDA-approved,
74–76
combination treatment for AUD,
79–80
interactions with OUD,
209
off-label
second-line interventions for AUD,
76–78
third-line interventions,
78–79
over-the-counter,
218
Medication treatment for opioid use disorder (MOUD),
260
Memory and learning circuit,
32, 33
Men, cisgender,
125.See also Men who have sex with men
Mental illness, PLWH and,
236
Men who have sex with men (MSM),
235.See also HIV; Transgender women
AUD and MUD and,
88
chemsex and,
246, 320
Methadone
to buprenorphine, for management of opioid effects,
147
drug-drug interactions,
209, 241
to extended-release naltrexone, for management of opioid effects,
148
false negatives on urine testing,
53
false positives on urine testing,
52
for management of acute pain,
341–342
for management of effects of opioids,
20, 144
for treatment of HIV,
241–243
for treatment of OUD during pregnancy,
259–260, 265
versus buprenorphine,
260, 261, 262
versus buprenorphine, for treatment of CUD in patients receiving OAT,
160
Methamphetamines
alcohol and,
86–88
clinical case example of,
66
clinical trials of treatment among LGBTQ+ population,
324–327
combined with opioids, epidemiology of,
3
cravings for,
214
description of,
298–299
effects of,
17
epidemiology of,
2–3
functional brain imaging studies in users of,
34
metabolism of,
54
pharmacotherapy for management,
182
plus alcohol
amphetamine use disorder and,
124–127
treatment of AUD and,
96
plus cannabis, treatment for,
128, 131
plus cocaine, treatment for,
124
plus tobacco/nicotine,
127–128
tobacco/nicotine and,
127–128
for treatment of AUD,
86–88
Methamphetamine use disorder (MUD)
case example of,
134
medications for treatment of,
129–130
pharmacological treatment,
86–88
strategies for treatment in patients receiving OAT,
161–162
Methemoglobinemia,
19
3,4-Methylenedioxymethamphetamine (MDMA),
196, 295
description of,
298
effects of,
17
use in the LGBTQ+ population,
320
Methylenedioxypyrovalerone (MDPV),
193
Methylphenidate
misuse of,
212
for treatment of AUD and MUD,
88
for treatment of HIV,
243
for treatment of methamphetamine and tobacco/nicotine,
128
for treatment of MSUDs,
182
Methylphenidate ER
for treatment of amphetamine use disorder,
126–127
for treatment of CUD,
111, 113
for treatment of MUD,
129
Microprocessor disorders
in adolescents,
307, 309–310
diagnosis,
309–310
neurobiology of,
309
treatment of,
309–310
Minority stress,
318
Mirtazapine
for management of effects of opioids,
20
for treatment of amphetamine use disorder,
125
for treatment of AUD,
84–85, 95, 96
for treatment of AUD and MUD,
86, 88
for treatment of comorbid stimulant and depressive disorders,
212–213
for treatment of CUD,
113
for treatment of HIV,
243
for treatment of MSUDs,
182
for treatment of MUD in patients receiving OAT,
162
trials for treatment of AUD and CUD,
90
Mitragyna speciosa,
192.See also Kratom
Mitragynine,
193
Mixed amphetamine salts plus topiramate, for treatment of cocaine,
183
Modafinil
for treatment of cocaine,
183
for treatment of CUD,
111, 113
in patients receiving OAT,
161
Models
of brain disease and addiction,
35, 36
Matrix Model,
126, 271–272
of psychological theories of addiction,
37–38
Monitoring the Future survey,
284
Monoamine oxidase inhibitor (MAOI), for treatment of CUD,
113
Mood disorders
AUD and,
200
CaUD and,
220–221
drug-drug interactions,
209
overview,
208
stimulants and,
212–213
TUD and,
216–217
MOTHER. See Maternal Opioid Treatment: Human Experimental Research trial
Motivational enhancement therapy
in the LGBTQ+ population,
320–321
for treatment of CaUD and anxiety disorders,
221
Motivational interviewing, for treatment of adolescents with SUDs,
