# Presentation: 663515

## Substance Abuse Treatment for Persons with Co-Occurring Disorders

- Inservice Training
- TIP 42

## What is a TIP?

- Best-practice guidelines for treatment of substance use disorders
- Developed by Center for Substance Abuse Treatment (CSAT)
- Draws on experience and knowledge of clinical, research, and administrative experts in a particular topic area
- Consensus Panel for TIP 42, page xi

## ATTC Network 2001-2006 

**ATTC of****New England**

**Northeast****ATTC**

**Pacific****Southwest****ATTC**

**Northwest****Frontier****ATTC**

**Prairielands ****     ATTC**

**Mid-America****ATTC**

**Great Lakes****ATTC**

**Gulf Coast ATTC**

**Mountain****West****ATTC**

** ****Mid-Atlantic ATTC**

**Southern Coast****ATTC**

**Southeast ATTC**

**Central East****ATTC**

**Caribbean Basin, Hispanic/Latino & US Virgin Islands ATTC**

**Central East ATTC**

**Northwest****Frontier****ATTC**

**ATTC National Office**

**ATTC Network 2001-2006 **

## Module 1

**Introduction: **
***The Evolving Field of***
***Co-Occurring Disorders***

## In This Module . . .

- Overview of the evolving field of Co-Occurring Disorders
- Understanding of the important developments that led to TIP 42
- Initial exploration of TIP 42 and how it is organized.

## TIP Exercise—Terms

- Read the left column on Page 27
- Discuss with your partner:
- Which of these terms have you ever used or heard?
- Which of these terms are used in your programs?
- What advantages does the term “co-occurring disorders” have over “dual diagnosis” and “dual disorder”?  Over the other terms?

## Co-Occurring Disorders

*Co-occurring disorders*
- Refers to co-occurring substance use (abuse or dependence) and mental disorders.
*Clients said to have co-occurring disorders have:*
- one or more disorders relating to the use of alcohol and/or other drugs of abuse _*and*_* *one or more mental disorders.
*Diagnosis of co-occurring disorders (COD) occurs when*
- at least one disorder of each type can be established independent of the other _*and*_* *is not simply a cluster of symptoms resulting from the one disorder.

## Co-Occurring Disorders:Your setting

- Do these definitions describe clients in your practice/program*?* *(Estimate percentage or describe prevalence**)*
- How has serving clients with COD affected your practice/program?
- What challenges do clients with COD present to your clinical knowledge and skills?

## Co-Occurring Disorders:Implications

- Treatment
- Prevalence of COD, multiple problems they create, impact on treatment and treatment outcome, new models/strategies are receiving attention and encouraging treatment innovation
- Clinicians & Knowledge Dissemination
- Knowledge of both mental health and substance abuse is essential and dissemination of knowledge has become widespread

## Why a new TIP on Co-Occurring Disorders?

- Availability of data
- Treatment innovations for other populations with COD
- Changes in treatment delivery
- Advances in treatment
- Recent developments

## Prevalence of COD

- In 2002, 4 million adults met the criteria for both serious mental illness (SMI) and substance dependence and abuse.
- An estimated 10 million Americans of all ages and in both institutional and non-institutional settings have COD in any given year.

## Prevalence of COD among SMI and SA Adult Populations

## Prevalence and Other Data 

*Data now show:*
- COD are common in general adult population.
- Increased prevalence of people with COD and programs for people with COD.
- People with COD are more likely to be hospitalized and the rate may be increasing.
- Rates of mental disorders increase as the number of substance use disorders increase.

## Why a new TIP on Co-Occurring Disorders?

- Availability of data
- Treatment innovations for other populations with COD
- Changes in treatment delivery
- Advances in treatment
- Recent developments

## Advances in Treatment of COD

- “No wrong door” policy
- Mutual self-help for people with COD
- Integrated care as a priority for people with severe and persistent mental illness
- Development of effective approaches, models, and strategies
- Pharmacological advances

## Recent Developments

- National Registry of Effective Programs and Practices (NREPP)
- Co-Occurring Disorders State Incentive Grants (COSIG)
- Co-Occurring Center for Excellence (COCE)
- Report to Congress on the Prevention and Treatment of Co-Occurring Substance Use Disorders and Mental Disorders
- Co-Occurring Disorders: Integrated Dual Disorders Treatment Implementation Resource Kit