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Review
. 2007;9(4):431-45.
doi: 10.31887/DCNS.2007.9.4/tgardner.

Therapeutic options and challenges for substances of abuse

Tracie J Gardner  1 , Thomas R Kosten
Affiliations
Review

Therapeutic options and challenges for substances of abuse

Tracie J Gardner et al. Dialogues Clin Neurosci. 2007.

Abstract
in English, Spanish, French

Addiction to substances continues to be a significant public health concern in the United States. The following review of current pharmacological treatments discusses a range of substances: nicotine, alcohol, cocaine, and opioids. The goal is to provide an overview of currently available and new pharmacological treatments for substance use disorders, while also addressing the pharmacotherapeutic challenges remaining. The significant advances in pharmacotherapy have had limited utilization, however. For example, naltrexone for alcoholism is infrequently prescribed, buprenorphine for opiates still has relatively few qualified prescribers, and stimulants have no Food and Drug Administration-approved pharmacotherapy. These pharmacotherapies are needed, with the rate of even the relatively uncommon abuse of opiates now rising sharply.

La adicción a sustancias sigue siendo un importante tema de salud pública en los Estados Unidos. La siguiente revisión acerca de los tratamientos farmacológicos actuales incluye diversas sustancias: nicotina, alcohol, cocaína y opioides. El objetivo es entregar una panorámica de los actuales tratamientos disponibles y de las nuevas terapias farmacológicas para los trastornos por el uso de sustancias, consignando además el resto de los desafíos farmacoterapéuticos. A pesar de los significativos avances en la farmacoterapia, ésta ha tenido una utilización limitada. Por ejemplo, la naltrexona se prescribe infrecuentemente para el alcoholismo, la buprenorfina para los opioides todavía tiene relativamente pocos prescriptores calificados, y los estimulantes no tienen una farmacoterapia aprobada por la Food and Drug Administration. Estas farmacoterapias son necesarias, considerando que el porcentaje de abuso de opiáceos que ha sido relativamente constante ahora está creciendo marcadamente.

La dépendance à une substance reste encore un problème de santé publique préoccupant aux États-Unis. Cet article sur les traitements pharmacologiques actuels passe en revue une série de substances : la nicotine, l'alcool, la cocaïne et les opiacés. Il a pour but de donner une vue d'ensemble des nouveaux traitements pharmacologiques actuellement disponibles pour traiter les troubles liés à l'utilisation d'une substance, tout en abordant les autres options thérapeutiques pharmacologiques. Les progrès importants en pharmacothérapie ont cependant été peu utilisés. Ainsi, la naltrexone (pour l'alcoolisme) est rarement prescrite, la buprénorphine (pour les opiacés) seulement par quelques médecins qualifiés et les stimulants n'ont pas été approuvés par la Food and Drug Administration. Ces traitements sont nécessaires, car la dépendance aux opiacés, même si elle est relativement rare, augmente maintenant nettement.

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