Addiction is rarely a stand-alone problem. As research and clinical reality demonstrate, concurrent addiction, mental health and other medical problems are quite common.
Due to the stigma associated with substance use issues, there is often a focus on substances such as cocaine, cannabis and opiates. However, substance use issues involving sedatives, various pain medications and other over-the-counter and prescription drugs are often seen in the primary care setting. Primary care practitioners also likely see many clients who use tobacco, alcohol and caffeine, but client use of these substances often remains unexplored. Due to the potential interaction of these substances with other medications, the possible impact on clients' work and school performance and the biological effects of using substances, primary care practitioners should look for substance use problems as a normal part of general assessment and in a way that begins to lift the stigma around such problems.
- anxiety disorder and alcohol use problems
- schizophrenia and cannabis use
- depression and benzodiazepine abuse
- borderline personality disorder and oxycodone dependence
- eating disorder and cocaine use
- problem gambling and depression
- attention-deficit/hyperactivity disorder and stimulant abuse.
- stress, trauma and substance use problems
- anxiety disorders and substance use problems
- impulsivity and substance use problems
- mood disorders (including bipolar disorders) and substance use problems
- psychosis and substance use problems.
Skinner (2010) outlined the role of primary care for people with concurrent disorders using the acronym I–SEE:
- substance use problems
- mental health problems
- understanding of the relationship between these problems
- motivation to change
- psychosocial functioning.
- be empathic and hopeful
- provide integrated and co-ordinated care
- recognize that this work will involve multiple treatment sessions