Pharmacotherapy for Clients Dependent on a Substance Essay

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Medications approved by the FDA for treatment of alcohol and opioid dependence, including acamprosate, disulfiram, naltrexone, methadone, and buprenorphine, have not been widely studied in the dually diagnosed population. Often, study participation criteria exclude individuals with co-occurring substance use disorders and mental illness, and it is only in recent years that research specifically focused on this population has become more common.
Pharmacotherapy has also been underutilized in practice. A survey of 955 bipolar individuals found that while 8% met criteria for a current alcohol use disorder and 5% met criteria for a current non-alcohol substance use disorder, only 0.4% received disulfiram, methadone, naltrexone, and/or buprenorphine (Simon et al., 2004). The high prevalence of comorbid substance abuse and mental illness, and the challenges associated with treatment, mean that underutilization and lack of research are likely to have a critical impact on client outcomes.
This paper explores evidence for the safety and efficacy of pharmacotherapy for substance use disorders in clients with comorbid mental illness. It was hypothesized that use of such medications carries risks unique to this client group, and that pharmacotherapy nonetheless has a role in treating substance dependence for these clients. The MNCat and Google Scholar research databases were searched for publications addressing the use of FDA-approved medications for alcohol and opioid dependence in…

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