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Module 1. Substance Abuse Treatment for Persons with Co-Occurring Disorders Inservice Training Based on A Treatment Improvement Protocol TIP 42. What is a TIP?. Best-practice guidelines for treatment of substance use disorders Developed by Center for Substance Abuse Treatment (CSAT)
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Module 1 Substance Abuse Treatment for Persons with Co-Occurring DisordersInservice Training Based on A Treatment Improvement Protocol TIP 42
What is a TIP? • Best-practice guidelines for treatment of substance use disorders • Developed by Center for Substance Abuse Treatment (CSAT) • Draws on experience and knowledge of clinical, research, and administrative experts in a particular topic area • Consensus Panel for TIP 42, page xi
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Introduction—Module 1 The Evolving Field of Co-Occurring Disorders
In This Module . . . • Overview of the evolving field of Co-Occurring Disorders • Understanding of the important developments that led to TIP 42 • Initial exploration of TIP 42 and how it is organized.
TIP Exercise—Terms • Read the left column on Page 27 • Discuss with your partner: • Which of these terms have you ever used or heard? • Which of these terms are used in your programs? • What advantages does the term “co-occurring disorders” have over “dual diagnosis” and “dual disorder”? Over the other terms?
Co-Occurring Disorders Co-occurring disorders • Refers to co-occurring substance use (abuse or dependence) and mental disorders. Clients said to have co-occurring disorders have: • one or more disorders relating to the use of alcohol and/or other drugs of abuse and one or more mental disorders. Diagnosis of co-occurring disorders (COD) occurs when • at least one disorder of each type can be established independent of the other and is not simply a cluster of symptoms resulting from the one disorder.
Co-Occurring Disorders:Your setting 1. Do these definitions describe clients in your practice/program? (Estimate percentage or describe prevalence) 2. How has serving clients with COD affected your practice/program? 3. What challenges do clients with COD present to your clinical knowledge and skills?
Co-Occurring Disorders:Implications • Treatment • Prevalence of COD, multiple problems they create, impact on treatment and treatment outcome, new models/strategies are receiving attention and encouraging treatment innovation • Clinicians & Knowledge Dissemination • Knowledge of both mental health and substance abuse is essential and dissemination of knowledge has become widespread
Why a new TIP on Co-Occurring Disorders? • Availability of data • Treatment innovations for other populations with COD • Changes in treatment delivery • Advances in treatment • Recent developments
Prevalence of COD • In 2002, 4 million adults met the criteria for both serious mental illness (SMI) and substance dependence and abuse. • An estimated 10 million Americans of all ages and in both institutional and non-institutional settings have COD in any given year.
Prevalence and Other Data Data now show: • COD are common in general adult population. • Increased prevalence of people with COD and programs for people with COD. • People with COD are more likely to be hospitalized and the rate may be increasing. • Rates of mental disorders increase as the number of substance use disorders increase.
Why a new TIP on Co-Occurring Disorders? • Availability of data • Treatment innovations for other populations with COD • Changes in treatment delivery • Advances in treatment • Recent developments
Advances in Treatment of COD • “No wrong door” policy • Mutual self-help for people with COD • Integrated care as a priority for people with severe and persistent mental illness • Development of effective approaches, models, and strategies • Pharmacological advances
Recent Developments • National Registry of Effective Programs and Practices (NREPP) • Co-Occurring Disorders State Incentive Grants (COSIG) • Co-Occurring Center for Excellence (COCE) • Report to Congress on the Prevention and Treatment of Co-Occurring Substance Use Disorders and Mental Disorders • Co-Occurring Disorders: Integrated Dual Disorders Treatment Implementation Resource Kit