306
Motivation/drive circuit,
32, 33
Motivation-reward,
32
MOUD. See Medication treatment for opioid use disorder
MSM. See Men who have sex with men
MSUDs. See Multi-substance use disorders
MUD. See Methamphetamine use disorder
Multidimensional family therapy, for treatment of adolescents with SUDs,
308
Multimodal Treatment of Attention-Deficit/Hyperactivity Disorder study,
289
Multi-substance use disorders (MSUDs)
.See also Substance use disorders
abstinence syndrome,
184
approach to patients with
comparison between DSM-IV and DSM-5 criteria for SUDs,
26–27
comprehensive review of electronic medical records,
13
diagnosis,
2–25
general medical evaluation,
15, 21
history taking,
14–15
intoxication and withdrawal states,
22
laboratory testing,
21
overview,
12–14
preparation of interview location,
13
preparation of screening or assessment tools,
13
psychiatric evaluation,
22–23
case example of,
98
characteristics of persons with,
171–172
compared with SUDs,
11–12
effects of commonly used substances and combinations,
16–20
epidemiology of,
3
general approach to treatment of,
172–176, 174
check in with patient,
176
patient triage,
173–174
patients in hospital or residential facility,
177
pharmacotherapy to establish abstinence or reduce harm,
175–176, 178–179
“quitting cold turkey,”
174
revise plan as necessary,
176
sample questions for collecting patient history,
174
substance evaluation,
172–173
understanding patient’s goals for treatment,
175
“getting clean,”
183
guiding principles of,
184–185
management of benzodiazepineinvolved withdrawal,
180–181
management of cannabis-involved withdrawal,
184
management of opioid-involved withdrawal,
177–180, 178–179
management of stimulant-involved withdrawal,
181, 183–184
medical consequences of,
56
overview,
171–172
prevalence among adults,
4–5
psychiatric disorders and,
6
screening for,
5–6
treatment options for,
91, 95–96
trinity combinations,
176–177
Multisystemic therapy, for treatment of adolescents with SUDs,
308
N-acetylcysteine (NAC)
Naloxone
identifying discordant urine buprenorphine testing and,
61–62
for management of effects of opioids,
20
plus bupropion, for treatment of amphetamine use disorder,
127
Naltrexone
to buprenorphine, for management of effects of opioids,
147
case example of,
98
for management of acute pain,
341–342
for management of effects of opioids,
146
plus bupropion
for treatment of amphetamine use disorder,
127
for treatment of AUD and MUD,
87–88
for treatment of MUD,
129
plus disulfiram, for treatment of AUD and CUD,
123–124
plus gabapentin combination, for treatment of AUD,
80
plus or minus disulfiram, for treatment of AUD,
96
plus sertraline combination, for treatment of AUD,
80
plus topiramate, for treatment of AUD and CUD,
124
plus varenicline combination, for treatment of AUD,
82
risks of,
208
for treatment of AUD,
74–75, 83, 93, 95, 328
for treatment of AUD and CUD,
89, 122–123
for treatment of AUD and MUD,
87–88
for treatment of AUD and PTSD,
206
for treatment of AUD during pregnancy,
251, 252
for treatment of cannabis,
131–132
for treatment of CaUD,
131–132
for treatment of MSUDs,
182
for treatment of OUD during pregnancy,
259–260, 261, 262–263
Naltrexone XR plus bupropion, for treatment of AUD,
96
Narcotics, in adolescents,
284
National Ambulatory Medical Care Survey, 2014–2016,
156
National Comorbidity Survey (NCS),
200
National Epidemiologic Survey on Alcohol and Related Conditions (NESARCIII) 2012–2013,
155–156, 200, 282
National Institute on Drug Abuse (NIDA) Quick Screen,
5
National Survey on Drug Use and Health (NSDUH),
200, 288
survey on opioids and alcohol,
