According to a review, "in order to be effective, all pharmacological or biologically based treatments for<unk>  need to be integrated into other established forms of<unk>  rehabilitation, such as cognitive behavioral therapy, individual and group psychotherapy, behavior modification strategies, twelve-step programs, and residential treatment facilities." A biosocial approach to the treatment of<unk>  brings to the fore the social determinants of illness and wellbeing and considers the dynamic and reciprocal relationships that exist for, and influence, the individual's experience. The work of A.V. Schlosser (2018) aims to pronounce the individual lived experiences of women receiving medication-assisted treatment (e.g., methadone, naltrexone, burprenorphine) in a long-term rehabilitation setting, through a twenty month long ethnographic fieldwork investigation. This person-centred research shows how the experiences of these women “emerge from stable systems of inequality based in intersectional gender, race, and class marginalization entangled with processes of intra-action." Viewing<unk>  treatment through this lens also highlights the importance of framing clients’ own bodies as “social flesh.” As Schlosser (2018) points out, “client bodies” as well as the “embodied experiences of self and social belonging emerge in and through the structures, temporalities, and expectations of the treatment centre." Further challenges and embodied tensions have the potential to arise as a result of the dynamics inherent in the patient-provider relationship, in<unk>  to the experience of being “alienated from their own bodies, psyches and sociality's when sedated on medications in treatment." Biotechnologies currently make up a large portion of the future treatments for<unk> . To name a few, deep-brain stimulation, agonist/antagonist implants and hapten conjugate vaccines. Vaccinations against<unk>  specifically overlaps with the belief that memory plays a large role in the damaging effects of<unk>  and relapses. Hapten conjugate vaccines are designed to block opioid receptors in one area, while allowing other receptors to behave normally. Essentially, once a high can no longer be achieved in relation to a traumatic event, the relation of drugs to a traumatic memory can be disconnected and therapy can then play a role in treatment. Behavioral therapy A meta-analytic review on the efficacy of various behavioral therapies for treating drug and behavioral<unk> s found that cognitive behavioral therapy (e.g., relapse prevention and contingency management), motivational interviewing, and a community reinforcement approach were effective interventions with moderate effect sizes. Clinical and preclinical evidence indicate that consistent aerobic exercise, especially endurance exercise (e.g., marathon running), actually prevents the development of certain drug<unk> s and is an effective adjunct treatment for drug<unk> , and for psychostimulant<unk>  in particular. Consistent aerobic exercise magnitude-dependently (i.e., by duration and intensity) reduces drug<unk>  risk, which appears to occur through the reversal of drug induced<unk> -related neuroplasticity. One review noted that exercise may prevent the development of drug<unk>  by altering ΔFosB or immunoreactivity in the striatum or other parts of the reward system. Aerobic exercise decreases drug self-administration, reduces the likelihood of relapse, and induces opposite effects on striatal dopamine receptor D2 (DRD2) signaling (increased DRD2 density) to those induced by<unk> s to several drug classes (decreased DRD2 density). Consequently, consistent aerobic exercise may lead to better treatment outcomes when used as an adjunct treatment for drug<unk> . Medication Alcohol<unk>  Alcohol, like opioids, can induce a severe state of physical dependence and produce withdrawal symptoms such as delirium tremens. Because of this, treatment for alcohol<unk>  usually involves a combined approach dealing with dependence and<unk>  simultaneously. Benzodiazepines have the largest and the best evidence base in the treatment of alcohol withdrawal and are considered the gold standard of alcohol detoxification. Pharmacological treatments for alcohol<unk>  include drugs like naltrexone (opioid antagonist), disulfiram, acamprosate, and topiramate. Rather than substituting for alcohol, these drugs are intended to affect the desire to drink, either by directly reducing cravings as with acamprosate and topiramate, or by producing unpleasant effects when alcohol is consumed, as with disulfiram. These drugs can be effective if treatment is maintained, but compliance can be an issue as alcoholic patients often forget to take their medication, or discontinue use because of excessive side effects. According to a Cochrane Collaboration review, the opioid antagonist naltrexone has been shown to be an effective treatment for alcoholism, with the effects lasting three to twelve months after the end of treatment. Behavioral<unk> s