Medical Treatment for Substance Use Disorder (SUD)

Comprehensive Treatment Approach

The American Medical Association recommends that all individuals at risk for or with HIV should receive screening, diagnosis, and treatment for SUDs, with a strong evidence base 1
Early identification of substance use problems is critical, using standardized screening tools in healthcare settings, as recommended by the American Academy of Child and Adolescent Psychiatry 3
Screening, Brief Intervention, and Referral to Treatment (SBIRT) should be implemented in various settings including primary care, with moderate evidence supporting its effectiveness 3

The American College of Physicians recommends FDA-approved medications for specific SUDs, including methadone, buprenorphine, and naltrexone for opioid use disorder, with high evidence quality 2, 4
The American College of Physicians also recommends naltrexone and acamprosate for alcohol use disorder, with moderate evidence quality 2, 4

The American Psychological Association recommends evidence-based behavioral approaches, including cognitive-behavioral therapy (CBT), contingency management, and motivational enhancement therapy, with strong evidence supporting their effectiveness 2, 5, 6
Combined pharmacotherapy with CBT shows greater efficacy than usual care with pharmacotherapy, as reported by the JAMA network open, with high evidence quality 5, 7

The American Society of Addiction Medicine recommends medication-assisted treatment (MAT) as the gold standard for opioid use disorder, combining medications with behavioral therapies, with high evidence quality 2, 4
The American Society of Addiction Medicine also recommends first-line pharmacotherapy, including naltrexone and acamprosate, for alcohol use disorder, with moderate evidence quality 2, 4

The National Institute of Mental Health recommends integrated treatment for co-occurring mental health disorders and SUDs, with moderate evidence supporting its effectiveness 1
The Centers for Disease Control and Prevention recommends harm reduction services, including naloxone distribution, safe injection education, and referral to syringe service programs, with strong evidence supporting their effectiveness 1, 2

The National Institute on Drug Abuse recommends digital interventions for prevention, early intervention, and treatment, with emerging evidence supporting their effectiveness 3
The American Academy of Neurology recommends neuromodulation techniques, such as transcranial magnetic stimulation, as adjunctive treatments, with emerging evidence supporting their effectiveness 6

The American Medical Association recommends avoiding withholding SUD medications due to concerns about drug interactions with HIV or HCV treatments, with strong evidence supporting their safety 1
The American Academy of Child and Adolescent Psychiatry recommends avoiding focusing solely on abstinence rather than harm reduction approaches, with moderate evidence supporting the importance of harm reduction 1, 3