Drug and alcohol addiction: new challenges

Abstract

SummaryThere have been many developments in addiction psychiatry over the past decade. Some of these are political, such as preference for recovery-/ abstinence-based programmes. Prohibition is becoming increasingly unrealistic, especially considering the effective legalisation of recreational cannabis in Uruguay and two US states. Legal highs and diversion of prescribed drugs (such as methadone, gabapentinoids, methylphenidate and benzodiazepines) are now a major problem. Furthermore, diversion of opioid drugs that are prescribed for pain is reaching epidemic proportions, causing a significant change in the nature of patients being referred to addiction services.Learning Objectives•Be aware of political issues regarding abstinence-based treatment and prohibition.•Be aware of risks and increased prevalence of diversion of drugs of misuse, especially opioid pain killers, gabapentinoids and benzodiazepines.•Update knowledge of problems with methadone such as cardiac arrhythmias and diversion.