Cannabinoid<unk>  , there are no effective pharmacological interventions for cannabinoid<unk> . A 2013 review on cannabinoid<unk>  noted that the development of CB1 receptor agonists that have reduced interaction with β-arrestin 2 signaling might be therapeutically useful. Nicotine<unk>  Another area in which drug treatment has been widely used is in the treatment of nicotine<unk> , which usually involves the use of nicotine replacement therapy, nicotinic receptor antagonists, or nicotinic receptor partial agonists. Examples of drugs that act on nicotinic receptors and have been used for treating nicotine<unk>  include antagonists like bupropion and the partial agonist varenicline. Opioid<unk>  Opioids cause physical dependence, and treatment typically addresses both dependence and<unk> . Physical dependence is treated using replacement drugs such as suboxone or subutex (both containing the active ingredients buprenorphine) and methadone. Although these drugs perpetuate physical dependence, the goal of opiate maintenance is to provide a measure of control over both pain and cravings. Use of replacement drugs increases the addicted individual's ability to function normally and eliminates the negative consequences of obtaining controlled substances illicitly. Once a prescribed dosage is stabilized, treatment enters maintenance or tapering phases. In the United States, opiate replacement therapy is tightly regulated in methadone clinics and under the DATA 2000 legislation. In some countries, other opioid derivatives such as dihydrocodeine, dihydroetorphine and even heroin are used as substitute drugs for illegal street opiates, with different prescriptions being given depending on the needs of the individual patient. Baclofen has led to successful reductions of cravings for stimulants, alcohol, and opioids, and also alleviates alcohol withdrawal syndrome. Many patients have stated they "became indifferent to alcohol" or "indifferent to cocaine" overnight after starting baclofen therapy. Some studies show the interconnection between opioid drug detoxification and overdose mortality. Psychostimulant<unk>  , there is no effective pharmacotherapy for any form of psychostimulant<unk> . Reviews from 2015, 2016, and 2018 indicated that TAAR1-selective agonists have significant therapeutic potential as a treatment for psychostimulant<unk> s; however, , the only compounds which are known to function as TAAR1-selective agonists are experimental drugs. Research Research indicates that vaccines which utilize anti-drug monoclonal antibodies can mitigate drug-induced positive reinforcement by preventing the drug from moving across the blood–brain barrier; however, current vaccine-based therapies are only effective in a relatively small subset of individuals. , vaccine-based therapies are being tested in human clinical trials as a treatment for<unk>  and preventive measure against drug overdoses involving nicotine, cocaine, and methamphetamine. The new study shows, that the vaccine may also save lives during a drug overdose. In this instance, the idea is that the body will respond to the vaccine by quickly producing antibodies to prevent the opioids from accessing the brain. Since<unk>  involves abnormalities in glutamate and GABAergic neurotransmission, receptors associated with these neurotransmitters (e.g., AMPA receptors, NMDA receptors, and GABAB receptors) are potential therapeutic targets for<unk> s. N-acetylcysteine, which affects metabotropic glutamate receptors and NMDA receptors, has shown some benefit in preclinical and clinical studies involving<unk> s to cocaine, heroin, and cannabinoids. It may also be useful as an adjunct therapy for<unk> s to amphetamine-type stimulants, but more clinical research is required. Current medical reviews of research involving lab animals have identified a drug class – class I histone deacetylase inhibitors – that indirectly inhibits the function and further increases in the expression of accumbal ΔFosB by inducing G9a expression in the nucleus accumbens after prolonged use. These reviews and subsequent preliminary evidence which used oral administration or intraperitoneal administration of the sodium salt of butyric acid or other class I HDAC inhibitors for an extended period indicate that these drugs have efficacy in reducing addictive behavior in lab animals that have developed<unk> s to ethanol, psychostimulants (i.e., amphetamine and cocaine), nicotine, and opiates; however, few clinical trials involving humans with<unk> s and any HDAC class I inhibitors have been conducted to test for treatment efficacy in humans or identify an optimal dosing regimen. Gene therapy for<unk>  is an active area of research. One line of gene therapy research involves the use of viral vectors to increase the expression of dopamine D2 receptor proteins in the brain.
Addiction
Amphetamine dependence
Behavioral addiction
Cocaine dependence
Polysubstance dependence
Benzodiazepine dependence
Substance dependence
Suicide