Chapter V
Treatment and Management of Addiction
(^)
Addiction* is a disease that can be treated and
managed effectively at venues where regular
medical care is delivered by physicians,
including addiction physician specialists, and
including a multi-disciplinary team of other
health professionals using an array of evidence-
based pharmaceutical and psychosocial†
approaches. In accordance with standard
medical practice for the treatment of other
chronic diseases, best practices for the effective
treatment and management of addiction must be
consistent with the scientific evidence of the
causes and course of the disease. Best practices
require:^1
Comprehensive assessment of the extent
and severity of the disease, determination of
a clinical diagnosis, evaluation of co-
occurring health conditions and the
development of a tailored treatment plan;
- In this report, we have used the general term
addiction to apply to those who meet criteria for past-
month nicotine dependence based on the Nicotine
Dependence Syndrome Scale (NDSS) and those who
meet diagnostic criteria for past year alcohol and/or
other drug abuse or dependence (excluding nicotine)
in accordance with the Diagnostic and Statistical
Manual of Mental Disorders (DSM-IV). (The DSM
refers to substance abuse and substance dependence
collectively as substance use disorders. The criteria
for nicotine dependence in the NDSS parallel those
of the DSM-IV.) This definition is consistent with
the current move to combine abuse and dependence
into an overarching diagnosis of addiction in the
upcoming DSM-V.
† Psychosocial therapy is a general term for non-
pharmaceutical-based interventions and includes
various forms of individual and group psychotherapy
that address psychological, behavioral and social
issues that contribute to risky substance use and
addiction. Behavioral therapies are those
psychosocial interventions that focus more directly
on addressing the patient’s substance-related
behaviors, typically through behavioral reinforcement
approaches, with less of an emphasis on the
psychological or social determinants of their
substance use.