158
N-bomb. See NBOMe
NBOMe (N-Methoxybenzyl),
191, 196
NCS. See National Comorbidity Survey
Nelfinavir, drug interactions with,
242
Neonatal opioid withdrawal syndrome (NOWS),
259.See also Pregnancy
Neonates
.See also Pregnancy
Apgar scores,
257
spina bifida,
257
NESARC-III. See National Epidemiologic Survey on Alcohol and Related Conditions) 2012–2013
Nexus. See Hallucinogens, synthetic
Nicotine
alcohol with AUD and,
80–83
cigarette use and,
2
co-occurring addictive disorders in adolescents and,
292–293
co-occurring psychiatric disorders and,
114–122
dependence on,
2
effects of,
16
on the adolescent brain,
287
epidemiology of,
2
mechanisms of,
41
methamphetamines and,
127–128
OUD and,
149–151
for treatment of TUD,
117
gum/lozenge,
116
nasal spray,
116
patch,
116
use during pregnancy,
267–270
vaped,
2
withdrawal management from,
178
Nicotine replacement therapy (NRT)
.See also Tobacco use disorder
drug-drug interactions,
216
for smoking cessation,
218
for treatment of AUD,
81, 95
for treatment of methamphetamine and tobacco/nicotine,
128
for treatment of TUD,
115, 121
during pregnancy,
269
for treatment of TUD with OUD,
150
Nicotine use disorder, treatment for adolescents with,
304–305
Nicotinic acetylcholine receptors (nAChRs),
287
NIDA. See National Institute on Drug Abuse
Nitrous oxide, effects of,
19
NMDA. See N-methyl-d-aspartate N-Methoxybenzyl,
191, 196
N-methyl-d-aspartate (NMDA),
36.See also Ketamine
alcohol and,
40
ketamine and,
203
low-dose naltrexone and,
333, 334
opioid-induced hyperalgesia and,
332
NNRTI. See Non-nucleoside reverse transcriptase inhibitor
Non-nucleoside reverse transcriptase inhibitor (NNRTI), for treatment of SUDs and HIV,
239
Nonsteroidal anti-inflammatory drugs (NSAIDs)
for management of effects of opioids,
20
for pain management,
346, 348
Nortriptyline
for pain management,
348
for treatment of TUD,
119, 120–121
Novel psychoactive substances (NPSs)
cannabinoid-like substances,
189–191
epidemiology of,
3
hypnotics,
195–196
novel hallucinogens,
196–197
novel sedatives,
195–196
opioid-like substances,
188
fentanyl,
192
kratom,
192–193
tianeptine,
193
overview,
187
“psychonauts,”
197
summary of,
188–191
synthetic hallucinogens,
191
synthetic stimulants and cannabinoids
Delta-8 tetrahydrocannabinol,
194–195
synthetic cannabinoids,
194
synthetic cathinones,
193–194
urine toxicology screening for,
187
NOWS. See Neonatal opioid withdrawal syndrome
NPSs. See Novel psychoactive substances
NRT. See Nicotine replacement therapy
NRTI. See Nucleoside reverse transcriptase inhibitor
NSAIDs. See Nonsteroidal anti-inflammatory drugs
NSDUH. See National Survey on Drug Use and Health
Nucleoside reverse transcriptase inhibitor (NRTI), for treatment of SUDs and HIV,
239–240
OAT. See Opioid agonist treatment
OFC. See Orbitofrontal cortex
Ondansetron
for treatment of AUD,
78, 94
for treatment of CUD,
112, 114
for treatment of OUD during pregnancy,
264
trials for treatment of AUD and CUD,
90
Opiates
false negatives on urine testing,
53
false positives on urine testing,
52
metabolism of,
55
Opioid agonist treatment (OAT)
clinical practice of,
263, 264, 265–266
for management of effects of opioids,
144–145
for management of effects of opioids and tobacco or nicotine,
149–150
Opioid antagonist treatment, for management of effects of opioids,
146
Opioids
combined with methamphetamine, epidemiology of,
3
co-occurring addictive disorders in adolescents and,
293–294
effects of,
20
epidemiology of,
3
history of epidemic of,
143
as hypernym,
293–294
mechanisms of,
40
opioid-induced hyperalgesia (OIH),
331–332
sexual behavior and,
