Addiction, not surprisingly, behaves like other mental disorders. No one is too shocked when a patient with a history of major depression develops a new episode. The same is true of alcoholism: it often follows a relapsing-remitting course characterized by partial remission.

Alcoholism and anxiety go hand in hand. The extent of this comorbidity is clear from the numbers: as many as 45% of patients with alcohol disorders meet diagnostic criteria for a co-occurring anxiety disorder.

Over 20 years ago, at the time of planning for DSM-IV, alcohol abuse was thought to be a milder form of alcohol dependence, or perhaps even something separate involving more episodic, as opposed to daily or near daily, drinking. However, new research has proven this is not so.

The American Academy of Pediatrics recommends keeping daily television viewing to no more than two hours per day, on the basis of research linking excessive TV to behavioral problem, poor body image, and other issues (AAP Policy Statement, Pediatrics 2001;107(2):423–426).

Download and print this contract for your patients on Suboxone.

Opioid drugs represent one of the great triumphs of medicine, because they are extremely effective at relieving pain. Since the 1960s, multiple forms of synthetic opioids have been introduced, including such wellknown drugs as hydrocodone (Vicodin) and oxycodone (Percocet, Oxycontin).

If you are a typical psychiatrist practicing in a setting other than a substance abuse clinic, chances are good that you rarely order drug testing on most of your patients. But should you be doing this more?

Motivational interviewing is really a way of talking to people that calls forth their own motivations for change. Instead of telling them that they need to change, it’s a way of encouraging them to want to change.

The NIAAA (National Institute on Alcohol Abuse and Alcoholism) has recently posted a practical guide for professionals interested in improving their skills in evaluating and treating patients with alcohol problems. Here are some useful tips for treating alcoholism, adapted both from the NIAAA and other sources.

The current issue of the American Journal of Psychiatry carries a meta-analysis of different psychosocial interventions for the treatment of substance abuse (Dutra L et al., Am J Psychiatry 2008 165: 179-187). This review focuses specifically on techniques for treating abusers of cannabis, cocaine, and opiates. What works the best, and what techniques can you bring into your practice.