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Evidence-Based Treatments for Substance Use Disorders

From the Department of Psychiatry and Behavioral Sciences of the Medical University of South Carolina.

Correspondence: Address reprint requests to Dr. Gold, Medical University of South Carolina, Department of Psychiatry and Behavioral Sciences, 67 President Street, P.O. Box 250861, Charleston, SC 29425; goldpb{at}musc.edu, e-mail.

A wide variety of evidence-based psychotherapies and pharmacotherapies demonstrate efficacy and effectiveness in the treatment of substance use disorders. Among recent developments in behavioral therapies are expanded uses of contingency management and developments in pharmacotherapies including a new opioid agonist therapy. Studies show superiority in combinations of therapies, such as contingency management to enhance compliance with naltrexone for alcohol dependence. Choice of treatment should be based primarily on the needs of the individual client, within the constraints of a treatment program’s service array and capacity of clients to pay for services. For persons with severe addictions and complex medical and psychosocial problems, a comprehensive service package with continuing care and monitoring is essential.

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