240–241
for treatment of HIV,
240–241
withdrawal management from,
178
Opioid treatment program (OTP),
260
Opioid use disorder (OUD)
.See also Cannabis
alcohol and,
155–158
clinical practice and,
156–157
epidemiology,
155–156
overview,
155
pharmacotherapy for comorbid AUD and,
157–158
behavioral interventions for,
150
cannabis and,
152–155
clinical practice and,
154–155
epidemiology,
152–153
medications for CaUD and,
154
overview,
152
treatment outcomes with,
153
case examples of,
162–164
clinical case example of,
67, 68
clinical practice and,
151, 162–164
drug-drug interactions,
209
during pregnancy,
259–267
barriers to treatment,
266–267
comparison of treatment options,
259–263, 261
overview,
259
prescribing opioid agonists in clinical practice,
263–266, 264
risks of not treating,
259
withdrawal from,
263
epidemiology of,
3, 152–153
management of withdrawal from,
177–180, 178–179
medication considerations,
208
medication for treatment of,
333–334
medications for CaUD and,
154
medications for treatment of,
144–148
medications for TUD with,
150–151
mood and anxiety disorders and,
208–211
overdose deaths from,
46, 143
overview,
143, 152
pain evaluation and management for patients with,
331
pharmacological management of,
144–148
PTSD and,
209–211
stimulants and,
158–162
morbidity and mortality,
158–159
motivations for co-use of,
159
overview,
158
strategies for treatment of,
160–162, 111–112, 129–130
treatment of,
159–160
tobacco or nicotine and,
149–151
treatment and buprenorphine ratios,
57–59
treatment for adolescents with,
305–306
treatment outcomes with co-use of cannabis and,
153
Orbitofrontal cortex (OFC),
32, 33
OTC drugs. See Over-the-counter drugs
OTP. See Opioid treatment program
OUD. See Opioid use disorder
Over-the-counter (OTC) drugs, cooccurring addictive disorders in adolescents and,
295, 300
Oxycodone, false negatives on urine testing,
53
Oxycodone hydrochloride (OxyContin),
143
Oxymorphone, false negatives on urine testing,
53
Pain, SUDs and
alcohol and,
344–346
alternatives to opioids for chronic pain management,
346–347, 348–349
cannabis and,
342–344
evaluation and management for patients taking buprenorphine,
334–338, 339–340
adjunct medications,
336–337
role of pain perception,
337–338
evaluation and management for patients with OUD,
331
management of acute pain for procedures,
338, 341
medication for treatment of OUD in pain management,
333–334
nociplastic,
346, 347, 348–349
pseudoaddiction,
332–333
tolerance and opioid-induced hyperalgesia,
331–332
Paliperidone
for treatment of amphetamine use disorder,
125
for treatment of CUD,
113
for treatment of MUD,
130
in patients receiving OAT,
162
Panic attacks, cannabis use and,
221
Paroxetine
for treatment of AUD,
86
for treatment of comorbid PTSD and OUD,
210
Party drugs,
295, 296–299
Patient Health Questionnaire–9 (PHQ-9),
6
Patients
.See also LGBTQ+ population
approach to history taking,
14–15
with AUD, care of,
207
diagnosis of SUDs,
23–25
feigning compliance with medications,
58
general medical evaluation of,
15, 21
with MSUDs, approach to history taking,
14–15
review of childhood history,
212
safety of,
214
PDMP. See Prescription drug monitoring program
People living with HIV (PLWH),
235, 236
treatment of,
238
Personality, neurobiology of addiction and,
35–37
Pharmacodynamics, description of,
39–41
Pharmacogenetics. See Pharmacogenomics Pharmacogenomics, description of,
39
Pharmacokinetics, description of,
38–39
Pharmacotherapy
.See also individual medications
for AUD,
74–80
combination treatment for AUD,
79–80
FDA-approved medications for AUD,
74–76
maintenance for PTSD and AUD,
