Physician–Patient Relationship Considerations

Physician–Patient Relationship Considerations

The treatment of cocaine use disorders should be undertaken in the context of a thorough understanding of the disease (Table 38.2). The physician should develop individual treatment plans for pa-tients based on the presenting complaints and symptoms related to cocaine abuse and any abstinence syndrome. Treatment plans include assessment for psychiatric and medical illnesses, phar-macological interventions, psychotherapy and other psychosocial interventions.

The physician is the provider who will make decisions re-garding pharmacotherapy for cocaine dependence. This is an im-portant consideration because there are currently no medications for cocaine use disorders that are approved by the US Food and Drug Administration. Therefore, any decision to provide medica-tion to assist with the maintenance of abstinence from cocaine abuse must be carefully considered with documentation of the rationale for medication choice, risks and benefits of treatment and informed consent from the patient.