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Psychiatry

Outpatient program is tailored to people with co-occurring addiction and mental illness

09/27/2013

Outpatient program is tailored to people with co-occurring addiction and mental illnessdownload the newsletter

At least one-third of people with drinking problems and about half of all people with drug addictions also battle mental illness. The realization that so many individuals experience co-occurring disorders — referred to as a dual diagnosis — has led to numerous studies illuminating the most effective approaches to treatment.

The UCLA Dual Diagnosis Program specializes in treating people with addiction who have also been diagnosed with a mental illness, which may include a depressive disorder, anxiety disorder, bipolar disorder, post-traumatic stress disorder, or attention deficit hyperactivity disorder. The intensive outpatient program offers evidence-based, comprehensive treatment that can significantly improve the prospects for successful recovery from alcoholism or drug addiction.

Research supports addressing both disorders simultaneously

The treatment of underlying mental-health problems among people with substance-use disorders is now considered critical to recovery. Conventional treatment programs, such as those based on a 12-step philosophy, have typically focused only on the addiction. This approach stems in part from the lack of involvement of medical professionals in such programs and the belief — now outdated — that mental-health issues should be addressed only after a substance-use problem has been brought under control.

That paradigm has changed. Research has demonstrated that untreated mental-health conditions can adversely impact the outcome of addiction treatment. Studies show that people with mental illness who have achieved short-term sobriety may be more likely to relapse if they continue to experience the dysphoric symptoms associated with depression or anxiety. These findings support the inclusion of medical doctors in the treatment of addiction and co-occurring disorders.

Intensive outpatient treatment

At UCLA’s Dual Diagnosis Program, individuals receive an initial 70-minute diagnostic assessment with a board-certified psychiatrist. This careful diagnostic assessment may be particularly useful to primary care physicians who have questions regarding the role of substance abuse in a patient’s particular medical condition.

Individuals enrolled in the Dual Diagnosis Program receive eight weeks of outpatient care that addresses both conditions. The services include:

  • Life Skills Course group therapy from 6 pm to 8 pm, Monday through Friday
  • Weekly individual therapy sessions
  • Weekly Q&A sessions for patients and family members or friends
  • Twice-monthly sessions with a psychiatrist

With conveniently scheduled evening sessions, most patients are able to continue meeting their work, school and family obligations. The eight-week program can be repeated in accordance with the patient’s wishes and professional recommendations. Most insurance plans provide some level of coverage.

Expert management of medications

Treatment consists of both individual and group counseling as well as medication prescribed by physicians with expertise in addiction medicine. The physicians at UCLA’s Dual Diagnosis Program have professional training in prescribing psychotropic medications in a safe and effective manner. Group therapy sessions combine patients who share common characteristics, such as drug addiction and an anxiety disorder or alcoholism and depression.

Individuals who complete treatment in the Dual Diagnosis Program emerge with an improved understanding of the roots of the substance-use disorder and better tools to manage the vulnerabilities that could lead to relapse. Treatment of the underlying mental-health disorder enhances the patient’s return to a healthy and productive life.

Helping to understand interrelated conditions

Separating a substance-use disorder from another psychiatric disorder can be challenging, says Jason E. Schiffman, MD, director of the Dual Diagnosis Program.

“One of the main services we’re providing is to help primary care physicians who wonder whether a patient’s substance use is contributing to whatever pathology they’re treating,” he says. “They can refer the patient to us, and we’ll have a psychiatrist do a thorough assessment to try to tease apart what is actually going on.”

The presence of an underlying mental-health disorder may be the cause of failed attempts at sobriety. Simultaneous treatment of both conditions can increase the chances for long-term recovery, he says.

“Given that mental-health conditions are so prevalent among people with substance-use disorders, there really is a need for trained and qualified physicians to be able to assess patients and provide appropriate treatments for these mental health conditions — treatments that are not going to interfere with the addiction treatment,” says Dr. Schiffman.

Participating Physicians

Jason E. Schiffman, MD, MBA
Associate Physician
Director, UCLA Dual Diagnosis Program

Dana Harris, MD
Associate Physician

Margaret Haglund, MD
Associate Physician

Contact Information

For appointments: (310) 983-3598
1640 S. Sepulveda Blvd., Suite 120
Los Angeles, CA. 90025
www.semel.ucla.edu/dual-diagnosis-program

 





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