This category includes “uppers” (cocaine, crack, methamphetamine, Adderall, Ritalin, ecstasy) and are notoriously difficult to treat due to lack of adequate medications to target the addiction. The treatment of choice is not medications, it’s psychotherapy/behavioral treatment. In the literature, there is some evidence for the use of Naltrexone, Topamax and even smaller evidence for Depakote. The mainstay of treatment will be detox and psychotherapy.
Addiction to nicotine is not only a physiologic addiction, but is also strongly ingrained in the daily habits of the smoker. Many people are under the impression that switching to vaporizing is healthier, however, the literature does not support this notion at this time. The healthier choice will always be abstinence from cigarettes/vaping. Medications that can help you to become abstinent include but are not limited to nicotine replacement (nicotine gum, lozenges), Varenicline (Chantix) and Buproprion (Wellbutrin). A strong desire to quit combined with medication and behavioral therapy have a high likelihood of getting and staying clean.
Long term hallucinogen use (LSD, mushrooms, PCP, salvia), has profound effects on one’s baseline mental status. This category of substance use also does not have many medications that can help with the addiction itself. If there are underlying mental health problems then those areas can be targeted, otherwise, the treatment of choice is detox and psychotherapy.