Substance Use Disorders
Problematic use across alcohol, opioids, stimulants, cannabis, or other substances.
Combined approaches outperform single modalities. Engagement and ambivalence work (MI) precedes change-focused treatment. Medication-assisted treatment (MAT) is essential for opioid and alcohol use disorders.
First-line:MI · CBT
Behavioral Addictions
Compulsive engagement in non-substance behaviors (gambling, gaming, pornography, shopping) despite harm.
Gambling disorder is the only DSM-5 behavioral addiction, but treatment principles generalize. Combine motivational engagement, stimulus control, cognitive work on distortions (gambler's fallacy, escape coping), and relapse prevention.
First-line:CBT · MI