Concurrent Substance and Addictive Disorders Flashcards
What is a concurrent disorder?
Person has at least 1 substance related/addictive disorder co-occurring with at least one another mental disorder. This is very common and there’s lots of different combinations.
Should you screen for a concurrent mental disorder when someone has a substance related/addictive disorder?
yes it’s recommended
How many people that seek help from addiction also suffer from a mental disorder?
50%
6 domains to assess in concurrent disorders?
- Acute intoxication or withdrawal potential
- Biomedical conditions and complications
- Emotional/behavioural/cognitive conditions
- Readiness to change (most important)
- Relapse/continued use/continued problem potential
- Recovery environment
What is sequential treatment ?
One treatment after the other so it focuses on one treatment at a time
What is parallel care?
Different providers/treatment teams address each disorder separately.
Integrated care?
Attempt to fully/partially blend behavioural health services with medical services. The same provider/treatment team will address both disorder concurrently. This is the best approach.
Concurrent substance use/mood disorders?
15-50% of substance use disorder have dx of at least one depressive disorder. Bipolar/substance use disorder prevalence is 40%. There’s an increased suicide risk and need to implement integrated care
Most effective therapy for substance use/anxiety disorder?
CBT
Substance use and PTSD?
60% of people who suffer from PTSD also suffer from addictive disorder. Treatment is combining first line medication with EMDR, prolonged exposure therapy, or cognitive processing therapy.
Substance used and ADHD interventions?
Stimulant medications, non stimulant medications, psychosocial interventions (CBT).
Substance use and psychotic disorder interventions?
Ensure adequate safety/security, concurrent treatment of psychotic symptoms/substance use, medication adherence, pharmacotherapy, and psychosocial approaches
Substance use and personality disorder interventions?
DBT, ensure safety to self/others, pharmacotherapy for combed conditions like (MDD, ED)
Nursing management for concurrent disorders?
Recognize sigma, relapse prevention, psychoeducation for goal setting, denial is a common defensive mechanism, use a non judgemental approach