205–207
for MUD,
328
off-label
for second-line interventions,
76–78
for third-line interventions for AUD,
78–79
for third-line interventions for CaUD,
321–322
for SUDs in the LGBTQ+ population,
321–322
for treatment of SUDs in adolescents,
304–306
Phencyclidines
effects of,
20
false positives on urine testing,
52
PHQ-9. See Patient Health Questionnaire–9
PLWH. See People living with HIV
Poison. See Fentanyl
Polysubstance use disorder. See Multisubstance use disorders
Posttraumatic stress disorder (PTSD)
in adolescents,
215
AUD and,
205–207
cannabis use to relieve symptoms of,
222
case example of,
162–164
CaUD and,
222
co-occurring addictive disorders in adolescents and,
290
OUD and,
209–211
remission from,
222
stimulants and,
215
Potassium bicarbonate, for management of effects of inhalants,
19
Prazosin
for treatment of AUD,
79, 94
for treatment of comorbid PTSD and OUD,
210
PREDICT study,
76
Pre-exposure prophylaxis (PrEP), for reduction of HIV transmission,
245
Pregabalin, for treatment of AUD,
86
Pregnancy
AUD during,
250–258
nicotine use during,
267–270
OUD during,
259–267
stigma surrounding treatment,
266–267
overview,
249–250
SUD during,
270–273
TUD during,
267–270
vitamins during,
258
PrEP. See Pre-exposure prophylaxis
Prescription drug monitoring program (PDMP),
48
Prescription stimulants, epidemiology of,
3
PRIME (plans, responses, impulses, motives, and evaluations) theory,
38
Propoxyphene, false negatives on urine testing,
53
Pseudoaddiction,
332–333
Psilocybin
description of,
196
effects of,
18
Psychedelics,
196–197
Psychiatric disorders
.See also Substance use disorders
co-occurring SUDs and,
4
MSUDs and,
6
overview,
199–200
patient evaluation,
22–23
“Psychonauts,”
197
Psychosis
co-occurring addictive disorders in adolescents and,
290–291
etiology,
213–214
stimulants and,
213–214
Psychosocial interventions, for treatment for adolescents with SUDs,
306–307, 308
Psychostimulants
for treatment of amphetamine use disorder,
126–127
for treatment of CUD,
113
withdrawal management from,
178, 179
Psychotherapy
for AUD,
203
for comorbid PTSD and CUD,
215
Psychotic disorders
CaUD and,
223–225
TUD and,
219
PTSD. See Posttraumatic stress disorder
Public health,
281.See also Addiction; Adolescents
Purple wave. See Cathinones
“Quitting cold turkey,”
174
Reboxetine, for treatment of CUD,
113
Reward circuit,
32, 33
Rimonabant, for reduction of pleasurable effects of cannabis,
220
Risperidone
for treatment of amphetamine use disorder,
125
for treatment of CUD,
113
for treatment of methamphetamine and tobacco/nicotine,
128
for treatment of MUD,
130
in patients receiving OAT,
162
Rohypnol. See Flunitrazepam
Salvia divinorum,
40
Saliva testing,
48, 50
SARS-CoV-2
disease. See Coronavirus SARS-CoV-2 disease (COVID-19)
SBIRT. See Screening, Brief Intervention, and Referral to Treatment
School, risk factors for adolescent substance use in,
291, 291
Screening, Brief Intervention, and Referral to Treatment (SBIRT),
150, 301
during pregnancy,
268
Screening to Brief Intervention (S2BI),
302
Sedatives
description of,
190
novel,
195–196
withdrawal management from,
178, 179
Selective serotonin reuptake inhibitors (SSRIs)
for treatment of AUD and PTSD,
206–207
for treatment of CUD,
113
Serotonin-norepinephrine reuptake inhibitor (SNRI), for treatment of CUD,
113
Sertraline
as false-positive for benzodiazepine,
49
for treatment of comorbid PTSD and OUD,
210
plus naltrexone combination, for treatment of AUD,
80
Sexual behavior,
125
opioids and,
240–241
Skills-building, in the LGBTQ+ population,
320–321
Smiles. See NBOMe
Smoking. See Tobacco; TUD
SNRI. See Serotonin-norepinephrine reuptake inhibitor
