Comorbid conditions need rounded response
A leading drug and alcohol researcher says we have to stop treating addiction and mental health separately.
Around three out of four Australians being treated for drug and alcohol problems have at least one other mental illness that is holding back their chance of recovery, according to Dr Christina Marel from the National Drug and Alcohol Research Centre at the University of New South Wales (UNSW).
Dr Marel believes patients miss out on optimal care because health care providers tend to treat the two conditions separately, leaving clients stuck on a “merry-go-round” where each condition maintains and exacerbates the other.
The research group is launching updated guidelines on the treatment of mental health and substance use disorders at the National Drug and Alcohol Research Centre Annual Symposium today.
The Federal Government-funded Guidelines on the management of co-occurring alcohol and other drug and mental health conditions in alcohol and other drug treatment settings (Second Edition), is intended to give alcohol and other drug workers evidence-based information to help manage the debilitating comorbidities.
“It can be really distressing for people who, despite their best intentions and despite complying with treatment, find themselves not really recovering either from their mental illness or their substance use issues,” says Dr Marel.
“But there are effective treatments out there and the research evidence has increased significantly since we published the first edition seven years ago.
“Unfortunately, despite the research evidence it is still common for mental illness and substance use problems to be treated separately, and for mental health clients to be told they can’t access treatment until they are abstinent from drugs and alcohol.”
The new guidelines include information for people with ADHD and eating disorders for the first time, as they are both more common in people with substance use disorders compared with the general population.
But even with the best guidelines, there is no single best treatment for comorbid mental health disorders and drug and alcohol treatment, says Dr Marel.
“Best practice is to use the most effective treatment for each disorder and ensure treatments are given either in an integrated fashion or concurrently with specialist services communicating about the treatments rather than operating in silos.”
The guidelines recommend practitioners use traditional therapies while also incorporating alternative treatments, including physical activity and complementary therapies.
A broad multi-faceted approach addressing other issues such as employment, housing and education is recommended as well.
“Comorbid mental health and substance use disorders are incredibly debilitating,” says Dr Marel.
“This is why clients so often have many other health and social problems to contend with including cardiovascular disease, unemployment and homelessness.”