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Individual Homework Discussions1

THIRTY-THREE PHARMACOLOGICAL INTERVENTIONS FOR SUBSTANCE USE DISORDERS It is the goal of this chapter to provide an overview of the pharmacological treatment of substance use disorders. The use of such medications is a natural outgrowth of the disease model of the addictionsif it is a disease, we medicate it! Unfortunately, the ma or pharmaceutical companies do not seem to share this perspective! they do not view the field of addictions as worth the trouble and are not involved in investigating pharmaceuticals that might be useful for treating the addictions. "irtually every compound used to help treat the substance use disorders was developed for another purpose, and then it was discovered that they provided some benefit to those persons who had a substance use disorder as well. #owever, in this chapter we will discuss the most commonly used pharmacological treatments to the substance use disorders. Student Name: Patricia Razafindrambinina Homework Discussion #1: $hould the addictions be treated with pharmaceutical agents% Although he is !h"si#i $% B&iggi$ '())*+ h s lo$g ,ee$ #&iti# o- the !h &. #euti# l i$/ust&"0 Fo& e1 .!le% he o,se&2e/ th t3 D&ug #o.! $ies he 2il" !&o.ote the u$!&o2e$ s!e#ul tio$ th t the !&o,le.s the" t&e t &e ,iologi# l i$ o&igi$ $/ &esult -&o. ,io#he.i# l i., l $#es0 This is% s he !oi$ts out% $ u$!&o2e$ h"!othesis0 It !!e &s to ,e &ight% ,ut so.eti.es the ##e!te/ theo&" is !&o2e$ to ,e ,solutel" 4&o$g0 Fo& e1 .!le% -i-t" "e &s go e2e&" !h"si#i $ &new th t sto. #h ul#e&s 4e&e # use/ ," st&ess% $/ the st $/ &/ t&e t.e$t 4 s $t #i/s $/ !ossi,l" t& $5uili6e&s0 No4 it is 7$o4$ th t the 2 st . 8o&it" o- ul#e&s &e # use/ ," , #te&i l i$-e#tio$s i$ the 4 ll o- the sto. #h% $/ the st $/ &/ t&e t.e$t i$ su#h # ses is #ou&se o$ti,ioti#s $/ $t #i/s to hel! the sto. #h li$i$g he l0 Thus% the 9,io#he.i# l i., l $#e: is $ot uto. ti# ll" #o&&e#t% it is 8ust the .ost !&o.isi$g theo&" /e2elo!e/ to / te0 Ho4e2e&% $o,o/" 7$o4s 4h t $o&. l $eu&o#he.i# l , l $#e i$ the ,& i$ #tu ll" is% .u#h less ho4 to #hie2e th t , l $#e; I$ s!ite o- thei& 94e<&e he&e to hel!: !u,li# i. ge% !h &. #euti# l #o.! $ies 4 $t to sell "ou .o&e !h &. #euti# ls so th t the" . 7e !&o-it 'B&eggi$% ())*+0 Th&ough .e/i # .! ig$s the" tte.!t to . 7e !h"si#i $s $/ the ge$e& l !u,li# ,elie2e th t the" need !h &. #euti# ls to /e l 4ith li-e<s
= All e1 .!les !&o2i/e/ i$ this te1t &e /& 4$ -&o. o2e& >) "e &s o- #li$i# l e1!e&ie$#e s 4ell s -&o. . te&i l &e!o&te/ i$ the !u,li# .e/i 0 'o &ese.,l $#e to $" !e&so$% li2i$g o& /e#e se/% is i$te$/e/ $o& shoul/ su#h ,e i$-e&&e/ ," the &e /e&0