Social anxiety, AUD and,
204–205
Sodium bicarbonate, for management of effects of inhalants,
19
Spectrum. See Hallucinogens, synthetic
“Speedballing,”
158
effects of,
18
Spice. See Cannabis; Synthetic marijuana
Spiking,
57–58
Spina bifida,
257
SSPs. See Syringe services programs
Stigma, recommended terminology for people with SUDs,
7, 8
Stimulant agonist therapy, for treatment of AUD and MUD,
88
Stimulants
ADHD and,
133, 211–212
anxiety disorders and,
214
co-occurring substance use and
cocaine use disorder,
110, 111, 113–114
overview,
109–110
effects of combining with depressants,
18
epidemiology of,
2–3
management of MSUDs,
181, 183–184
mechanisms of,
40
mood disorders and,
212–213
OUD and,
158–162
overview,
109–110, 211
psychosis and,
213–214
PTSD and,
215
TUD and,
215–220
treatment and,
110
for treatment of CUD in patients receiving OAT,
161
for treatment of HIV,
243
for treatment of MUD in patients receiving OAT,
161
Stimulant use disorders (SUDs)
clinical practice and,
133–134
during pregnancy,
270–272
clinical practice,
272
epidemiology,
270–272
risks of not treating,
271
treatment,
271–272
Street names. See individual drug names
S2BI. See Screening to Brief Intervention
Subcallosal cortex,
32, 33
Substance use disorders (SUDs)
.See also Addiction; Alcohol use disorder; Laboratory testing, for SUDs; LGBTQ+ population; Multi-substance use disorders; Stimulants; Urine drug screen
American Psychiatric Association definition of,
37–38
compared with MSUDs,
11–12
co-occurring and psychiatric disorders
cocaine, tobacco, or nicotine,
114–122
epidemiology of,
4
COVID-19 and,
8
criteria in DSM-5 for diagnosis in adolescents,
300
diagnostic criteria changes from DSM-IV,
x
in DSM-5,
x
epidemiology of,
1–5, 199–200
lifetime prevalence of,
221
medical consequences of,
5–6
ongoing challenges of,
7–8
during pregnancy,
270–273
prevalence among adolescents,
283
psychosocial interventions, for treatment of adolescents with,
306–307, 308
stigma against people with,
7, 8, 249
Subutex (buprenorphine with naloxone), for treatment of OUD during pregnancy,
262
SUDs. See Substance use disorders
Suicidal ideation,
249
Suicidality, AUD and,
201–202
Suicide
.See also Death
among adolescents,
4–5
epidemiology of,
4–5
Synthetic cannabinoids, false negatives on urine testing,
53
Synthetic Drug Abuse Prevention Act of 2012,
187
Synthetic marijuana, epidemiology of,
3
Syringe services programs (SSPs), for reduction of HIV transmission,
245
TAPS. See Tobacco, Alcohol, Prescription medication, and other Substance use screener
TCAs. See Tricyclic antidepressants
Thang. See Kratom
Thiamine, deficiency during pregnancy,
258
Thom. See Kratom
Tianeptine, description of,
188, 193
Tianna Red. See Tianeptine
Tobacco
.See also Methamphetamines; Tobacco use disorder
addiction
epidemiology of,
2
legislation and,
2
clinical case example of UDS,
67
effects of,
16
HIV treatment and,
244–245
increased impulsivity with,
217
morbidity and mortality,
216–217
OUD and,
149–151
plus alcohol, AUD and,
95
Tobacco, Alcohol, Prescription medication, and other Substance use (TAPS) screener,
5
Tobacco use disorder (TUD)
.See also Nicotine replacement therapy; Tobacco
ADHD and,
220
anxiety disorders and,
217–219
case examples of,
97–98, 134
co-occurring psychiatric disorders and,
114–122
epidemiology of,
3
methamphetamines and,
127–128
mood disorders and,
216–217
with OUD, medications for,
150–151
overview,
114–115, 215–216
during pregnancy,
267–270
epidemiology,
267
risks of not treating,
267–268
treatment options,
268–270
clinical practice,
270
pharmacology,
269–270
SBIRT,
268
