NURS-243 Co-occurring Mental Disorders

Co-occurring Disorders

• Coexistence of a mental and a substance use disorder (SUD)

  • Both are primary mental disorders

  • Difficult to determine between recreational use and actual substance abuse

Co-occurring Disorders Treatment Goal

• comprehensive recovery plan for the complex problems presented

Risk for Substance Abuse

• Antisocial Personality Disorder

• Bipolar Depression

• Conduct Disorder

• Oppositional Defiant Disorder

• Attention-deficit hyperactivity disorder

Most Commonly Used Substances

1. Alcohol

2. Marijuana

3. Cocaine

Barriers to Treatment

• Denial of problem

  • Treatment not sought

  • Reluctant for treatment

• Stigma

• Health Issues

Stages of Treatment

1. Engagement

2. Persuasion/Motivation

3. Active Treatment

4. Relapse Prevention

Mood Disorders and Substance Use

• Substance use often to self-medicate underlying mood disorder

• difficult to differentiate between disorders

• Treated w/SSRIs

Anxiety Disorders and Substance Use

• Symptoms of anxiety: from anxiety disorder or secondary to drug or alcohol use (withdrawal)

• Self-medication for emotional pain

• Treated w/SSRIs, mood stabilizers

Personality Disorders and Substance Use

• Highest risk associated with antisocial personality disorder

Interventions for Persons With Co-occurring Disorders

• Medication Management

• Substance-abuse counseling

• Cognitive-behavioral therapy

• Patient education

• Mutual self-help groups

• Family support/education

Continuum of Care

• Outpatient treatment

• Hospitalization

  • Detoxification

  • Exacerbation of medical disorders

• Crisis Stabilization

• Recovery

  • Social network

  • Relapse prevention plan