Evidence-based consensus guidelines for the pharmacological management of substance dependence: Recommendations from the British Association for Psychopharmacology

Julia M.A. Sinclair; Nicola J. Kalk; Stephen J. Kaar; Roberta Agabio; Shalini Arunogiri; Adam Bisaga; Edward Chesney; Chris Daly; Jonathan Dewhurst; Tom P. Freeman; Abhishek Ghosh; Sophia Hemrage; Lorenzo Leggio; Anne Lingford-Hughes; Catriona Matheson; Rebecca McKetin; Louise M. Paterson; Emmert Roberts; Deborah Robson; Jenny Scott; Sarah Welch

doi:10.1177/02698811251399593

Evidence-based consensus guidelines for the pharmacological management of substance dependence: Recommendations from the British Association for Psychopharmacology

Julia M.A. Sinclair, Nicola J. Kalk, Stephen J. Kaar, Roberta Agabio, Shalini Arunogiri, Adam Bisaga, Edward Chesney, Chris Daly, Jonathan Dewhurst, Tom P. Freeman, Abhishek Ghosh, Sophia Hemrage, Lorenzo Leggio, Anne Lingford-Hughes, Catriona Matheson, Rebecca McKetin, Louise M. Paterson, Emmert Roberts, Deborah Robson, Jenny ScottSarah Welch

Research output: Contribution to journal › Article › peer-review

Abstract

The British Association for Psychopharmacology guidelines for the management of substance dependence focus primarily on the pharmacological aspects of treatment. A group of international experts from a wide range of disciplines reviewed the current evidence in their field, considered the strength of the evidence and discussed the clinical implications at a consensus meeting. The guidelines focus on the pharmacological management of dependence on alcohol, benzodiazepines, ‘z-drugs’, γ-hydroxybutyrate (GHB), gabapentinoids, opioids, nicotine, cannabis and synthetic cannabinoids, cocaine, amphetamine and methamphetamine, dissociative drugs and their analogues. They are based on the available evidence and make recommendations to aid clinical decision making, as well as highlighting the gaps in the current evidence-base.

Original language	English
Journal	Journal of Psychopharmacology
Early online date	23 Feb 2026
DOIs	https://doi.org/10.1177/02698811251399593
Publication status	E-pub ahead of print - 23 Feb 2026

Data Availability Statement

Data sharing not applicable to the article as no datasets were generated or analysed during the current study.

Funding

The authors disclosed receipt of the following financial support for the research, authorship, and/or publication of this article: The following authors acknowledge funding sources for their research time: JMAS is supported by the National Institute for Health and Care Research (NIHR Southampton Biomedical Research Centre (NIHR203319); NJK by the National Institute for Health and Care Research (NIHR) Maudsley Biomedical Research Centre (BRC); SJK has received Wellcome Trust and NIHR research funding via the Mental Health Implementation Network, Manchester Academic Health Science Centre and Greater Manchester Applied Research Collaboration, and the Efficacy and Mechanism Evaluation programme; SA is supported by Australian National Health and Medical Research Council (NHMRC) Investigator Grant (GNT2008193); TPF is funded by a UKRI Future Leaders Fellowship (MR/Y017560/1); LL is a NIH federal employee and is supported by the NIH Intramural Research Program (NIDA/NIAAA). The contributions of the NIH authors were made as part of their official duties as NIH federal employees, follow agency policy requirements, and are considered Works of the United States Government. However, the findings and conclusions presented in this paper are those of the authors and do not necessarily reflect the views of the NIH or the U.S. Department of Health and Human Services; ER is funded by an NIHR Advanced Fellowship (NIHR302215).

UN SDGs

This output contributes to the following UN Sustainable Development Goals (SDGs)

SDG 3 Good Health and Well-being

Keywords

detoxification
evidence-based guidelines
harm reduction
international
medically assisted withdrawal
pharmacotherapy
relapse prevention
substance dependence
substance use disorder
substitution therapy
tapering
treatment

ASJC Scopus subject areas

Pharmacology
Psychiatry and Mental health
Pharmacology (medical)

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10.1177/02698811251399593Licence: CC BY-NC

Cite this

Sinclair, J. M. A., Kalk, N. J., Kaar, S. J., Agabio, R., Arunogiri, S., Bisaga, A., Chesney, E., Daly, C., Dewhurst, J., Freeman, T. P., Ghosh, A., Hemrage, S., Leggio, L., Lingford-Hughes, A., Matheson, C., McKetin, R., Paterson, L. M., Roberts, E., Robson, D., ... Welch, S. (2026). Evidence-based consensus guidelines for the pharmacological management of substance dependence: Recommendations from the British Association for Psychopharmacology. Journal of Psychopharmacology. Advance online publication. https://doi.org/10.1177/02698811251399593

Sinclair, JMA, Kalk, NJ, Kaar, SJ, Agabio, R, Arunogiri, S, Bisaga, A, Chesney, E, Daly, C, Dewhurst, J, Freeman, TP, Ghosh, A, Hemrage, S, Leggio, L, Lingford-Hughes, A, Matheson, C, McKetin, R, Paterson, LM, Roberts, E, Robson, D, Scott, J & Welch, S 2026, 'Evidence-based consensus guidelines for the pharmacological management of substance dependence: Recommendations from the British Association for Psychopharmacology', Journal of Psychopharmacology. https://doi.org/10.1177/02698811251399593

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abstract = "The British Association for Psychopharmacology guidelines for the management of substance dependence focus primarily on the pharmacological aspects of treatment. A group of international experts from a wide range of disciplines reviewed the current evidence in their field, considered the strength of the evidence and discussed the clinical implications at a consensus meeting. The guidelines focus on the pharmacological management of dependence on alcohol, benzodiazepines, {\textquoteleft}z-drugs{\textquoteright}, γ-hydroxybutyrate (GHB), gabapentinoids, opioids, nicotine, cannabis and synthetic cannabinoids, cocaine, amphetamine and methamphetamine, dissociative drugs and their analogues. They are based on the available evidence and make recommendations to aid clinical decision making, as well as highlighting the gaps in the current evidence-base.",

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Evidence-based consensus guidelines for the pharmacological management of substance dependence: Recommendations from the British Association for Psychopharmacology

Abstract

Data Availability Statement

Funding

UN SDGs

Keywords

ASJC Scopus subject areas

Access to Document

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