October 6th, 2020 
Colleague 1
: Week 5 Discussion
COLLAPSE
According to Zorii, Karlovi, Buljan, and Marui (2003), post-traumatic stress disorder (PTSD) and alcohol addiction or abuse is reportedly amongst forty to eighty percent of PTSD clients and is one of the most prevalent comorbidities. PTSD symptoms can cause a challenge to treatment for alcohol addiction because the substance decreases the clients tension (Zorii et al., 2003). Another common co-diagnosis among people who use substances is bipolar spectrum disorder (BD) and alcohol dependence (Altinbas & Evren, 2013). One obstacle to treating this pair is that the dual diagnosis causes the clinical course of the illness more severe and worse (Altinbas & Evren, 2013, p. 379). To treat substance-using clients with a dual diagnosis a counselor needs to have the competency to treat all the conditions presented (Capuzzi & Stauffer, 2016). Also, the helping professional should use assessment tools to screen this population to obtain accurate information about the patients symptomology and diagnosis (Capuzzi & Stauffer, 2016). Finally, counselors should join forces with competent professionals to ensure a better treatment outcome (Capuzzi & Stauffer, 2016).
Altinbas, K., & Evren, C. (2013). Pharmacotherapy Options in Comorbid Bipolar Disorder and Alcohol-Substance Use Disorders. Klinik Psikofarmakoloji Bulteni, 23(4), 378389. https://doi-org.ezp.waldenulibrary.org/10.5455/bcp.20131122111840
Capuzzi, D., & Stauffer, M. D. (2016). Foundations of addictions counseling (3rd ed.). New York, NY: Pearson Education, Inc.
Zorii, Z., Karlovi, D., Buljan, D., & Marui, S. (2003). Comorbid alcohol addiction increases aggression level in soldiers with combat-related post-traumatic stress disorder. Nordic Journal of Psychiatry, 57(3), 199. https://doi-org.ezp.waldenulibrary.org/10.1080/08039480310001337
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Colleague 2tl
RE: Week 5 Discussion
COLLAPSE
Dual diagnosis of mental health and substance abuse disorders must meet criteria for both diagnosis and be independent of each other. It can be challenging at times to determine and diagnose dual diagnosis as some symptoms may be manifested or heightened due to the effects of substance use, causing it to resemble mental health symptoms (Hawkins, 2009). There are various diagnoses that are commonly seen with those who have substance use disorders to include, depression, anorexia, or PTSD(Drake et. al, 2007).
One of the challenges that can occur when dealing with occurring disorders is that patients may not be upfront regarding substance use. A client who comes to you for treatment of depression may not disclose that he also is an alcoholic, which will affect the treatment planning and goals for the client. Additionally the assessment process can be difficult as when a substance abuse disorder is diagnosed, often clinician will need to wait 30 days or more after the client has achieved sobriety before reviewing additional diagnosis which can present as a challenge, particularly in an outpatient session. Other challenges such as prematurely prescribing medications or clients noncompliance with medication can be affected with individuals who have both substance use and mental health diagnosis (Pierre, 2018 ).
Evidence based research suggests that the best practices for treating dual diagnosis with substance use disorder is to first ensure that treatment is integrated and simultaneous. Ideally treatment will include a multidisciplinary team, to support in treating both disorders concurrently. Evidence based practices for addiction and mental health disorders include motivational interviewing, cognitive behavioral therapy, relapse prevention, and ongoing case management. It is aso important to ensure that providers work together to create a medication regimen that can support clients in being in compliance with taking medication prescribed (Pierre, 2018).
Drake, R. E., Mueser, K. T., & Brunette, M. F. (2007). Management of persons with co-occurring severe mental illness and substance use disorder: program implications. World psychiatry : official journal of the World Psychiatric Association (WPA), 6(3), 131136.
Hawkins, E. H. (2009). A tale of two systems: Co-occurring mental health and substance abuse disorders treatment for adolescents. Annual Review of Psychology, 60, 197227. https://doi.org/10.1146/annurev.psych.60.110707.163456
Pierre, Joseph M. “Real-world challenges in managing ‘dual diagnosis’ patients: Diligent assessment and judicious prescribing can help optimize outcomes.” Current Psychiatry, vol. 17, no. 9, 2018, p. 25+. Gale OneFile: Health and Medicine, . Accessed 1 Oct. 2020.
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