The determination as to whether an individual has succumbed to a co-occurring disorder as a result of substance abuse or that the substance abuse is a result of self-medicating a symptomatic mental disorder is near impossible. This is not to say it cannot be accomplished, but unless an extensive history and medical background is obtained, the source may not be determined. In the absence of such information, the clinician must evaluate the symptoms of the patient and history of pathological relationship between substance use and mental illness that drives the behavioral outcome of the patient. According to Sinacola & Peters-Strickland (2012), when individuals pursue gratification, they experience three basic neurochemical responses: arousal,
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While the client may be prescribed medication-assisted treatment (MAT), treatment therapy can be applied. Since a therapist cannot prescribe medication, the awareness of how medications side effects will manifest in behavior can help the therapist understand the behavior of the client through the recovery process. Serotonin as an example, is often affected by drugs like opiates, alcohol, and cannabinoids and a safer way to treat depression is found in a Selective Serotonin Reuptake Inhibitor (SSRI’s). Some SSRI’s like Fluoxetine have shown to have a minimal increase to methadone blood levels (SAMHSA, 2005). In cases like these a patient may be treated for depression or anxiety while decreasing opiate withdrawals. The approach to MAT in combination to other treatment interventions can depend greatly on the disorder of the client. As a client may suffer with social anxiety, the introduction to 12-step programs may be resisted. Just as likely a MAT client may find resistance from members of these groups due to personal beliefs of drug use. Drake, Mueser, Brunette & McHugo (2004) state that there is a widespread recognition that a significant number of people need something more than outpatient counseling. This constitutes support groups in conjunction to continued therapy in either the group or individual setting. Recovery is a process that begins in the treatment phase, but continues for a lifetime, and it is only through understanding of the client’s needs can a therapist treat the dual diagnosed
While the client may be prescribed medication-assisted treatment (MAT), treatment therapy can be applied. Since a therapist cannot prescribe medication, the awareness of how medications side effects will manifest in behavior can help the therapist understand the behavior of the client through the recovery process. Serotonin as an example, is often affected by drugs like opiates, alcohol, and cannabinoids and a safer way to treat depression is found in a Selective Serotonin Reuptake Inhibitor (SSRI’s). Some SSRI’s like Fluoxetine have shown to have a minimal increase to methadone blood levels (SAMHSA, 2005). In cases like these a patient may be treated for depression or anxiety while decreasing opiate withdrawals. The approach to MAT in combination to other treatment interventions can depend greatly on the disorder of the client. As a client may suffer with social anxiety, the introduction to 12-step programs may be resisted. Just as likely a MAT client may find resistance from members of these groups due to personal beliefs of drug use. Drake, Mueser, Brunette & McHugo (2004) state that there is a widespread recognition that a significant number of people need something more than outpatient counseling. This constitutes support groups in conjunction to continued therapy in either the group or individual setting. Recovery is a process that begins in the treatment phase, but continues for a lifetime, and it is only through understanding of the client’s needs can a therapist treat the dual diagnosed