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01 - Introduction

Maudsley's guidelines 09 - Chapter 4 Addictions and substance...

Introduction The Maudsley® Prescribing Guidelines in Psychiatry, Fifteenth Edition. David M. Taylor, Thomas R. E. Barnes and Allan H. Young. © 2025 David M. Taylor. Published 2025 by John Wiley & Sons Ltd. Chapter 4 Introduction Mental and behavioural problems...

02 - References

Maudsley's guidelines 09 - Chapter 4 Addictions and substance...

References 478 The Maudsley® Prescribing Guidelines in Psychiatry CHAPTER 4 ■ ■evidence of tolerance ■ ■neglect of alternative interests ■ ■persistent use despite harm. Substance use disorders should generally be treated with a combination of psychosocial and ...

03 - Alcohol dependence

Maudsley's guidelines 09 - Chapter 4 Addictions and substance...

Alcohol dependence

04 - Assessment and brief structured intervention

Maudsley's guidelines 09 - Chapter 4 Addictions and substance...

Assessment and brief structured intervention Addictions and substance misuse CHAPTER 4 Alcohol dependence In the UK 1 unit of alcohol is 10mL of ethanol or 1L of 1% alcohol. For example, 250mL of wine that is 10% alcohol contains 2.5 units. In the USA, one dri...

05 - Alcohol withdrawal

Maudsley's guidelines 09 - Chapter 4 Addictions and substance...

Alcohol withdrawal 480 The Maudsley® Prescribing Guidelines in Psychiatry CHAPTER 4 The following structured assessment tools are recommended:2 ■ ■The Alcohol Use Disorders Identification Test (AUDIT)4 questionnaire is a ­10-­item questionnaire which is useful...

06 - Pharmacologically assisted withdrawal (alcoho

Maudsley's guidelines 09 - Chapter 4 Addictions and substance...

Pharmacologically assisted withdrawal (alcohol detoxification) 482 The Maudsley® Prescribing Guidelines in Psychiatry CHAPTER 4 Pharmacologically assisted withdrawal (alcohol detoxification) Alcohol withdrawal is associated with significant morbidity and morta...

07 - Wernickes encephalopathy

Maudsley's guidelines 09 - Chapter 4 Addictions and substance...

Wernicke’s encephalopathy Addictions and substance misuse CHAPTER 4 Carbamazepine is an alternative to a benzodiazepine for managing withdrawal in situations where benzodiazepines are not a safe first-­line option.15,16 Examples include: ■ ■A history of advers...

08 - Relapse prevention

Maudsley's guidelines 09 - Chapter 4 Addictions and substance...

Relapse prevention Addictions and substance misuse CHAPTER 4 Relapse prevention There is no place for the continued use of benzodiazepines beyond treatment of the acute alcohol withdrawal syndrome. Acamprosate and supervised disulfiram are licensed in some cou...

09 - Pregnancy and alcohol use

Maudsley's guidelines 09 - Chapter 4 Addictions and substance...

Pregnancy and alcohol use 492 The Maudsley® Prescribing Guidelines in Psychiatry CHAPTER 4 Baclofen Baclofen is a GABA-­B agonist that does not have a licence for use in alcohol ­dependence but is nevertheless used by some clinicians as second-­line treatment ...

10 - Children and adolescents

Maudsley's guidelines 09 - Chapter 4 Addictions and substance...

Children and adolescents

11 - Older adults

Maudsley's guidelines 09 - Chapter 4 Addictions and substance...

Older adults

12 - Concurrent alcohol and substance use disorder

Maudsley's guidelines 09 - Chapter 4 Addictions and substance...

Concurrent alcohol and substance use disorders Addictions and substance misuse CHAPTER 4 ­healthcare professionals and likes to follow up on pregnancies that require alcohol ­detoxification. Specialist advice should always be sought. (See also Chapter  7.) No ...

13 - Comorbid mental health disorders in AUD

Maudsley's guidelines 09 - Chapter 4 Addictions and substance...

Comorbid mental health disorders in AUD 494 The Maudsley® Prescribing Guidelines in Psychiatry CHAPTER 4 Coexisting alcohol and nicotine dependence Encourage individuals to stop smoking. Refer for smoking cessation in primary care and other settings. In in-­pa...

14 - References

Maudsley's guidelines 09 - Chapter 4 Addictions and substance...

References 496 The Maudsley® Prescribing Guidelines in Psychiatry CHAPTER 4 ­optimised11 and clozapine may be considered. However, there is insufficient evidence to recommend the use of any one antipsychotic medication over another in AUD. Antipsychotics do no...

15 - Opioid dependence

Maudsley's guidelines 09 - Chapter 4 Addictions and substance...

Opioid dependence

16 - Prescribing for opioid dependence

Maudsley's guidelines 09 - Chapter 4 Addictions and substance...

Prescribing for opioid dependence

17 - Treatment of opioid overdose

Maudsley's guidelines 09 - Chapter 4 Addictions and substance...

Treatment of opioid overdose 498 The Maudsley® Prescribing Guidelines in Psychiatry CHAPTER 4 Opioid dependence Prescribing for opioid dependence The treatment of opioid dependence is a rapidly changing and dynamic field. A decade or so ago, maintenance treatm...

18 - Opioid substitution treatment (OST)

Maudsley's guidelines 09 - Chapter 4 Addictions and substance...

Opioid substitution treatment (OST) 500 The Maudsley® Prescribing Guidelines in Psychiatry CHAPTER 4 Opioid substitution treatment (OST) The mainstay of pharmacological management of opioid dependence is OST. OST can be prescribed for detoxification, that is, ...