MANAGING DRUG-DEPENDENCE - PSYCHOTHERAPY OR PHARMACOTHERAPY

Drug dependence involves the repetitive use of substances that produce reinforcing effects in the CNS. Drug dependence disorders can often be more effectively and less expensively treated than the consequences of dependence (e.g. HIV infection, liver cirrhosis, lung cancer). Systematic psychotherapy or behavioural intervention is the most widely studied and used treatment for drug dependence. Medications can be used to treat aspects of drug dependence by reducing withdrawal symptoms, blocking the addicting effects of the drugs, and by protracting episodes of remission. We conclude that insofar as a critical therapeutic goal is a change of behaviour, some form of behavioural intervention is the cornerstone of all therapies for drug dependence, and that a comprehensive drug dependence treatment programme should include the option to administer medications as indicated. Additionally, the most cost-effective approaches to treating drug dependence in large populations may be those that integrate psychotherapeutic and medication-based approaches as per the needs of the individual patients.