addiction & mental health - chateau...

Addiction &

Mental Health:Facts & Myths about

Co-occurring Disorders

KASEY CLABORN, PHD

ASSISTANT PROFESSOR

& LICENSED CLINICAL PSYCHOLOGIST

THE UNIVERSITY OF TEXAS AT AUSTIN

DELL MEDICAL SCHOOL

APRIL 23, 2018

Acknowledgements

Funding Support: Conflicts: None

R34 DA041237 (NIH)

K23 DA039037 (NIH)

The contents of this presentation are those of the authors and do not necessarily

represent the views of the National Institutes of Health

Overview

What is dual diagnosis?

Common Myths.

What you can do.

Treatment Options.

Resources.

DUAL DIAGNOSIS IS:

The co-existence of

both a mental health

and substance use

disorder

Examples of Dual Disorders:

MENTAL DISORDERS Schizophrenia

Bipolar

Schizoaffective

Major Depression

Borderline Personality

Post Traumatic Stress

Social Phobia

others

SUBSTANCE USE DISORDERS Alcohol Abuse/Dependence

Cocaine

Opiates

Marijuana

Polysubstance combinations

Prescription drugs

Ex: Bipolar disorder and

smokes cannabis twice a week

Ex: Schizophrenia and alcohol

dependence

Ex: Someone who uses recreational

drugs on the weekend and

starts to experience

depressed mood

Ex: Someone habitually using

heroin and crack cocaine who experiences depression

Severe

Mental Illness

Mild

Mental Illness

Severe

Substance

Misuse

Mild

Substance

Misuse

Dual Diagnoses are an

EXPECTATION,

not an EXCEPTION

Is Dual Diagnosis Common

& Who’s At-Risk?

50% of persons with a mental

illness ALSO have a

substance use problem

Risk Factors

Severe Mental Illness

Males ages 18-44 years

Adolescents with serious behavioral

problems

Family history/genetic vulnerability

Environmental Stress

What is Addiction?

Chronic, relapsing brain disease characterized by compulsive behavior of a

person to continue taking drugs despite their many adverse health and negative

consequences.

Addiction is a brain disease

Using drugs over time changes brain structure and function

Some brain changes may persist after use stops

Long-lasting brain changes effect:

Cognitive functioning

Emotional functioning

What Causes Addiction?

What Causes Dual Diagnosis?

Debunking Common Addiction Myths

Addiction is a CHOICE.

Debunking Common Addiction Myths

Addiction is a CHOICE.

Addiction is a DISEASE.

Debunking Common Addiction Myths

People with an addiction LACK willpower.

Debunking Common Addiction Myths

People with an addiction LACK willpower.

Debunking Common Addiction Myths

People with an addiction have

to hit rock bottom before

being treated.

Debunking Common Addiction Myths

People with an addiction have

to hit rock bottom before

being treated.

Debunking Common Addiction Myths

Relapse means failure.

Debunking Common Addiction Myths

Relapse means failure.

Relapse is a part of recovery.

The Danger of Myths…

Cycle of Pain & Addiction

Effects of Addiction of the Family

Negative family interactions

Denial

Parental inconsistency

Miscarried expression of anger

Self-medication

Unrealistic expectations

Financial instability

Isolation

When you’re concerned about

someone….

Stages of Change Model

What YOU Can Do

Don’t give up. Try & try again.

Listen.

Express your concern.

Be supportive of the person, but not the

behavior.

Separate the behavior from the person.

Remove the stigma around mental health

and addiction.

Treatment that doesn’t work

Sequential Treatment

Parallel Treatment

Addiction

Treatment

Mental Health

Treatment

Addiction

TreatmentMental Health

Treatment

Treatment that works

Integrated Addiction and Mental

Health Treatment

Client-centered approach

Uses evidence-based treatment

strategies (e.g., cognitive behavior

therapy, motivational interviewing)

Addiction & Mental

Health Treatment

What to Look for in a Treatment

Program

Integrated treatment of mental health and substance use disorders by the members of a highly trained treatment team.

Acknowledgement of the importance of psychotherapeutic medications (e.g., antidepressants, anti-anxiety) in the treatment of co-occurring disorders.

A supportive approach to therapy:

reinforces self-esteem

builds self-confidence

An inclusive treatment strategy that brings partners, spouses, children and other household members into therapy for individual counseling, group meetings or education.

Treatment Options

•Detox

•Inpatient Rehab

•Medications

Severe Symptoms

•Partial Hospital Outpatient Program

•Intensive Outpatient Program

Moderate Symptoms

•Supportive Housing

•Support Groups (AA/NA)

•Self-Help

Recovering

Want to Learn More?

National Institute on Drug Abuse:

https://www.drugabuse.gov/

National Institute on Alcohol Abuse &

Alcoholism

https://www.niaaa.nih.gov/

SAMHSA

https://www.samhsa.gov/find-

help/national-helpline

Contact:Kasey.Claborn@austin.utexas.edu

http://www.sites.utexas.edu/BHIP

Biobehavioral Health Innovation & Promotion Lab

The University of Texas at Austin

Dell Medical School

@BHIPlab