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The Neurocircuitry of Substance Use Disorder, Treatment, and Change: A Resource for Clinical Psychiatrists

Caesar G. Imperio, Frances R. Levin, Diana Martínez

American Journal of Psychiatry October 9, 2024 DOI: 10.1176/appi.ajp.20231023 (opens in new tab)

Study at a glance

AI-extracted from the abstract
Characteristics Review Peer reviewed
Interventions pharmacotherapy ketamine psilocybin transcranial magnetic stimulation
Topics Addiction Ketamine Psilocybin
Keywords Craving Substance use Transcranial magnetic stimulation Substance abuse Pharmacotherapy Psychotherapist
Citations 9
Key findings Pharmacotherapy targeting craving, intoxication, and withdrawal, along with neuroplasticity-promoting treatments like ketamine, psilocybin, and TMS, are discussed as promising approaches for treating substance use disorder.

Abstract

Substance use disorder (SUD) is common in psychiatric patients and has a negative impact on health and well-being. However, SUD often goes untreated, and there is a need for psychiatrists, of all specialties, to address this pervasive clinical problem. In this review, the authors' goal is to provide a resource that describes treatments for SUD, using neuroscience as a framework. They discuss the effect of pharmacotherapy on craving, intoxication, and withdrawal and its ability to interrupt the cycle of substance use in SUD. The neuroscience of stress is reviewed, including medications targeting neurotransmitter systems activated by alarm and fear. Neuroplasticity and promising treatments that use this mechanism, including ketamine, psilocybin, and transcranial magnetic stimulation (TMS), are discussed. The authors conclude by listing resources and practice guidelines for physicians interested in learning more about treatments for SUD.

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