Abstract
Background: Substance use disorders (SUDs) are an increasing problem worldwide. In the United States, there is currently an “opioid epidemic,” primarily initiated by the over-prescription of opioid medications, barriers to continued access to those same medications, and the eventual procurement of illegal opioids to prevent withdrawal. In addition to the diversion of prescription opioids (especially oxycodone and fentanyl), other, more powerful opioids (e.g., carfentanil) have found their way to the street. Of especial concern is the number of adolescents who have access to legal- but diverted- or illegal drugs, as they are at risk for developing SUDs. Clinicians in various treatment settings (such as primary care offices, emergency departments, and mental health clinics) may lack the knowledge and training to safely and effectively treat patients who have SUDs. Fortunately, there are several pharmacologic agents that are approved for the treatment of opioid, alcohol and nicotine use disorders in adults and several agents have been explored to treat cannabis use disorder. To date, none of these medications have been approved for those indications in adolescents, although they can be-and are- used off-label in that patient population. All medications can be associated with adverse events, which are of particular concern in younger patients.
Objective: To address the most common adverse effects from medications used to treat substance use disorders, and to offer suggestions regarding management of those unwanted effects.
Method: The method utilized was PubMed search, from January 1, 2002 through November 1, 2017, with cross-referencing medications used to treat SUDs, adverse events and their treatment.
Results: The substances addressed in this article (opioids, alcohol, tobacco and cannabis) are the most commonly abused in the general population, and are the most likely to be associated with adverse medical, psychiatric, social, financial and legal consequences. Medications used to treat opioid, alcohol, tobacco and cannabis use disorders are described, along with important adverse effects and their treatment.
Conclusion: Given that there is no “drug of choice” to treat any given SUD, the selection of agent will depend on the patient’s personal characteristics (e.g., age, gender, medical status, degree of social support, etc.) and preferences, and the prescriber’s knowledge, comfort, and experience regarding the available medications. The pharmacotherapy of SUDs should always be accompanied by psychosocial therapies.
Keywords: Opioids, alcohol, nicotine, cannabis, pharmacotherapy, adverse events, addiction, treatment.
Graphical Abstract
Current Psychopharmacology
Title:Management of Adverse Effects from Medications Used to Treat Substance Use Disorders
Volume: 7
Author(s): Joseph L. Calles*
Affiliation:
- Department of Psychiatry, Western Michigan University, Homer Stryker MD School of Medicine, Kalamazoo, Michigan, MI,United States
Keywords: Opioids, alcohol, nicotine, cannabis, pharmacotherapy, adverse events, addiction, treatment.
Abstract: Background: Substance use disorders (SUDs) are an increasing problem worldwide. In the United States, there is currently an “opioid epidemic,” primarily initiated by the over-prescription of opioid medications, barriers to continued access to those same medications, and the eventual procurement of illegal opioids to prevent withdrawal. In addition to the diversion of prescription opioids (especially oxycodone and fentanyl), other, more powerful opioids (e.g., carfentanil) have found their way to the street. Of especial concern is the number of adolescents who have access to legal- but diverted- or illegal drugs, as they are at risk for developing SUDs. Clinicians in various treatment settings (such as primary care offices, emergency departments, and mental health clinics) may lack the knowledge and training to safely and effectively treat patients who have SUDs. Fortunately, there are several pharmacologic agents that are approved for the treatment of opioid, alcohol and nicotine use disorders in adults and several agents have been explored to treat cannabis use disorder. To date, none of these medications have been approved for those indications in adolescents, although they can be-and are- used off-label in that patient population. All medications can be associated with adverse events, which are of particular concern in younger patients.
Objective: To address the most common adverse effects from medications used to treat substance use disorders, and to offer suggestions regarding management of those unwanted effects.
Method: The method utilized was PubMed search, from January 1, 2002 through November 1, 2017, with cross-referencing medications used to treat SUDs, adverse events and their treatment.
