Due to the pervasive nature of co-occurring disorders, particularly mental health conditions paired with substance abuse, treatment for such illnesses can be daunting. Co-occurring disorders are often treated by a combination of behavioral and pharmacological approaches, thus increasing the treatment’s effectiveness. However, treatment for comorbidity using medications can present its own share of problems as well.
Co-Occurring Disorders With Substance Abuse
It’s frequently the case that mental health problems are compounded or further exacerbated by the use of substances such as alcohol and illicit drugs. Abuse of these substances can cause a person to exhibit symptoms indicative of mental illness or heighten the symptoms of the existing mental illness. Conversely, those suffering from mental illnesses may use drugs or alcohol to self-medicate the negative aspects of the illness. Psychology Today estimates that nearly half of all persons suffering from a severe mental illness will also use alcohol or other substances. It is not uncommon to see persons with major depressive disorder use cocaine in order to combat or stabilize the symptoms of depression, for example. In effect, it can be difficult to diagnose one or the other until the alcohol and drugs are out of the individual’s system.
Not only can substance abuse complicate the mental illness and its symptoms, but it can also lead to several other problems for the individual that include decreased performance at work or school, hospitalization, increased risk of relapse, impaired social function, increased possibility for infectious diseases like HIV, and effectiveness of medication.
Guidelines and Principles for Pharmacological Treatment of Comorbidity
It is strongly recommended that clinicians use good judgment and careful monitoring when prescribing medication to a person with a co-occurring disorder, particularly those with heavy or severe substance abuse and/or addiction problems. The Substance Abuse and Mental Health Services Administration (SAMHSA) outlined 15 principles for pharmacological treatment that span from general maintenance to diagnosing the disorder. We’ll highlight a few below:
- Engagement. A clinician prescribing medication should provide both medication and treatment information to the individual. Additionally, the prescriber of medication should also ensure that the individual has access to medication and other treatment approaches.
- Shared decision-making. Because persons with co-occurring disorders can often be resistant to treatment, it’s recommended that clinicians and individuals work together to develop an individualized treatment plan.
- Screening and assessment. Current or ongoing substance abuse can cause a hindrance when prescribing medication to an individual. It’s important to wait until the alcohol and drugs have left the body before making a diagnosis. Assessment should also occur over time, as some symptoms of mental illness can remain latent for a time or occur sporadically.
- Integrated interventions. Using both a combination of behavioral or cognitive approaches with pharmacological methods can be most effective in helping a person overcome substance abuse and manage his/her mental illness. Plans including medication should always be developed using a person-centered approach that fosters personal well-being, recovery goals, and long-term maintenance.
- Medications and crossover benefits. It’s interesting to note that some medications used to treat substance abuse may very well show some benefit to reducing the severity of the symptoms of mental illness. This can also work inversely in that medications for mental illness can help with substance abuse recovery. Prescribing physicians should be aware of the potential crossover benefits, but also remain mindful of possible risks.
Getting Help for Co-Occurring Disorders
The Oaks at La Paloma is proud to have a knowledgeable team of nurses, counselors, and consulting physicians who understand the complexity of co-occurring disorders. We have the tools and resources necessary to help you develop a personalized treatment plan that focuses on your recovery and maintenance of your mental illness. The important part of the recovery process is for you to remain committed to your goals and learn that the road to a happy life is within your reach. Let The Oaks at La Paloma help you; call us today.