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Addiction &
Mental Health:Facts & Myths about
Co-occurring Disorders
KASEY CLABORN, PHD
ASSISTANT PROFESSOR
& LICENSED CLINICAL PSYCHOLOGIST
THE UNIVERSITY OF TEXAS AT AUSTIN
DELL MEDICAL SCHOOL
APRIL 23, 2018
Acknowledgements
Funding Support: Conflicts: None
R34 DA041237 (NIH)
K23 DA039037 (NIH)
The contents of this presentation are those of the authors and do not necessarily
represent the views of the National Institutes of Health
Overview
What is dual diagnosis?
Common Myths.
What you can do.
Treatment Options.
Resources.
DUAL DIAGNOSIS IS:
The co-existence of
both a mental health
and substance use
disorder
Examples of Dual Disorders:
MENTAL DISORDERS Schizophrenia
Bipolar
Schizoaffective
Major Depression
Borderline Personality
Post Traumatic Stress
Social Phobia
others
SUBSTANCE USE DISORDERS Alcohol Abuse/Dependence
Cocaine
Opiates
Marijuana
Polysubstance combinations
Prescription drugs
Ex: Bipolar disorder and
smokes cannabis twice a week
Ex: Schizophrenia and alcohol
dependence
Ex: Someone who uses recreational
drugs on the weekend and
starts to experience
depressed mood
Ex: Someone habitually using
heroin and crack cocaine who experiences depression
Severe
Mental Illness
Mild
Mental Illness
Severe
Substance
Misuse
Mild
Substance
Misuse
Dual Diagnoses are an
EXPECTATION,
not an EXCEPTION
Is Dual Diagnosis Common
& Who’s At-Risk?
50% of persons with a mental
illness ALSO have a
substance use problem
Risk Factors
Severe Mental Illness
Males ages 18-44 years
Adolescents with serious behavioral
problems
Family history/genetic vulnerability
Environmental Stress
What is Addiction?
Chronic, relapsing brain disease characterized by compulsive behavior of a
person to continue taking drugs despite their many adverse health and negative
consequences.
Addiction is a brain disease
Using drugs over time changes brain structure and function
Some brain changes may persist after use stops
Long-lasting brain changes effect:
Cognitive functioning
Emotional functioning
What Causes Addiction?
What Causes Dual Diagnosis?
Debunking Common Addiction Myths
Addiction is a CHOICE.
Debunking Common Addiction Myths
Addiction is a CHOICE.
Addiction is a DISEASE.
Debunking Common Addiction Myths
People with an addiction LACK willpower.
Debunking Common Addiction Myths
People with an addiction LACK willpower.
Debunking Common Addiction Myths
People with an addiction have
to hit rock bottom before
being treated.
Debunking Common Addiction Myths
People with an addiction have
to hit rock bottom before
being treated.
Debunking Common Addiction Myths
Relapse means failure.
Debunking Common Addiction Myths
Relapse means failure.
Relapse is a part of recovery.
The Danger of Myths…
Cycle of Pain & Addiction
Effects of Addiction of the Family
Negative family interactions
Denial
Parental inconsistency
Miscarried expression of anger
Self-medication
Unrealistic expectations
Financial instability
Isolation
When you’re concerned about
someone….
Stages of Change Model
What YOU Can Do
Don’t give up. Try & try again.
Listen.
Express your concern.
Be supportive of the person, but not the
behavior.
Separate the behavior from the person.
Remove the stigma around mental health
and addiction.
Treatment that doesn’t work
Sequential Treatment
Parallel Treatment
Addiction
Treatment
Mental Health
Treatment
Addiction
TreatmentMental Health
Treatment
Treatment that works
Integrated Addiction and Mental
Health Treatment
Client-centered approach
Uses evidence-based treatment
strategies (e.g., cognitive behavior
therapy, motivational interviewing)
Addiction & Mental
Health Treatment
What to Look for in a Treatment
Program
Integrated treatment of mental health and substance use disorders by the members of a highly trained treatment team.
Acknowledgement of the importance of psychotherapeutic medications (e.g., antidepressants, anti-anxiety) in the treatment of co-occurring disorders.
A supportive approach to therapy:
reinforces self-esteem
builds self-confidence
An inclusive treatment strategy that brings partners, spouses, children and other household members into therapy for individual counseling, group meetings or education.
Treatment Options
•Detox
•Inpatient Rehab
•Medications
Severe Symptoms
•Partial Hospital Outpatient Program
•Intensive Outpatient Program
Moderate Symptoms
•Supportive Housing
•Support Groups (AA/NA)
•Self-Help
Recovering
Want to Learn More?
National Institute on Drug Abuse:
https://www.drugabuse.gov/
National Institute on Alcohol Abuse &
Alcoholism
https://www.niaaa.nih.gov/
SAMHSA
https://www.samhsa.gov/find-
help/national-helpline
Contact:[email protected]
http://www.sites.utexas.edu/BHIP
Biobehavioral Health Innovation & Promotion Lab
The University of Texas at Austin
Dell Medical School
@BHIPlab
