Comprehensive Strategies to Treat Substance use Disorders: Medications and Support Services for SUDs

Craig Robin^*
*Correspondence: Craig Robin, Department of Pharmacy, University of Toronto, Toronto, Canada, Email:

Received: 19-Apr-2024, Manuscript No. IJP-24-137596; Editor assigned: 23-Apr-2024, Pre QC No. IJP-24-137596 (PQ); Reviewed: 08-May-2024, QC No. IJP-24-137596; Revised: 16-May-2024, Manuscript No. IJP-24-137596 (R); Published: 24-May-2024, DOI: 10.37522/2249-1848.2024.14(3).109

About the Study

Substance Use Disorders (SUDs) represent a significant public health challenge, characterized by the recurrent use of alcohol or other drugs that leads to clinically significant impairment or distress. SUDs encompass a range of behaviour and symptoms, including increased tolerance, withdrawal symptoms, and an inability to reduce or control usage despite negative consequences.

SUDs are complex conditions influenced by a combination of genetic, environmental, and psychological factors. The Diagnostic and Statistical Manual of Mental Disorders, Fifth Edition (DSM-5), categorizes SUDs based on the substance involved, such as alcohol, opioids, stimulants, and cannabis. The severity of a SUD is determined by the number of diagnostic criteria met, ranging from mild (2-3 criteria) to severe (6 or more criteria).

Common symptoms include

• Taking the substance in larger amounts or over a longer period than intended.

• Persistent desire or unsuccessful efforts to cut down or control use.

• Spending a great deal of time obtaining, using or recovering from the substance.

• Cravings or strong urges to use the substance.

• Recurrent use resulting in a failure to fulfil major obligations at work, school, or home..

• Continued use despite persistent social or interpersonal problems.

• Giving up important social, occupational or recreational activities due to use.

• Using substances in situations where it is physically hazardous.

• Continued use despite knowledge of having a persistent or recurrent physical or psychological problem likely caused or exacerbated by tolerance, as defined by the need for markedly increased amounts to achieve the desired effect or markedly diminished effect with continued use of the same amount.

Withdrawal symptoms which are characteristic of the specific substance used.

Treatment approaches

Treating SUDs requires a multifaceted approach, tailored to the individual's specific needs and circumstances. Effective treatment typically involves a combination of behavioural therapies, medications, and support services.

Behavioral therapies: These are the foundation for SUD treatment, aiming to modify the individual's attitudes and behaviors related to drug use and increase healthy life skills. Common behavioral therapies include:

Cognitive-Behavioral Therapy (CBT): Helps individuals recognize and avoid triggers and develop coping strategies.

Motivational Interviewing (MI): Enhances motivation to change by exploring and resolving ambivalence.

Contingency Management (CM): Provides tangible rewards for positive behaviors such as maintaining sobriety.

12-Step facilitation therapy: Promotes engagement in 12-step programs like Alcoholics Anonymous (AA) and Narcotics Anonymous (NA).

Medications: Pharmacotherapy can be important; especially for certain SUDs like opioid and alcohol use disorders. Medications can help manage withdrawal symptoms, reduce cravings, and normalize brainfunction.

Opioid use disorder:  Medications such as methadone, buprenorphine  symptoms and cravings, while naltrexone blocks the euphoric effects and naltrexone are used. Methadone and buprenorph ine reduce withdrawl of opioidsthe substance.

Alcohol use disorder: Medications like disulfiram, naltrexone, and acamprosate can be effective. Disulfiram causes unpleasant reactions if alcohol is consumed, naltrexone reduces the rewarding effects of alcohol, and acamprosate helps maintain abstinence.

Case management: Helps individual’s access medical, social, legal, and housing services.

Peer support: Involves engagement with individuals who have lived experience with SUDs.

Family therapy: Addresses familial relationships and dynamics that may contribute to substance use.

Challenges and considerations

Treating SUDs can be challenging due to the chronic nature of the disorder, high relapse rates and co-occurring mental health condition stigma remains a significant barrier, preventing many individuals from seeking help. There is also a need for greater access to treatment, particularly in underserved communities.

Additionally, addressing the root causes of substance use, such as trauma, mental health disorders, and social determinants of health, is crucial for effective treatment and long-term recovery. Prevention efforts, including education and policy changes, are also essential components of a comprehensive approach to reducing the prevalence of SUDs.

Conclusion

In conclusion, while SUDs pose significant challenges, advances in treatment modalities and a better understanding of the disorder offer hope for recovery. An integrated approach that includes behavioral therapies, medications, and support services is key to helping individuals achieve and maintain sobriety, improving overall health and well-being.