Co-occurring Self-Reported Behavioral Problems in a Substance Use Disorder Treatment Population: Treatment Perspective

Abstract

Research and clinical experience indicate that individuals with substance use disorders (SUD) may also experience problems with excessive food intake, sexual activity, exercise, and gambling. Such behavioral problems cause individual suffering and might also complicate substance abuse treatment. In clinical practice, however, behavioral problems seem to escape identification. Through the use of a questionnaire, this study investigated whether patients in substance abuse treatment considered themselves having experienced behavioral problems, and whether behavioral problems had been acknowledged during treatment. Sixty-nine individuals in substance abuse treatment answered the questionnaire. Sixtyseven percent of the participants reported behavioral problems, predominantly two or more behaviors. Forty percent of the participants reported that their behavioral problems had been acknowledged in treatment. Based on these findings, it is suggested that treatment units should be prepared to identify behavioral problems and meet the treatment needs of patients who experience one or several behavioral problems.

“It’s A Deficiency Disorder”. Clients Understanding of Substance and Behavioral Addictions and Treatment Needs: An Interview Study

“…Moreover, substance abuse treatment needs to be holistic and address a variety of difficulties among clients concerned [6,14]. The need to address a variety of difficulties is in line with findings that show that overuse of alcohol, drugs, nicotine, and food seem to reflect a dysfunction of the D2 dopamine receptors [41].…”

“…It has been estimated that 58% of individuals with any addiction have 2-4 other co-occurring addictions [5]. When clients in substance abuse treatment had the opportunity to self-report behavioral addictions (sexual activities, food intake, gambling and exercise), 67% reported such difficulties [6]. Through brain imaging studies it is possible to evaluate underlying brain systems pathology and also visualize effectiveness of treatment [7] and through interview studies it is possible to investigate the shared phenomenology of addiction to substances and behaviors [8][9][10].…”

Excessive behaviors in clinical practice—A state of the art article

“…There are researchers who do not use terms that are connected to psychiatric classification systems, instead choosing terms such as excessive or problematic behaviors (Bonke & Borregaard, 2009 ; Caputo, 2015 ; Giugliano, 2003 ; Griffiths, Parke, & Wood, 2002 ; Orford, 2001 ; Thomas, 2014) and misuse or overuse (Essig, 2012 ; Mudry et al, 2011 ; Punzi, Tidefors, & Fahlke, 2015 ). In this paper, the term excessive behaviors is used, since it is not connected to any diagnostic category or to any specific explanatory model or theoretical approach.…”

“…Excessive behaviors are often self-destructive, and the self-inflicted negative consequences might awaken overwhelming reactions among the practitioners who encounter these clients. It is therefore important to encourage practitioners to respectfully raise questions about a range of excessive behaviors and to be prepared to listen to their clients’ experiences (Benson & Eisenach, 2013 ; Essig, 2012 ; Punzi & Fahlke, 2015 ). In order to support practitioners in listening to their clients’ suffering and handling their own reactions, it is recommended to provide adequate supervision in which excessive behaviors are not treated in trivializing or superficial ways (Shalev & Yerushalmi, 2009 ; Southern, 2007 ).…”

“…Behaviors and even substances might furthermore replace each other, so that when one excessive behavior is terminated it might be substituted with another behavior or a substance (Freimuth et al, 2008 ; Goodman, 2008 ; Shaffer et al, 2004 ; Sussman et al, 2011 ). Power ( 2005 ) as well as Punzi and Fahlke ( 2015 ) note that practitioners seem to be aware that their clients might experience difficulties with excessive behaviors even when treatment is sought for other reasons, and practitioners also seem to be aware that excessive behaviors might accompany as well as replace each other. Nevertheless, excessive behaviors can pass unnoticed in clinical practice and therefore the capacity to identify and approach these behaviors needs to be enhanced (Fernandez-Aranda et al, 2006 ; Freimuth et al, 2008 ; Plant & Plant, 2003 ; Power, 2005 ; Punzi & Fahlke, 2015 ; Robbins & Clark, 2015 ).…”