Mirin S M, Weiss R D
Psychiatr Clin North Am. 1986 Sep;9(3):503-14.
The evaluation and treatment of substance abusers are complicated tasks, requiring a multifaceted approach. In addition to the patient's substance abuse problems, a substantial minority appear to be suffering from concurrent, nondrug-related psychiatric disorders. The early identification of such individuals allows for the development of specific treatment strategies that address both the substance abuse and the associated nondrug psychopathology. On the other hand, attention to nondrug psychopathology should not preclude our simultaneously addressing the patient's substance abuse problem. Thus, manic depressive patients who are also alcoholic may need a treatment program that includes alcoholism counseling. Alcoholics Anonymous, and chronic administration of disulfiram in addition to lithium carbonate and a supportive psychotherapeutic relationship. As in other areas of medicine, attention to the "whole patient" is the sine qua non of good treatment.
对药物滥用者的评估和治疗是复杂的任务，需要多方面的方法。除了患者的药物滥用问题外，相当一部分人似乎同时患有与药物无关的精神疾病。尽早识别这些人有助于制定针对药物滥用和相关非药物精神病理学的具体治疗策略。另一方面，关注非药物精神病理学不应妨碍我们同时解决患者的药物滥用问题。因此，患有躁郁症且酗酒的患者可能需要一个包括酗酒咨询、戒酒互助会以及除碳酸锂和支持性心理治疗关系之外长期服用双硫仑的治疗方案。与医学的其他领域一样，关注“整体患者”是良好治疗的必要条件。
