Detox (also known as “medically supervised withdrawal”) refers to treatment to help patients withdraw from substances that cause physical dependence, such as alcohol, sedative-hypnotics, and opioids. But detox is far more than a several-day process of ridding the body of an addictive substance. It should be considered an important component in the overall care and treatment of addiction.

Currently in the US, cannabis has evolved into an issue of individual freedom, leading to full legalization in some states on the presumption that the substance isn’t addictive. Unfortunately, cannabis use disorder is indeed a problem for many patients, Kevin Hill, MD, tells us. In fact, says Dr. Hill, one of the greatest challenges you’ll encounter while treating patients is convincing them that cannabis use disorder is a real thing. Here are some treatment strategies.

Kratom (Mitagyna speciose) is a tropical evergreen tree in the coffee family whose leaves have been used for centuries in South Asian countries as a stimulant and pain reliever. Recently, kratom has entered US and European markets and is now sold in various forms, both online and at local head shops.

Opioid withdrawal protocols often rely on a buprenorphine taper, but other medications are regularly used either in addition to or in the place of buprenorphine. In particular, tramadol ER, a mild opiate, may be effective and was recently studied at Johns Hopkins University School of Medicine.

The post-test for this issue is available for one year after the publication date to subscribers only. By successfully completing the test you will be awarded a certificate for 2 CME credits.

Everyone knows about Alcoholics Anonymous (AA), the original 12-step group. There are more than 60,000 weekly AA meetings in the U.S. alone. Despite this near-monopoly, however, many patients object to some of the most basic tenets of 12-step groups. This article presents alternatives, such as SMART Recovery.

Online programs to provide substance abuse treatment? Phone apps that can measure someone’s blood alcohol level? Welcome to the future­—in some cases, the very near future. Dr. Nunes, the deputy director for intervention studies at the Center for Technology and Behavioral Health, sheds light on technology-assisted care.

Contingency management (CM) programs are often effective, but they can be expensive, with typical incentives costing $900–$3,000 for a 12-week program. Expensive CM programs are referred to as “high magnitude.” In this new study, researchers tested an “ultra-low magnitude” program (basically, a very cheap program) to see if offering inexpensive reinforcers would be effective for an opioid-abusing clientele.

The post-test for this issue is available for one year after the publication date to subscribers. By successfully completing the test you will be awarded a certificate for 2 CME credits.

How can you help increase the odds that Robert, or any of your patients, will succeed in recovery? Here are eight key strategies that support long-term recovery.