Adaptation of an Acute Psychiatric Unit to a Concurrent Disorders Unit to Increase Capacity and Improve Patient Care

Raymond, Holly; Amlung, Michael; Leo, Joseph A. De; Hashmani, Talia; Younger, Jodi; MacKillop, James

doi:10.1097/02024458-201609000-00004

Cited by 1 publication

(4 citation statements)

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“…The annual prevalence of substance use disorders (SUDs) in Canada is 3.0–3.8% ( 1 , 2 ) and 21.6% of Canadians experience a SUD in their lifetime ( 3 ). SUDs are commonly comorbid with other psychiatric conditions and, in contrast to the term dual-diagnosis, individuals with a SUD and another psychiatric condition are referred to as concurrent disorder patients in Canada ( 4 ). Annually, 1.2–1.7% of the Canadian population age 15 and above meet criteria for a concurrent disorder.…”

Section: Introductionmentioning

confidence: 99%

“…Annually, 1.2–1.7% of the Canadian population age 15 and above meet criteria for a concurrent disorder. These individuals are disproportionately represented in the mental healthcare system ( 1 , 2 , 4 ). Concurrent disorders are associated with several negative health outcomes and high utilization of the healthcare system, particularly emergency services and inpatient treatment programs ( 4 – 6 ).…”

Section: Introductionmentioning

confidence: 99%

“…These individuals are disproportionately represented in the mental healthcare system ( 1 , 2 , 4 ). Concurrent disorders are associated with several negative health outcomes and high utilization of the healthcare system, particularly emergency services and inpatient treatment programs ( 4 – 6 ). Concurrent disorders have also been found to be associated with more complex healthcare needs, and potentially more severe substance misuse when compared with those without a comorbid psychiatric diagnosis ( 7 ).…”

Section: Introductionmentioning

confidence: 99%

“…Contraband substance use of tobacco, alcohol, cannabis, and illicit drugs is a persistent issue in clinical settings, posing a risk not only to the patient, but also to other patients, staff, and visitors ( 5 , 6 , 8 ). Patients who use illicit drugs are more likely to be discharged prior to completing treatment due to non-compliance with hospital policies, resulting in negative health outcomes and greater rates of readmissions ( 4 – 6 ).…”

Section: Introductionmentioning

confidence: 99%

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Perceptions of prevalence, consequences, and strategies for managing contraband substance use in an inpatient concurrent disorders program: A qualitative study of patient perspectives and survey of clinician perspectives

et al. 2022

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ObjectiveInpatient treatment programs for substance use disorders (SUDs) typically have an abstinence policy for patients, but unsanctioned substance use nonetheless takes place and can have significant negative clinical impacts. The current study sought to understand this problem from a patient perspective and to develop strategies for improved contraband substance management in an inpatient concurrent disorders sample.MethodsFirst, a qualitative study (n = 10; 60% female) was undertaken to ascertain perceived prevalence, impact, and patient-generated strategies. Second, an anonymous follow-up survey was conducted with unit staff clinicians to evaluate the suggested strategies.ResultsPatients reported that contraband substance use was present and had significant negative consequences clinically. Recommendations from patients included more extensive urine drug screening, the use of drug-sniffing dogs, and direct contingencies for contraband use. Nineteen staff competed an anonymous follow-up questionnaire to evaluate the viability of these strategies, revealing variable perceptions of feasibility and effectiveness.ConclusionThese findings emphasize the adverse consequences of contraband substance use in addiction treatment programs and identify patient-preferred strategies for managing this challenge.

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Section: Introductionmentioning

confidence: 99%