Ch. 4: Summary

This module opened with an examination of issues related to inhalant misuse—what kinds of substances are commonly involved and who tends to engage in this type of substance misuse. The practice was identified as being particularly risky, not as much because of addiction concerns as because of the heavy toll it can take on the brain and other critical organ systems in the body. Then we looked at concerns related to anabolic steroid misuse. The next topics examined in this chapter were over-the-counter (OTC) and prescription drug misuse. The great fallacy of thinking that drugs sold as OTC (or behind-the-counter, BTC) substances are safer than prescription or “street” drugs was addressed, and you learned about some of the most commonly misused OTC products. Prescription drug misuse has appeared in several modules in our course as we looked into specific types of drugs like amphetamines, sedative-hypnotic/CNS depressants, opioids, and cannabis. In this module we looked a bit more deeply into the epidemiology of prescription drug misuse and some policy response ideas. In our final chapter, we (re)visited the topic of pharmacotherapy/medication assisted treatment for alcohol and other substance misuse/use disorders. The topic was discussed to some extent in our prior modules on alcohol and opioids; here we delved more deeply into the topic. In particular, we explored the interdisciplinary detoxification (detox) and stabilization process, and then the subsequent treatment uses of different pharmacotherapy approaches to treatment of substance misuse and substance use disorders. The science in this area continues to develop and new pharmacotherapy strategies are emerging. The evidence does support the combined use of behavioral and case management interventions with pharmacotherapy: “Treating addiction more commonly requires longer-term intervention, such as Alcoholics Anonymous, methadone-buprenorphine maintenance, ‘sober living’ residential facilities, and extended case monitoring” (Humphreys et al., 2017). At this point, you are prepared to review some key terms used in this module and proceed to our final course topic.