!&o,le.s0 ?hile this is $ot to /is.iss the ,e$e-it o- #e&t i$ .e/i# tio$s i$ the t&e t.e$t o#e&t i$ /iso&/e&s 'su#h s h"!e&te$sio$% -o& e1 .!le+% /o 4e $ee/ .e/i# tio$s to /e l 4ith all oli-e<s !&o,le.s@ Peo!le h 2e -ou$/ 4 "s to #o!e 4ith the !&o,le.s o- li2i$g -o& =)%))) ge$e& tio$s ,e-o&e the &ise o- the !h &. #euti# l i$/ust&"0 ?h" /o the" su//e$l" $ee/ .e/i# tio$s to #o!e@ The&e is & the& i$te&esti$g ! & /o1 i$he&e$t i$ the !h &. #euti# l t&e t.e$t osu,st $#e use /iso&/e&% i$ th t 4e tte.!t to .e/i# te h"!otheti# l #he.i# l i., l $#es i$ the ,& i$% the e1 #t $ tu&e o- 4hi#h 4e /o $ot u$/e&st $/% 4ith !h &. #euti# ls 4hose e--e#ts 4e lso /o $ot -ull" u$/e&st $/0 It is i.!o&t $t to 7ee! i$ .i$/ th t lthough . &7ete/ s t&e t.e$ts -o& s!e#i-i# #o$/itio$s% the !s"#ho!h &. #euti# ls h 2e ,l $7et e--e#t o$ the entire ,& i$% $ot 8ust the o$e su,s"ste. th t is h"!otheti# ll" . l-u$#tio$i$g0 As &esult% othe& !h &. #euti# l ge$ts &e lso use/ to t&e t 2 &ious -o&.s o- .e$t l ill$ess si/e-e--e#ts su#h s /&o4si$ess% t 1i % et#0 B&eggi$ '())*+ suggeste/ th t so.e o- !s"#ho!h &. #euti# ls i$ use to/ " # use li-elo$g / . ge to the ,& i$0 The , si# !&e.ise o- !s"#ho!h &. #euti# ls is th t the" /is&u!t the -u$#tio$ o- the ,& i$% hopefully i$ .o&e $o&. l . $$e&0 The !&e.ise is the s .e -o& l#ohol $/ -o& the /&ugs o,use% lthough the" usu ll" see7 $ot .o&e $o&. l st te o- .i$/ ,ut eu!ho&i 0 Su&!&isi$gl"% -&o. this !e&s!e#ti2e% it is !ossi,le to &gue th t the su,st $#e use /iso&/e&s &e tte.!ts t sel-.e/i# tio$ ," the ,use&0 Ho4e2e&% 4e 7$o4 so little ,out the $o&. l -u$#tio$ o- the ,& i$ th t $eithe& the #u&&e$t ge$e& tio$ o- !s"#ho!h &. #euti# ls $o& $" o- the /&ugs o- ,use &e ,le to sele#ti2el" / .!e$ the -u$#tio$ o- 8ust o$e &egio$ o- the ,& i$ 'B&eggi$% ())*+0 The .e/i# tio$s i.! i& the -u$#tio$ o- every &egio$ o- the ,& i$ to so.e /eg&ee% le 2i$g the 5uestio$ o- 4hethe& the" h 2e 9#u&e/: the /iso&/e&% o& 8ust i..o,ili6e/ it ,ehi$/ #he.i# l st& ight 8 #7et% u$ $s4e&e/0 These e--e#ts &e 9000the$ i$te&!&ete/ 'o& .isi$te&!&ete/+ s i.!&o2e.e$ts: 'B&eggi$% ())*% !0 =+0 ?he$ l#ohol o& illi#it /&ugs &e ,use/% the ,io#he.ist&" o- the i$/i2i/u l<s e$ti&e ,& i$ is lso --e#te/% lthough it .ight o$l" ,e o,se&2e/ i$ o$e /o. i$ o$eu&ologi# l -u$#tio$0 Although the &e /e& .ight 5uestio$ the &ele2 $#e o- this /is#ussio$ to the //i#tio$s% it is i.!o&t $t to &e.e.,e& th t the su,st $#e use /iso&/e&s 'SUDs+ h 2e ,ee$ #l ssi-ie/ s medical /iso&/e&s0 The !h &. #euti# l #o.! $ies &e se &#hi$g -o& .e/i# tio$s th t # $ ,e use/ to t&e t the SUDs% $/ l&e /" e1isti$g .e/i# tio$s &e o-te$ ,ei$g use/ 9o-- l ,el: ( to t&e t l#ohol $/ illi#it /&ug //i#tio$0 Auestio$s =0 A&e t&e t.e$ts usi$g the !h &. #euti# l ge$ts /es#&i,e/ ,o2e $ i.!&o2e.e$t o2e& the / . ge th t the /&ugs o- ,use # use to the ,& i$@ ?h" o& 4h" $ot@ The" &e $ot $ i.!&o2e.e$t% ,e# use the Bh &. #euti# l ge$ts ,o2e 8ust // i$to the so # lle/ #he.i# l i., l $#e i$ the ,& i$0

2 A te&. th t &e-e&s to the !!li# tio$ o- !h &. #euti# l to /iso&/e& -o& 4hi#h it h s
$ot ,ee$ i/e$ti-ie/ s $ e--e#ti2e t&e t.e$t ," the Foo/ $/ D&ug A/.i$ist& tio$0

(0 M $" ! tie$ts $eithe& 4 $t% $o& 4ill the" ##e!t% !h &. #othe& !" -o& thei& su,st $#e use /iso&/e&s 'H &&is% Ci2l h $% Bo4e% D Hu.!h&e"s% ()=)+0 I. gi$e th t s#ie$#e /is#o2e&s #o.!ou$/ th t 4ill eli.i$ te the i$/i2i/u l<s 9#& 2i$g: -o& l#ohol o& $othe& /&ug o- ,use 4ith =))E #e&t i$t"% 4hi#h is huge i.!&o2e.e$t o2e& the #u&&e$t ge$e& tio$ o- !h &. #euti# l su!!o&ts0 Do 4e% s so#iet"% h 2e the &ight to -o&#e su#h t&e t.e$ts o$ ! tie$t% e2e$ i- the" &e e--e#ti2e@ ?ho shoul/ ,e ,le to /e#i/e 4h t .e/i# tio$s $ //i#t &e#ei2es to hel! hi. o& he& es# !e -&o. the //i#tio$@ The t&e t.e$t to gi2e $ //i#t h s to . t#he the //i#t<s go ls0 I- the //i#t 4 $ts -ull so,&iet"% the$ the /&ugs 4oul/ 4o&7% ,ut i- th t<s $ot the go l the //i#t 4 $ts% he 4ill still &e-use t&e t.e$t% $/ the /&ugs go to 4 ste >0 A&e the SUDs #tu ll" .e/i# l /iso&/e&s% ,eh 2io& l /iso&/e&s th t --e#t the ,o/"% > o& leg l !&o,le.@ ?h"@ SUD is #o.,i$ tio$ o- ll >0 It is .e/i# l /iso&/e& o-te$ # use/ ," ,eh 2io& l &es!o$sesF !&ee1isti$g ,eh 2io& l /iso&/e&0 The&e is $o !&oo- o- ge$eti# 2 &i tio$ th t # uses SUD% ,ut 4ith ,eh 2io& l !&o,le.s% !e&so$ is .o&e li7el" to /e2elo! SUD0 ?he$ SUD --e#ts the !h"si# l ,o/"% it is .e/i# l !&o,le.0 ?he$ it # uses h &. to othe&s $/ ,&e 7s l 4s0 It is leg l !&o,le.0

3 Su#h s o,esit" /oes% -o& e1 .!le0