Prescribing psychotropic agents in opiate dependency: the need for caution.

The value of prescribing psychotropes to narcotic-dependent persons depends upon the indications for such prescriptions. This paper reviews the prevalence of psychological disorders in opiate dependency, effectiveness of existing psychotropic agents in treating these disorders and risks of prescribing these agents in a less than controlled, conservative manner. The existing data suggest that although psychotropic drugs are effective in specific narcotic-dependent persons, the potential for misuse, abuse and dependency is quite real. Such drugs should be prescribed only after careful consideration, with close monitoring for compliance. The most effective management of narcotic dependency in those without severe psychiatric symptoms may be psychotherapy combined with regular clinic services. If such therapy is effective, it is preferred to prescription of a mood-altering drug to an individual with a past history of substance abuse.