Minneapolis Mental Health | treating Substance Use Disorders

Mental health Minneapolise | Clinicians were urged to combine pharmacologic treatments with counseling programs when treating substance use disorders (SUDs).

Many practitioners believe in using only one type of treatment, but that is a mistake, said Charles O’Brien, MD, PhD, Kenneth E. Appel Professor of Psychiatry, University of Pennsylvania Treatment Research Center in Philadelphia.

• Research at his center into behavioral approaches and medications has not produced any evidence that one or the other is sufficient on its own, he said.

“There’s no reason not to combine them,” Dr. O’Brien said. “We have very good medications for some of the substance use disorders. They’re not used very much. They’re not known very well.”

Opioid use disorder, which has reached epidemic levels in recent years, is among the disorders which medication can help treat, he said. Opioids are responsible for 30,000 overdose deaths per year, according to O’Brien.

Patients with opiate addiction should be evaluated to see which medication is best for them, O’Brien told the attendees.

“We have very precise and effective pharmacological treatments for opiate addiction,” he said.

Medications can also be used in treating alcohol use disorder, but are underutilized, O’Brien said. Naltrexone, one such medication, works by blocking receptors involved in enjoying the alcohol.

Naltrexone was originally studied as an oral medication, O’Brien said, but “the trouble is people stop taking it because it takes away their pleasure.” A newer extended-release formulation may be a better choice because it lasts 30 to 40 days, he said.

Tobacco use disorder is another candidate for pharmacologic treatment, O’Brien said, encouraging all clinicians to be willing to treat it to help patients’ overall health.

• The brain’s reward system is involved in any kind of addiction, including behavioral addictions, making it necessary to change the brain in order to successfully treat the disorders, he argued.

“Addictions are diseases of the brain,” he said. “If all you do is put someone in a residential program and give them good food, massage, and psychotherapy, you haven’t changed the brain.”

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