After completing this module, you should be more aware of:

• distinctions between dependence, addiction, substance misuse disorder and withdrawal;
• key elements of behavioural and biological changes in addiction;
• the range of neuronal systems and neurotransmitters which are affected by repeated exposure to compounds capable of causing dependency and addiction;
• the significance of opioid receptors, subtypes and the functions they can influence;
• roles and relationships between dopamine , gamma aminobutyric acid (GABA), opioids and alcohol;
• pharmacological approaches to managing substance misuse;
• differences between methadone and buprenorphine in substitution therapy;
• how lofexidine, an adrenergic agonist, can be used in opioid dependency and why lofexidine is preferred to clonidine;
• naltrexone’s role in tackling opioid and alcohol dependency;
• bupropion’s potential in smoking cessation and, when in combination with naltrexone, its contribution to weight management in obesity;
• differences between acamprosate and nalmefene in alcohol dependency;
• naloxone’s opioid antagonist activity but general lack of pharmacological activity otherwise;
• naloxone in emergency treatment in opioid overdoses and ‘take home’ supplies;
• proposals to allow pharmacists and pharmacy technicians to supply naloxone without prescription, along with other named professionals.