Shifting Focus to Evidence-Based Management of Substance Use Disorders

EditorialsMay 2022Shifting Focus to Evidence-Based Management of Substance Use DisordersSarah Wakeman, MDSarah Wakeman, MDMassachusetts General Hospital, Boston, MassachusettsAuthor, Article, and Disclosure Informationhttps://doi.org/10.7326/M22-0150 SectionsAboutFull TextPDF ToolsAdd to favoritesDownload CitationsTrack CitationsPermissions ShareFacebookTwitterLinkedInRedditEmail In their article, Perry and colleagues (1) present key recommendations from joint guidelines from the U.S. Department of Veterans Affairs (VA) and U.S. Department of Defense (DoD) for the management of substance use disorder (SUD). The guideline covers the breadth of SUD; however, the recommendations discussed in the article focus on topics of particular relevance to internal medicine practice. In this 2021 update of 2015 guidelines, the VA/DoD recommends annual screening for unhealthy alcohol use using the Alcohol Use Disorders Identification Test–Consumption or the Single-Item Alcohol Screening Questionnaire (providing a brief intervention for scores of 5 or higher on the ...References1. Perry C, Liberto J, Milliken C, et al. The management of substance use disorders: synopsis of the 2021 U.S. Department of Veterans Affairs and U.S. Department of Defense clinical practice guideline. Ann Intern Med. 2022;175:691-700. doi:10.7326/M21-4011 LinkGoogle Scholar2. Spillane S, Shiels MS, Best AF, et al. Trends in alcohol-induced deaths in the United States, 2000-2016. JAMA Netw Open. 2020;3:e1921451. [PMID: 32083687] doi:10.1001/jamanetworkopen.2019.21451 CrossrefMedlineGoogle Scholar3. Curry SJ, Krist AH, Owens DK, et al; US Preventive Services Task Force. Screening and behavioral counseling interventions to reduce unhealthy alcohol use in adolescents and adults: US Preventive Services Task Force recommendation statement. JAMA. 2018;320:1899-1909. [PMID: 30422199] doi:10.1001/jama.2018.16789 CrossrefMedlineGoogle Scholar4. McNeely J, Adam A, Rotrosen J, et al. Comparison of methods for alcohol and drug screening in primary care clinics. JAMA Netw Open. 2021;4:e2110721. [PMID: 34014326] doi:10.1001/jamanetworkopen.2021.10721 CrossrefMedlineGoogle Scholar5. Manhapra A, Chakraborty A, Arias AJ. Topiramate pharmacotherapy for alcohol use disorder and other addictions: a narrative review. J Addict Med. 2019;13:7-22. [PMID: 30096077] doi:10.1097/ADM.0000000000000443 CrossrefMedlineGoogle Scholar6. Wakeman SE, Larochelle MR, Ameli O, et al. Comparative effectiveness of different treatment pathways for opioid use disorder. JAMA Netw Open. 2020;3:e1920622. [PMID: 32022884] doi:10.1001/jamanetworkopen.2019.20622 CrossrefMedlineGoogle Scholar7. National Academies of Sciences, Engineering, and Medicine. Medications for Opioid Use Disorder Save Lives. National Academies Pr; 2019. doi:10.17226/25310 CrossrefGoogle Scholar8. Lee JD, Nunes EV, Novo P, et al. Comparative effectiveness of extended-release naltrexone versus buprenorphine-naloxone for opioid relapse prevention (X:BOT): a multicentre, open-label, randomised controlled trial. Lancet. 2018;391:309-318. [PMID: 29150198] doi:10.1016/S0140-6736(17)32812-X CrossrefMedlineGoogle Scholar9. Ling W, Hillhouse M, Ang A, et al. Comparison of behavioral treatment conditions in buprenorphine maintenance. Addiction. 2013;108:1788-98. [PMID: 23734858] doi:10.1111/add.12266 CrossrefMedlineGoogle Scholar10. Ronsley C, Nolan S, Knight R, et al. Treatment of stimulant use disorder: a systematic review of reviews. PLoS One. 2020;15:e0234809. [PMID: 32555667] doi:10.1371/journal.pone.0234809 CrossrefMedlineGoogle Scholar Author, Article, and Disclosure InformationAffiliations: Massachusetts General Hospital, Boston, MassachusettsDisclosures: Disclosures can be viewed at www.acponline.org/authors/icmje/ConflictOfInterestForms.do?msNum=M22-0150.Corresponding Author: Sarah Wakeman, MD, Massachusetts General Hospital, 55 Fruit Street, Founders 880, Boston, MA 02114; e-mail, [email protected]org.This article was published at Annals.org on 22 March 2022. PreviousarticleNextarticle Advertisement FiguresReferencesRelatedDetailsSee AlsoThe Management of Substance Use Disorders: Synopsis of the 2021 U.S. Department of Veterans Affairs and U.S. Department of Defense Clinical Practice Guideline Christopher Perry , Joseph Liberto , Charles Milliken , Jennifer Burden , Hildi Hagedorn , Timothy Atkinson , James R. McKay , Larissa Mooney , James Sall , Comilla Sasson , Andrew Saxon , Christopher Spevak , Adam J. Gordon , and Annals On Call - Evidence-Based Care of Substance Use Disorders Robert M. Centor and Stefan G. Kertesz Metrics May 2022Volume 175, Issue 5Page: 753-754KeywordsAddictionAlcoholismAlcoholsBenzodiazepinesCocaineOpioid use disorderOpioidsSubstance abuse ePublished: 22 March 2022 Issue Published: May 2022 Copyright & PermissionsCopyright © 2022 by American College of Physicians. All Rights Reserved.PDF downloadLoading ...