[Compulsion and impulsion of substance dependence: frontline of pharmacotherapy for craving].

Substance-seeking behavior appears to be compulsive because of unclear motivation, and also appears to be impulsive because of difficulty to be predicted. Compulsivity and impulsivity of substance-dependent individuals are common in unaccountability. This unaccountability is the result form craving for psychoactive substance. If a therapist does not understand it, a treatment session is likely to be punished, not psychotherapeutic. This paper reviews the pharmacotherapies conducted in foreign countries, and suggests the pharmacotherapies which are expected to be introduced into Japan. One of the reasons why psychiatrists tend to be reluctant to treat substance-dependent patients is that there have been no available pharmacotherapies in Japan. Accordingly, pharmacotherapies for substance dependence are required to be developed and established.