Clinical Textbook of Addictive Disorders 3rd ed - R. Frances, S. Miller, A. Mack (Guilford, 2005) WW

26. Psychopharmacological Treatments 607NEUROLOGICAL AND COGNITIVE EFFECTSOF DRUG ABUSEThe neurocognitive effects of drug abuse, while not yet fully elucidated, arelikely to have several negative sequelae in drug abusers. Cognitive impairmentobserved clinically may be associated with perfusion deficits identified in neuroimagingstudies. Drug abusers with these deficits may have more difficultygrasping concepts imparted in drug abuse psychotherapy important for initiatingand maintaining abstinence. Drug users may be less able to utilize skillstaught in psychotherapy interventions aimed at drug and alcohol abuse. Thesedeficits may underlie the observation that some patients with SUDs have highrelapse rates despite participation in substance abuse treatment. Finally, thesedeficits may place drug users at higher risk for medical complications of drugand alcohol use due to both a primary effect of perfusion deficits and secondaryeffect of cognitive impairment that may contribute to high-risk behaviors leadingto medical morbidity. These findings indicate a need to address the issue ofcognitive impairment in the drug abuser and point to a new direction in thedevelopment of pharmacotherapies for SUDs in the future.SUMMARYSubstantial progress has been made in the development of pharmacotherapiesfor the treatment of SUDs. FDA-approved medication therapies are now availablefor the treatment of nicotine, alcohol, and opiate use disorders. Thesetreatments, utilized in conjunction with a program addressing the psychosocialneeds of the patient, represent the most effective regimens available to treataddictive disorders. Research is ongoing to continue to broaden the number ofpharmacotherapies available for these disorders. The search for effective medicationtreatments for other SUDs, such as stimulant use disorders, continues.ACKNOWLEDGMENTSThis work was supported by Grant Nos. K02-DA00478 (to Elinore F. McCance-Katz)and K05-DA00454 (to Thomas R. Kosten) from the National Institute on Drug Abuse.REFERENCESAgricola, R. (1982). Treatment of acute alcohol withdrawal syndrome with carbamazepine:A double-blind comparison with tiapride. J Int Med Res, 10, 160–165.Altice, F. L., Friedland, G. H., & Cooney, E. L. (1999). Nevirapine induced opiate