Since the publication in May 2006 of APA’s Practice Guideline for the Treatment of Patients With Substance Use Disorders, 2nd Edition (1), results have been reported for a multisite randomized, controlled trial evaluating the efficacy of medication, behavioral therapies, and their combinations for treatment of alcohol dependence in nonspecialty treatment settings (the COMBINE study, 2). In addition, two novel pharmacotherapies have been approved for use in the treatment of nicotine dependence (varenicline) and alcohol dependence (intramuscular naltrexone). This watch describes these developments.

During development and approval of this guideline watch, Dr. Connery received research support through the Eleanor and Miles Shore Fellowship at Harvard Medical School, the National Institute on Drug Abuse, and the National Institute on Alcohol Abuse and Alcoholism. Dr. Kleber served on the Scientific Advisory Board for the Researched Abuse, Diversion, and Addiction-Related Surveillance (RADARS) System and the Scientific Advisory Board for Abbott Laboratories; he served as a consultant to Alkermes; and he received grant support from the National Institute on Drug Abuse. The Executive Committee on Practice Guidelines has reviewed this watch and finds no evidence of influence from these relationships.

The American Psychiatric Association’s (APA’s) practice guidelines are developed by expert work groups using an explicit methodology that includes rigorous review of available evidence, broad peer review of iterative drafts, and formal approval by the APA Assembly and Board of Trustees. APA practice guidelines are intended to assist psychiatrists in clinical decision-making. They are not intended to be a standard of care. The ultimate judgment regarding a particular clinical procedure or treatment plan must be made by the psychiatrist in light of the clinical data presented by the patient and the diagnostic and treatment options available. Guideline watches summarize significant developments in practice since publication of an APA practice guideline. Watches may be authored and reviewed by experts associated with the original guideline development effort and are approved for publication by APA’s Executive Committee on Practice Guidelines. Thus, watches represent opinion of the authors and approval of the Executive Committee but not policy of the APA. This guideline watch was published in April 2007. Copyright © 2007. American Psychiatric Association. All rights reserved.