psychotic disorders and,
219
stimulants and,
215–220
for treatment of AUD and,
80–83
withdrawal management from,
178
Toluene, effects of,
19
Toonies. See Hallucinogens, synthetic
Topiramate
case examples of,
97, 98
for pain management,
345–346
plus mixed amphetamine salts, for treatment of CUD,
112, 114
plus naltrexone, for treatment of AUD and CUD,
124
plus or minus NRT plus or minus varenicline, for treatment of methamphetamine and tobacco/nicotine,
128
for treatment of amphetamine use disorder,
125
for treatment of AUD,
76–77, 83, 93, 96
for treatment of AUD and CUD,
90, 122, 124
for treatment of AUD and MUD,
87
for treatment of AUD and OUD,
157–158
for treatment of AUD and PTSD,
206
for treatment of AUD during pregnancy,
254, 252
for treatment of cocaine,
183
for treatment of comorbid depression and AUD,
203
for treatment of CUD,
111, 113
for treatment of HIV,
243
for treatment of MUD,
129
for treatment of PTSD and CUD,
215
Toxic femininity,
318
Toxic masculinity,
318
Tramadol, false negatives on urine testing,
53
Transgender women,
213.See also Men who have sex with men
Trauma, co-occurring addictive disorders in adolescents and,
290
Trazodone
as false-positive for amphetamines,
49
for management of effects of opioids,
20
for treatment of OUD during pregnancy,
264
Tricyclic antidepressants (TCAs)
for treatment of AUD and PTSD,
206–207
for treatment of TUD,
120–121
Trinity combinations,
176–177, 178–179.See also Multi-substance use disorders
TUD. See Tobacco use disorder
2C-B. See Hallucinogens, synthetic
25B. See NBOMe
25C. See NBOMe
25I. See NBOMe
Twins
.See also Genetics
development of an addiction in,
35
2’s. See Hallucinogens, synthetic
UDS. See Urine drug screen Urine drug screen (UDS)
clinical case examples of,
66–68
duration of detection of substances,
55, 56
false negatives and,
49, 52–53
false positives and,
52
identifying discordant urine buprenorphine testing,
60–62
managing positive results on,
47
for NPSs,
187
overview,
45
Valproate
for treatment of AUD,
85–86, 95
for treatment of comorbid depression and AUD,
203
Valproic acid, for treatment of AUD withdrawal during pregnancy,
256, 257–258
Vanilla sky. See Cathinones
Vaping, in adolescents,
284
Varenicline
black-box warning,
218
for smoking cessation,
218
for treatment of AUD,
94, 79
for treatment of AUD and TUD,
80–83
for treatment of CUD,
114
for treatment of TUD,
118, 120
during pregnancy,
269–270
for treatment of TUD with OUD,
151
plus bupropion, for treatment of TUD,
119, 121
plus naltrexone combination, for treatment of AUD,
82
plus NRT, for treatment of TUD,
118, 121
plus or minus naltrexone, for treatment of AUD,
95
Venlafaxine, for pain management,
348
Venus. See Hallucinogens, synthetic
Vicks inhaler,
57
Vitamins, during pregnancy,
258
Wernicke-Korsakoff syndrome, during pregnancy,
258
Women. See Fetus; Neonates; Pregnancy
Xanax. See Hypnotics
Xylene, effects of,
19
Young’s Internet Addiction Scale (YIAS),
309
Youth. See Adolescents
Zidovudine
drug interactions with,
242
for treatment of SUDs and HIV,
239

Information & Authors

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Go to Pharmacotherapy for Complex Substance Use Disorders
Pharmacotherapy for Complex Substance Use Disorders: A Practical Guide
Pages: 355 - 376
Editors: Thanh Thuy Truong, M.D., Benjamin T. Li, M.D., Daryl Shorter, M.D., Nidal Moukaddam, M.D., Ph.D., and Thomas R. Kosten, M.D.

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Published in print: 10 October 2023
Published online: 5 December 2024
© American Psychiatric Association Publishing

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