8. Substance dependence
8.1 Alcohol dependence
|The drugs listed below are for the acute/initial management of alcohol dependence and withdrawal. For longer term management and relapse prevention service users should be referred to CDAT service run by CRI.|
|Chlordiazepoxide||5mg capsules or tablets||See chlordiazepoxide for alcohol withdrawal regime|
|Thiamine||50mg and 100mg tablets|
|Vitamin B Co strong||Tablets|
|High potency vitamin B complex (Pabrinex)||IM injection||For in-patient use.
Facilities for treating anaphylaxis (including resuscitation facilities should be available when parenteral thiamine is administered.
8.2 Nicotine dependence
Transdermal patch: Nicorette® Inivsi Patches 25mg, 15mg and 10mg
Orodispersible film (strips): NiQuitin® 2.5mg oral film
Sublingual tablet: Nicorette® Microtab 2mg
Nasal spray: Nicorette® 500 microgram per actuation
Mouth spray: Nicorette® Quickmist 1mg per actuation
|See Nicotine Replacement Therapy Guidelines for Inpatients|
|Varenicline tartrate||500microgram and 1mg tablet.||
Clinicians should be aware of the possible emergence of serious neuropsychiatric symptoms in patients attempting to quit smoking with or without treatment. Smoking cessation, with or without pharmacotherapy, has been associated with exacerbation of underlying psychiatric illness (e.g. depression). Care should be taken with patients with a history of psychiatric illness and patients should be advised accordingly.
8.3 Opioid dependence
|Treatment of opioid dependence usually requires specialist intervention - generalists who do not have specialist experience should contact CDAT services before attempting to treat opioid dependence.
NICE -TA114 - Methadone and buprenorphine for the management of opioid dependence
|Buprenorphine hydrochloride||400microgram, 2mg and 8mg sublingual tablets||CD. Only in accordance with specialist recommendations.|
|Methadone hydrochloride||1mg/ml SF oral solution||CD. Only in accordance with specialist recommendations.|