Which substances lack FDA-approved pharmacotherapies for dependence and rely primarily on psychosocial treatment?

• A. Cannabis, cocaine, methamphetamine, and many other stimulants have no FDA-approved medications for dependence; rely on psychosocial interventions and, in some cases, off-label meds
• B. All substances have FDA-approved medications for dependence
• C. Only nicotine has no meds
• D. Alcohol has no meds.

Answer: (A)

The main idea here is that some substances currently have no FDA-approved medications to treat dependence, so treatment relies primarily on psychosocial approaches. For cannabis, cocaine, methamphetamine, and many other stimulants, there isn’t an approved pharmacotherapy to treat dependence, which means clinicians focus on evidence-based psychosocial treatments—such as cognitive-behavioral therapy, contingency management, motivational interviewing, and peer-support programs. Off-label medications may be explored in some cases, but they aren’t approved specifically for dependence on these substances.

In contrast, other substances do have FDA-approved pharmacotherapies to support cessation or treatment. Nicotine dependence has several approved options—nicotine replacement therapies, varenicline, and bupropion—while alcohol use disorder has medications like naltrexone, acamprosate, and disulfiram. So the statement pointing to cannabis, cocaine, methamphetamine, and many stimulants as lacking approved pharmacotherapies and relying on psychosocial treatment best captures the current landscape.