Around three out of four Australians being treated for drug and alcohol problems have at least one other mental illness that is holding back their chance of recovery, a drug and alcohol research conference will hear next week.
Clients are missing out on optimal care because many health care providers treat the two conditions separately, leaving clients stuck on a “merry-go-round” where each condition maintains and exacerbates the other, says Dr Christina Marel from the National Drug and Alcohol Research Centre at UNSW.
Dr Marel will launch updated guidelines on the treatment of mental health and substance use disorders at the National Drug and Alcohol Research Centre Annual Symposium at UNSW on Monday 12 September.
Guidelines on the management of co-occurring alcohol and other drug and mental health conditions in alcohol and other drug treatment settings (Second Edition), funded by the Australian Government Department of Health, is intended to give alcohol and other drug workers evidence-based information to help manage the debilitating comorbidities.
“It can be really distressing for people who, despite their best intentions and despite complying with treatment, find themselves not really recovering either from their mental illness or their substance use issues,” says Dr Marel. “But there are effective treatments out there and the research evidence has increased significantly since we published the first edition seven years ago.
“Unfortunately, despite the research evidence it is still common for mental illness and substance use problems to be treated separately, and for mental health clients to be told they can’t access treatment until they are abstinent from drugs and alcohol.”
The new guidelines for the first time include information on ADHD and eating disorders, which are both more common in people with substance use disorders compared with the general population.
Other mental health disorders covered by the guidelines include general anxiety disorders, depression and post-traumatic stress which are present in as many as three out of four people in drug and alcohol treatment. Personality disorders commonly seen in drug and alcohol treatment settings include borderline personality disorder (BPD), frequently accompanied by self-harming and suicidal behaviours, and anti-social personality disorder (ASPD).
There is no one treatment for comorbid mental health disorders and drug and alcohol treatment, says Dr Marel. “Best practice is to use the most effective treatment for each disorder and ensure treatments are given either in an integrated fashion or concurrently with specialist services communicating about the treatments rather than operating in silos.”
As well as traditional therapies, the guidelines recommend that practitioners consider incorporating alternative treatments, including physical activity and complementary therapies. A broad multi-faceted approach addressing other issues such as employment, housing and education is also recommended.
“Comorbid mental health and substance use disorders are incredibly debilitating,” says Dr Marel. “This is why clients so often have many other health and social problems to contend with including cardiovascular disease, unemployment and homelessness.”
What: Launch of the Guidelines on the management of co-occurring alcohol and other drug and mental health conditions in alcohol and other drug treatment settings (Second Edition)
When: Monday 12 September, 2016
Where: National Drug and Alcohol Research Centre Annual Symposium, University of New South Wales
The conference program is available for download here
Abstracts for each session can be viewed here