Managing comorbid schizophrenia and substance abuse

Drake, Robert E.; Mueser, Kim T.

doi:10.1007/s11920-996-0037-8

Cited by 28 publications

(15 citation statements)

References 67 publications

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“…A precedent for this was established with the bridging of the gap between alcohol versus drug treatment programs and mental health versus addiction treatment programs. There is an extensive literature supporting the need for integrated treatment in co-occurring disorders and polydrug addiction [53,54].…”

Section: Conceptual 'Reframe' For Managing Tobaccomentioning

confidence: 99%

Management of smoking in people with psychiatric disorders

Ziedonis¹,

Williams²

2003

Current Opinion in Psychiatry

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Purpose of reviewThe rates of tobacco addiction in individuals with psychiatric disorders (mental illness and addiction) continue to remain alarmingly high despite substantial decreases in smoking in the general population. Recent findings suggest that tobacco addiction treatment can be effective for smokers with psychiatric disorders, but will require both clinical interventions and systems changes. There is both an immediate need to address tobacco in this population and to expand research agendas to include the many remaining clinical questions for this population. Recent findingsNearly half of all cigarettes consumed in the United States are smoked by individuals with psychiatric disorders, who are at two to three times the risk of developing tobacco-related medical illnesses. Recent international studies have found high rates of heavy smoking among those with psychiatric disorders similar to those in the United States. Under-recognition and under-treatment of tobacco addiction in this population continues to be common despite the availability of effective management approaches. Smokers with psychiatric disorders are a broad treatment population that requires treatment specificity according to subtypes. Nicotine replacement medication, bupropion, atypical antipsychotics, and modified psychosocial treatments can improve outcomes. The effective model programs and system changes that have begun to address tobacco in this population have often not been published, disseminated, or replicated. Summary There continue to be relatively few treatment studies for this population, and the existing studies have small sample sizes. Research should test whether effective treatments used in the general population will work for this population. Program development and system changes should be described and evaluated. Abbreviations CBTcognitive behavioral therapy FDA Food and Drug Administration NRT nicotine replacement therapy SSRI selective serotonin reuptake inhibitor

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Section: Conceptual 'Reframe' For Managing Tobaccomentioning

confidence: 99%

Management of smoking in people with psychiatric disorders

Ziedonis¹,

Williams²

2003

Current Opinion in Psychiatry

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“…Individual office visits are also longer than in primary care. Integrated models have been successful for other co-occurring addictions (Drake and Mueser 2001; SAMHSA 2002) and would likely succeed for tobacco treatment as well. Perhaps most importantly, smokers endorse wanting their mental health center, counselor or psychiatrist to help them to quit smoking (Williams et al 2010b).…”

Section: Introductionmentioning

confidence: 99%

A Comprehensive Model for Mental Health Tobacco Recovery in New Jersey

Williams

Zimmermann

Steinberg

et al. 2010

Adm Policy Ment Health

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Despite the high prevalence of tobacco use, disproportionate tobacco consumption, and excess morbidity and mortality, smokers with mental illness have reduced access to tobacco dependence treatment across the health care spectrum. We have developed a comprehensive model for Mental Health Tobacco Recovery in New Jersey (MHTR-NJ) that has the overarching goal of improving tobacco cessation for smokers with serious mental illness. Important steps involve engaging patients, professionals and the community to increase understanding that addressing tobacco use is important. In addition to increasing demand for tobacco treatment services, we must educate mental health professionals in evidence-based treatments so that patients can seek help in their usual behavioral health care setting. Peer services that offer hope and support to smokers are essential. Each of the policy or cessation initiatives described address the two core goals of this model: to increase demand for tobacco cessation services for mentally ill smokers and to help more smokers with mental illness to quit. Each has been pilot tested for feasibility and/or effectiveness and revised with feedback from stakeholders. In this way this implementation model has brought together academics, clinicians, administrators and mental health consumers to develop tobacco programming and policy that has been tested in a real world environment and serves as a model for other states.

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“…25 This is supported by studies showing that dually diagnosed patients tend to experience greater adverse consequences in response to smaller amounts of drug use as compared with the general population. 26,27 Other biologic factors, such as genetic vulnerability, may also play a role in this co-occurrence. It has been proposed that there are overlapping biologic mechanisms between psychosis and drug use, as supported by one study that reported familial background is an important variable affecting the duration of psychosis associated with substance abuse.…”

Section: Overview Of the Problemmentioning

confidence: 99%