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Treating anxiety complicated by substance misuse (2002)

Treating anxiety complicated by substance misuse (2002)

  1. davestate
    Advances in Psychiatric Treatment(2002) 8:107-116 doi:10.1192/apt.8.2.107


    Anne Lingford-Hughes, John Potokar and David Nutt


    The relationship between anxiety disorders and substance misuse is intimate. Here we concentrate on alcohol, although for completeness we also briefly mention other substances taken for anxiety relief or
    that cause anxiety. The term ‘misuse’ is important and should be qualified. Many people drink alcohol or take illicit drugs without any apparent consequences. Once this use becomes problematic, at any level of consumption, misuse is a more appropriate term. Recent research exploring the molecular underpinning of anxiety disorders, together with advances in our understanding of how alcohol affects brain neurochemistry, can help to explain this intimate relationship. We review the evidence and how this can provide a framework for both diagnosis and management in a patient with comorbidity. Few studies address the best way of managing patients with dual diagnosis but several drugs are licensed for the treatment of individual anxiety disorders and are likely to be helpful in combination with alcohol treatment strategies.