Question

Answer these questions related to COD's 1. Why do you think the incidence of SUD is so high for those ident tified with a co-occurring or comorbid condition? 2. Explain an integrated treatment model. 3. Provide a good estimate for how many individuals are currently diagnosed with a COD

Answer 1

Answer:

1)

Although substance use disorders commonly occur with other mental illnesses, this does not mean that one caused the other, even if one appeared first. In fact, establishing which came first or why can be difficult. However, research suggests three possibilities for this common co-occurrence:

• Common risk factors can contribute to both mental illness and substance use disorders. Research suggests that there are many genes that can contribute to the risk of developing both a substance use disorder and a mental illness. For example, some people have a specific gene that can make them at increased risk of mental illness as an adult, if they frequently used marijuana as a child. A gene can also influence how a person responds to a drug – whether or not using the drug makes them feel good. Environmental factors, such as stress or trauma, can cause genetic changes that are passed down through generations and may contribute to the development of mental illnesses or a substance use disorder.
• Mental illnesses can contribute to drug use and substance use disorders. Some mental health conditions have been identified as risk factors for developing a substance use disorder.3 For example, some research suggests that people with mental illness may use drugs or alcohol as a form of self-medication.4Although some drugs may help with mental illness symptoms, sometimes this can also make the symptoms worse. Additionally, when a person develops a mental illness, brain changes may enhance the rewarding effects of substances, predisposing the person to continue using the substance.4
• Substance use and addiction can contribute to the development of mental illness.Substance use may change the brain in ways that make a person more likely to develop a mental illness.

2)

How are these comorbid conditions diagnosed and treated?

The high rate of comorbidity between substance use disorders and other mental illnesses calls for a comprehensive approach that identifies and evaluates both. Accordingly, anyone seeking help for either substance use, misuse, or addiction or another mental disorder should be evaluated for both and treated accordingly.

Several behavioral therapies have shown promise for treating comorbid conditions. These approaches can be tailored to patients according to age, the specific drug misused, and other factors. They can be used alone or in combinations with medications. Some effective behavioral therapies for treating comorbid conditions include:

• Cognitive behavioral therapy (CBT) helps to change harmful beliefs and behaviors.
• Dialectical behavioral therapy (DBT) was designed specifically to reduce self-harm behaviors including suicide attempts, thoughts, or urges; cutting; and drug use.
• Assertive community treatment (ACT) emphasizes outreach to the community and an individualized approach to treatment.
• Therapeutic communities (TC) are a common form of long-term residential treatment that focus on the “resocialization” of the person.
• Contingency management (CM) gives vouchers or rewards to people who practice healthy behaviors.

Effective medications exist for treating opioid, alcohol, and nicotine addiction and for alleviating the symptoms of many other mental disorders, yet most have not been well studied in comorbid populations. Some medications may benefit multiple problems. For example, bupropion is approved for treating both depression (Wellbutrin) and nicotine dependence (Zyban)

3) Prevalence of Co-Occurring Disorders. Co-occurring disorders are prevalent. The 2016 National Survey on Drug Use and Health (NSDUH) found that approximately 8.2 million American adults (3.4 percent) had a mental illness (AMI) as well as a substance use disorder within the past year.