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CLINICAL UPDATE

Medication Treatment of Anxiety Disorders in Substance Abusers

Daniel Carlat, MD
Daniel Carlat, MD  

Editor-in-Chief, Publisher, The Carlat Report.

Dr. Carlat has disclosed that he has no relevant relationships or financial interests in any commercial company pertaining to this educational activity.

While benzodiazepines are effective anti-anxiety workhorses for many patients, most guidelines tell us to avoid prescribing them to substance abusers. The concern is that the benzo high will remind patients of their substances of choice, and that benzo withdrawal symptoms will lead to old substance abuse habits.
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EXPERT Q&A

Benzodiazepines: Dependence, Tolerance, and Addiction

Alex Stalcup, MD

DrStalcup_headshot.jpgAlex Stalcup, MD
Medical director of the New Leaf Treatment Center in Lafayette, CA.
Dr. Stalcup has disclosed that he has no relevant financial or other interests in any commercial companies pertaining to this
educational activity.

One good way to think of benzodiazepines is that they are literally, physiologically anyway, alcohol in a pill. Especially the fast-onset/fast-offset benzodiazepines like alprazolam (Xanax) have a very similar pharmacologic profile to alcohol. This discussion with Dr. Alex Stalcum covers strategies of using benzodiazepines as anxiety treatments for substance-abusing patients.
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RESEARCH UPDATE

Synthetic THC and Antihypertensive Provide Little Benefit for Cannabis Dependence

Bret A. Moore, PsyD, ABPP
Bret A. Moore, PsyD, ABPP. Board-Certified Clinical Psychologist, San Antonio,.

Dr. Moore has disclosed that he has no relevant financial or other interests in any commercial companies pertaining to this educational activity.

Second only to alcohol, marijuana is the most common reason people enter substance abuse treatment. And unlike alcohol dependence, there are virtually no effective medications available for those addicted to it. It’s not from a lack of trying. A recent review of 14 drug studies for cannabis dependence revealed little benefit from antidepressants, anticonvulsants, or anxiolytics.
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RESEARCH UPDATE

When Physicians Become Addicted: How Well Do Treatment Programs Work?

Bret A. Moore, PsyD, ABPP
Bret A. Moore, PsyD, ABPP. Board-Certified Clinical Psychologist, San Antonio, TX.

Dr. Moore has disclosed that he has no relevant financial or other interests in any commercial companies pertaining to this educational activity.
When physicians are diagnosed with opioid or other drug dependence, they are required to receive treatment from special physician health programs (PHP) if they want to keep their medical licenses. Unlike treatment programs for the general population, PHPs do not use opiate agonists, such as methadone or buprenorphine.
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How to Treat Opiate Use Disorders

Michael Weaver, MD, FASAM
Michael Weaver, MD, FASAM.

Professor and medical director at the Center for Neurobehavioral Research on Addictions at the University of Texas Medical School.

Dr. Weaver has disclosed that he has no relevant financial or other interests in any commercial companies pertaining to this educational activity.

Opiate use disorder is increasingly common, and it is important to develop a systematic approach for treating it. In this article, I will discuss some of the more important elements of treatment, starting with the need to address patients’ denial and moving on to some of the nitty gritty aspects of medication-assisted treatment.
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Naloxone and the Harm Reduction Approach

Eliza Wheeler, MA, MS

CATR_MarchApril2016_Wheeler_headshot.png

Eliza Wheeler, MA, MS

DOPE (Drug Overdose Prevention Education) project manager, San Francisco Bay Area

Ms. Wheeler has disclosed that she has no relevant financial or other interests in any commercial companies pertaining to this educational activity

Eliza Wheeler gives her insight into harm reduction as a model for practicing public health that seeks to provide services in a nonjudgmental way. Harm reduction seeks behavior change while acknowledging the need to meet a person where they are—especially in their particular journey through substance use. Abstinence is not a prerequisite for treatment or a condition that someone must meet to receive services.
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Addiction and Family: What You Need to Know

Alison Knopf

Alison Knopf.

Editor of Alcoholism & Drug Abuse Weekly, a subscription newsletter published by Wiley that focuses on policy and programming, and a freelance journalist specializing in mental health and substance use issues.

Ms. Knopf has disclosed that she has no relevant financial or other interests in any commercial companies pertaining to this educational activity.

The addiction field has clearly become less enamored with terms such as codependency. This article brings you up to date on some tried and true approaches for working with the families of patients with substance use disorders.
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