New horizons for therapeutics in drug and alcohol abuse

Alcohol, tobacco and illicit drug dependence represents a serious health and social issue within the community. As drug dependence has become more widely recognized as a clinical disorder and the severity of the problem been fully realized, options available for treatment have grown along with our understanding of the neurobiological mechanisms underlying the development and persistence of addiction. Treatment has progressed from purely social and behavioral approaches to now encompass pharmacotherapy to attempt to disrupt the mechanisms underlying these disorders. Despite these advances, many forms of addiction lack effective therapeutics and the prevalence of this disorder remains unacceptably high. As a result, a significant effort within the research community has been dedicated to the identification of novel targets for the development of therapeutics based upon our understanding of the pathological processes underlying addiction. The current review aims to provide an overview of existing and clinically trialed pharmacotherapies for alcohol, opiate, psychostimulant, nicotine, cannabis and inhalant addictions. Further, we discuss some of the potential targets that have been recently indentified from basic studies that may hold promise for the development of novel treatments. (C) 2009 Elsevier Inc. All rights reserved.