Other sedatives drugs, such as benzodiazepines, have properties similar to alcohol (as described in the module on detoxification of benzodiazepine users), and the management of patients after detoxification is conceptually similar:
- cognitive behavioral therapy,
- re-establishment of alternative activities not related to obtaining and using drugs,
- possibly linked with random urine drug screens.
Cocaine and other stimulant addiction is very common, and no FDA-approved pharmacotherapy exists. However, several trials have shown promise using anticonvusants, and other medications including disulfiram. The use of relapse prevention medications is very complex in these patients and should be managed by an addiction specialist.
A much more complicated issue is the polydrug user: a subset of patients appear to use whatever drug is available: alcohol, cocaine, heroin, other stimulants, maybe mix in benzodiaepeines to counteract the highs. These patients typically have severe psychosocial stressors and are very difficult to treat. Patients with polysubstance abuse can present significant psychosocial and pharmacologic management challenges and are best managed by a team approach led by an addictions specialist.