Abstract
Taking psychoactive substances can cause psychiatric symptoms as well as behavioral disturbances. Opioids and psychostimulants such as cocaine and amphetamine have strong addictive potential. Substitute treatment with agonists of opioid receptors, mainly methadone, or antagonist of opioid receptors –naltrexone, is available only in few places in Poland.There are no algorithms in the treatment of substance dependence, although trials with antidepressants, mood stabilizers or with drugs acting by “disrupting the reward circuit”, such as flupenthixol, disulfiram or naltrexone have been conducted. The efficacy of the pharmacotherapy in the treatment of the relapse in addictive disturbances is minimal. In recent two decades there has been a growing interest in the patients showing comorbidity of psychiatric disorder and various substance use. Clinical observations have shown that such patients stay shorter in treatment, have more frequent hospitalizations, exhibit more aggressive and suicidal behaviour, and the results of their treatment are worse compared to the patients with only one diagnosis.