Loading…
Loading…
From dependence to recovery — evidence-based pharmacotherapy and psychosocial intervention
Substance use disorders affect over 36 million people globally and carry high mortality from overdose, medical complications, and suicide. Dr. Ruja's clinic provides integrated dual-diagnosis treatment, recognizing that addiction rarely occurs in isolation — depression, PTSD, ADHD, and personality disorders frequently co-occur and must be treated simultaneously. Treatment combines medication-assisted treatment (MAT), motivational interviewing, relapse prevention therapy, and harm reduction principles.
Kathmandu Neurology Clinic & Cognitive Center
Authored and reviewed by Dr. Ruja Shrestha (MBBS, MD (Psychiatry), NMC 19766). Evidence-based, no fabricated outcomes.
Substance use disorders affect over 36 million people globally and carry high mortality from overdose, medical complications, and suicide. Dr. Ruja's clinic provides integrated dual-diagnosis treatment, recognizing that addiction rarely occurs in isolation — depression, PTSD, ADHD, and personality disorders frequently co-occur and must be treated simultaneously. Treatment combines medication-assisted treatment (MAT), motivational interviewing, relapse prevention therapy, and harm reduction principles.
Reviewed by Dr. Ruja Shrestha, MBBS, MD — Consultant Psychiatrist & CBT Therapist (NMC 19766), Kathmandu Neurology Clinic. For evaluation, book an appointment.
Addiction assessment includes substance use history (type, quantity, frequency, route, duration), dependence indicators (withdrawal, tolerance, loss of control), medical complications, psychiatric comorbidity, and readiness for change. The clinic uses AUDIT (alcohol), DAST-10 (drugs), and ASI (Addiction Severity Index) for structured evaluation. Stage of change assessment (precontemplation → contemplation → preparation → action → maintenance) guides intervention intensity and style.
Pharmacotherapy: alcohol — naltrexone, acamprosate, disulfiram; opioids — buprenorphine/naloxone, methadone, naltrexone; nicotine — varenicline, bupropion, NRT; cannabis — no approved pharmacotherapy, focus on psychosocial. Psychosocial: motivational interviewing for engagement, CBT for relapse prevention, contingency management for behavioral reinforcement, 12-step facilitation, and family therapy. Harm reduction includes naloxone provision, needle exchange referrals, and safe use education.
Guidelines referenced:
SAMHSA TIP 63 — Medications for Opioid Use Disorder: Executive SummaryMattick RP et al. Buprenorphine maintenance versus placebo or methadone maintenance for opioid dependence. Cochrane DatabaseNICE CG115 — Alcohol-use disorders: diagnosis, assessment and managementContent on this website is for general educational purposes only and does not constitute medical advice, diagnosis, or treatment. It is not a substitute for evaluation by a qualified healthcare professional. Always seek the advice of your physician or other qualified provider with any questions regarding a medical condition. Never disregard professional medical advice or delay seeking it because of something you have read on this website. In case of a medical emergency, contact emergency services immediately. No doctor–patient relationship is established by use of this site or by contacting the clinic through the site.