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Guide lines PRACTICE GUIDELINE FOR THE Treatment of Patients With Substance Use Disorders Second Edition WORK GROUP ON SUBSTANCE USE DISORDERS Herbert D Kleber M D Chair Roger D Weiss M D Vice-Chair Raymond F Anton Jr M D Tony P George M D Shelly F Green

PRACTICE GUIDELINE FOR THE Treatment of Patients With Substance Use Disorders Second Edition WORK GROUP ON SUBSTANCE USE DISORDERS Herbert D Kleber M D Chair Roger D Weiss M D Vice-Chair Raymond F Anton Jr M D Tony P George M D Shelly F Green ?eld M D M P H Thomas R Kosten M D Charles P O ? Brien M D Ph D Bruce J Rounsaville M D Eric C Strain M D Douglas M Ziedonis M D Grace Hennessy M D Consultant Hilary Smith Connery M D Ph D Consultant This practice guideline was approved in December and published in August A guideline watch summarizing signi ?cant developments in the scienti ?c literature since publication of this guideline may be available in the Psychiatric Practice section of the APA web site at www psych org CAMERICAN PSYCHIATRIC ASSOCIATION STEERING COMMITTEE ON PRACTICE GUIDELINES John S McIntyre M D Chair Sara C Charles M D Vice-Chair Daniel J Anzia M D Ian A Cook M D Molly T Finnerty M D Bradley R Johnson M D James E Nininger M D Paul Summergrad M D Sherwyn M Woods M D Ph D Joel Yager M D AREA AND COMPONENT LIAISONS Robert Pyles M D Area I C Deborah Cross M D Area II Roger Peele M D Area III Daniel J Anzia M D Area IV John P D Shemo M D Area V Lawrence Lurie M D Area VI R Dale Walker M D Area VII Mary Ann Barnovitz M D Sheila Hafter Gray M D Sunil Saxena M D Tina Tonnu M D STAFF Robert Kunkle M A Senior Program Manager Amy B Albert B A Assistant Project Manager Laura J Fochtmann M D Medical Editor Claudia Hart Director Department of Quality Improvement and Psychiatric Services Darrel A Regier M D M P H Director Division of Research CCONTENTS Statement of Intent Guide to Using This Practice Guideline Development Process Part A Treatment Recommendations for Patients With Substance Use Disorders I Executive Summary of Recommendations A Coding System B General Treatment Principles C Nicotine Use Disorders Treatment Principles and Alternatives D Alcohol Use Disorders Treatment Principles and Alternatives E Marijuana Use Disorders Treatment Principles and Alternatives F Cocaine Use Disorders Treatment Principles and Alternatives G Opioid Use Disorders Treatment Principles and Alternatives II General Treatment Principles A Goals of Treatment B Assessment C Treatment Settings D Psychiatric Management E Somatic Treatments F Psychosocial Treatments G Clinical Features In uencing Treatment H Legal and Con ?dentiality Issues III Treatment of Nicotine Dependence A Overview B Assessment C Treatment Settings D General Approach to Treatment E Somatic Treatments F Psychosocial Treatments G Treatment of Smokers on Smoke-Free Wards H Clinical Features In uencing Treatment IV Treatment of Alcohol-Related Disorders A Overview B Treatment Settings C Somatic Treatments Treatment of Patients With Substance Use Disorders CD Psychosocial Treatments E Clinical Features In uencing Treatment V Treatment of Marijuana-Related Disorders A Overview B Treatment Setting C Somatic Treatments D Psychosocial