Results: The substances addressed in this article (opioids, alcohol, tobacco and cannabis) are the most commonly abused in the general population, and are the most likely to be associated with adverse medical, psychiatric, social, financial and legal consequences. Medications used to treat opioid, alcohol, tobacco and cannabis use disorders are described, along with important adverse effects and their treatment.
Conclusion: Given that there is no “drug of choice” to treat any given SUD, the selection of agent will depend on the patient’s personal characteristics (e.g., age, gender, medical status, degree of social support, etc.) and preferences, and the prescriber’s knowledge, comfort, and experience regarding the available medications. The pharmacotherapy of SUDs should always be accompanied by psychosocial therapies.
Export Options
About this article
Cite this article as:
Calles L. Joseph*, Management of Adverse Effects from Medications Used to Treat Substance Use Disorders, Current Psychopharmacology 2018; 7 (1) . https://dx.doi.org/10.2174/2211556006666171124161420
DOI https://dx.doi.org/10.2174/2211556006666171124161420 |
Print ISSN 2211-5560 |
Publisher Name Bentham Science Publisher |
Online ISSN 2211-5579 |

- Author Guidelines
- Bentham Author Support Services (BASS)
- Graphical Abstracts
- Fabricating and Stating False Information
- Research Misconduct
- Post Publication Discussions and Corrections
- Publishing Ethics and Rectitude
- Increase Visibility of Your Article
- Archiving Policies
- Peer Review Workflow
- Order Your Article Before Print
- Promote Your Article
- Manuscript Transfer Facility
- Editorial Policies
- Allegations from Whistleblowers
- Announcements
Related Articles
-
The Role of Adenosine in Rheumatoid Arthritis
Immunology, Endocrine & Metabolic Agents in Medicinal Chemistry (Discontinued) Gene Expression Analysis for High Throughput Screening Applications
Combinatorial Chemistry & High Throughput Screening From Brain Ischemia-Reperfusion Injury to Possible Sporadic Alzheimers Disease
Current Neurovascular Research Chemistry and Biology of Indoles and Indazoles: A Mini-Review
Mini-Reviews in Medicinal Chemistry Adenosine Neuromodulation and Traumatic Brain Injury
Current Neuropharmacology The Role of Mitochondrial Impairment in Alzheimer´s Disease Neurodegeneration: The Tau Connection
Current Neuropharmacology Novel Treatment Options of Binge Eating Disorder
Current Medicinal Chemistry Carnosine and Carnosine-Related Antioxidants: A Review
Current Medicinal Chemistry Pediatric Cutaneous Graft Versus Host Disease: A Review
Current Pediatric Reviews One-Pot Synthesis of (3-Phenylisoxazol-5-yl)methanol Derivatives Under Ultrasound
Letters in Organic Chemistry Time Dependent Distribution of MicroRNA 144 after Intravenous Delivery
MicroRNA Possible Role of Vascular Risk Factors in Alzheimer's Disease and Vascular Dementia
Current Pharmaceutical Design Asymmetric Alkynylation Reactions of Aldehydes Using a Zn(OTf)2-Chiral Ligand-Base System
Current Organic Chemistry Early Diagnosis of Alzheimers Disease: Is MCI Too Late?
Current Alzheimer Research Antineoplastic Activity of Monocrotaline Against Hepatocellular Carcinoma
Anti-Cancer Agents in Medicinal Chemistry Stem Cell Niche in Tissue Homeostasis, Aging and Cancer
Current Medicinal Chemistry Tocilizumab in SARS-CoV-2 Patients with the Syndrome of Cytokine Storm: A Narrative Review
Reviews on Recent Clinical Trials Feature Based Fusion of Multimodal Medical Image Slices with Combined Transforms
Current Medical Imaging Therapeutic Strategies in Parkinsons Disease
Recent Patents on Endocrine, Metabolic & Immune Drug Discovery (Discontinued) A Review on Recent Robotic and Analytic Technologies in High Throughput Screening and Synthesis for Drug Discovery
Letters in Drug Design & Discovery