Psychiatry for Physicians-Substance Use Disorders-Other Substances
Among other substances that are significant for abusive use are
1. Sedative, hypnotic, or anxiolytic drugs
2. Illicit drug
3. Opioid
4. Cocaine
5. Amphetamine
6. Phencyclidine
7. Hallucinogens
8. Cannabis
9. Nicotine
10. Inhalant
Among the 1st group benzodiazepines and barbiturates have potential for abuse. They often starts with some treatment. Treatment is very similar to that of alcohol.
Among the illicit drugs use of opioids are most common. Polysubstance has also been increasing in recent days. A very important medical aspect of such abuse is transmission of medical illnesses like AIDS, hepatitis etc. Treatment of opioid abuse and dependence includes opioid substitution and maintenance versus abstinence approaches. Clonidine and Naltrexone is also used for detoxification. Psychosocial therapy strategies include therapeutic community, Narcotics Anonymous, and psychotherapy.
Cocaine blocks neuronal dopamine, serotonin, and norepinephrine reuptake. Cocaine abuse leads to different medical problems like nasal pathology, spreading of blood born diseases etc. Treatment approach is done by both psychological and pharmacological methods. Symptom based approach is common here. Pharmacological treatment includes use of antagonists, aversive agents, treatment of psychiatric disorders, and treatment of intoxication, withdrawal and craving.
The cases of abuse and dependence by the last six variety of drugs are dealt in a manner more or less consistent with the others described above. As they have specific pharmacological properties treatment planning includes the management of the symptoms accordingly. Psychological interventions are also used for these drugs. Among these cannabis is very significant due to its very common effect of psychosis.
In fact substance use disorders can be described more elaborately for the purpose of understanding management. But the truth is real management of this huge multisectoral problem requires multisectoral approach for intervention which is almost impossible to elaborate in a short context like this. In the future, I have desire to approach this problem in broader context.
About the Author:
Dr. Mohammad Samir Hossain PhD is a researcher teacher of Psychiatry and a Psychotherapist in Bangladesh. He is renouned for his educational and research activity in mental health sector nationally and internationally. The Dictionary of International Biography cites his brief biography starting from its 33rd edition. One of the best educational institutions involved with his educational activity is the Harvard Medical School of USA. Visit his personal page at http://www.samirhossain.org
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