Co-occurring psychiatric and substance use disorders What’s the.ppt

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2018-04-17 发布于江西
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Co-occurring psychiatric and substance use disorders What’s the.ppt

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Co-occurring psychiatric and substance use disorders: What’s the fuss? Richard A. Rawson Ph.D. UCLA Integrated Substance Abuse Programs San Diego, California October 2004 What are we talking about? An oversimplified picture of the behavioral healthcare service systems in the US Mental Health Services Leadership-psychiatrists Staffing-psychologists, social workers, nurses, MFTs Role of medications-Substantial Impact of behavioral therapies research-Substantial Knowledge of substance use disorders and their treatment Minimal Role of self-help-Minimal Substance Abuse Services Leadership-A mixture of recovering addict/alcoholics, business people, professionals Staffing-paraprofessionals, with increasing role of professionals Role of medications and behavior therapies-Minimal Knowledge of psychiatric disorders-Minimal Role of self-help-Substantial The prototype patients for the current service delivery systems The mental health service system The uncomplicated schizophrenic The “simple” affective disordered individual The “pure” bi-polar patient The substance abuse service system The “plain vanilla” alcoholic The addict who uses only heroin The stimulant dependent individual w/o other psych diagnoses What’s the Problem? Estimates of psychiatric co-morbidity among clinical populations in substance abuse treatment settings range from 20-80% Estimates of substance use co-morbidity among clinical populations in mental health treatment settings range from 10-35% * Differences in incidence due to: nature of population served (e.g.: homeless vs. middle class), sophistication of psychiatric diagnostic methods used (psychiatrist or DSM checklist) and severity of diagnoses included (major depression vs. dysthymia). Why are substance use disorders treated in separate systems from other psychiatric disorders? How has the split occurred between substance use disorders and other psychiatric disorders? Before 1970 in the US, research and treatment for alcoholism and drug ab