Co-Occurring Basics
Which year were the terms dual diagnosis and co-occurring disorder (COD) introduced?
1980
- The active problem/need that is the focus of treatment.
- The specific goals/objectives tied to the problem/need.
- Interventions that will be used to help client move toward goals.
Which symptoms can complicate and confuse the dual diagnosis of ADHD and SUD?
Hyperactivity
Hypomania or Mania
Opioid withdrawal
Stimulant intoxication
What is a main treatment of Inpatient care?
Detox
Why are people with co-occurring disorders frequently drawn to alcohol? What is the long term issue?
-Short-term -decreased anxiety, enhanced social ease
-Long-term - lead to a broad range of clinical presentations
In the past, did substance abuse treatment include also treating mental health disorders?
False
Why would we use the Sequential Treatment approach now? Give 1 example.
Safety reasons.
Exp. Client needing to safely withdraw prior to treatment.
What is a key issue in the assessment of co-occurring depressive disorder and SUD? Name 2.
-Other mood episodes (hypomania or mania)
-Hx of depressive episodes that predates substance use issues
-Medications that cause depressive sx
-Family hx of other mood disorders/depressive disorders
-Medical condition present
-Withdrawal from substances
-Psychosocial stresses
True/False
A partial hospitalization program (PHP) focuses more on group support than individual needs/goals.
True
What are some underutilized treatments for tobacco use?
- Therapeutic strategies
- Medications
- Decisions made at government and organizational levels to increase likelihood of someone quitting
What is the "no wrong door" policy?
First presentation of mental health symptoms or first reason to pursue SUD treatment → Entirety needs to be addressed
This treatment approach includes different treatment settings and different providers.
Parallel Treatment
What will a pharmacology regimen include for someone suffering Bipolar Disorder and SUD?
Mood stabilizers
Medications to assist with substance cravings and other comorbid psychiatric disorders and sx
What are the 3 categories of a Residential program?
Addiction only
COD capable - mostly focused on SUD
COD enhanced - treat both
What are the 3 types of opioids?
-Agonist/Pure agonist-no ceiling effect (heroin, methadone, fentanyl)
-Antagonist - bind to opiate receptor and block from availability to other substances (Suboxone, Narcan)
-Partial agonist - has ceiling effect
What does it mean to practice with cultural competence?
Practicing with a focus on the whole person → multicural & systemic awareness, diverse practices, knowledge, & consultation
What do we help the client identify when they engage in Integrated Treatment?
How their dual diagnoses impact each other.
What is one point to remember during the assessment process of someone suffering PTSD and SUD?
-Withdrawal state - this can worsen anxiety, depression, and irritability
-Following a binge, anxiety sx can be exacerbated
-Which came first? Anxiety sx or substance abuse bx
Name 1 setting someone suffering low severity of both mental health and substance issues (sm) could benefit from.
Private practice, outpatient clinics.
May/may not require medication/medical component
How does cannabis affect both schizophrenia and bipolar disorder?
-Schizophrenia- increased psychotic sx
-Bipolar disorder-frequency of mania, psychosis, suicide attempts, and overall illness severity