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Table 1 Outpatient Addiction Pharmacotherapy

From: Substance abuse and pharmacy practice: what the community pharmacist needs to know about drug abuse and dependence

Drug of Abuse

Prescription Medication

Usual SIG

Notes

Support Systems

Tobacco

a) Nicotine Substitution

NTS1

Polacrilex gum

Nasal spray

Inhaler

Lozenge

b) Buproprion SR

a) various dosing protocols.

b) 150 mg once daily × 3 days then; 150 mg B.I.D.

a) Stop tobacco use before initiating treatment

b) Contraindicated in patients with a history of bulimia, anorexia nervosa, seizure, or currently taking an MAOI or another product containing buproprion.

Nicotine Anonymous http://www.nicotine-anonymous.org

American Lung Association http://www.lungusa.org

American Cancer Society http://www.cancer.org

American Heart Association http://www.americanheart.org

Alcohol

a) Disulfiram

b) Naltrexone

c) Benzodiazepines

a)500 mg once daily × 1 – 2 weeks, then 250 mg P.O. once daily

b)50 mg P.O. once daily.

c) dose varies on the basis of the specific agent, level of alcohol tolerance, history of past withdrawal, and presenting symptoms of withdrawal.

a) Stop before and avoid all alcohol use while taking this prescription. Contraindicated in patients with severe myocardial disease or coronary occlusion. Punishment when people drink.

b) Reduces the "high" from alcohol

c) For detoxification only.

Alcoholics Anonymous (A.A.) http://www.alcoholics-anonymous.org

Alanon, Alateen http://www.al-anon.org

Rational Recovery http://rational.org

Local resources for alcoholism treatment; groups and family therapy.

Opioids

a) Naltrexone

b) Methadone

c) LAAM2

d) Buprenorphine

The use of other opioids for the treatment of opioid dependence is a violation of federal law.

a) 50 mg P.O., once daily.

b) 20 – 120 mg P.O., once daily.

c) 80 – 100 mg P.O., every other day.

d) 4 to 16 mg/day sublingually for maintenance.

a) Will precipitate withdrawal if taken within 7 to 10 days of last opioid use.

b & c) Use for maintenance and detoxification tightly regulated by FDA

d) Sublingual tablet approved by FDA for medical withdrawal and maintenance. C-III drug.

Narcotics Anonymous (N.A.) http://www.na.org

Naranon http://www.naranon.com

Buprenorphine subscribers: http://buprenorphine.samhsa.gov

Local resources for substance abuse and addiction treatment and group and family therapy.

  1. 1 Nicotine Transdermal System 2 L-alpha-acetyl-methadol