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Management of Substance Use Disorder in Schizophrenia Patients: Current Guidelines

Published online by Cambridge University Press:  07 November 2014

Robert E. Drake
Robert E. Drake*
Affiliation:
Dr. Drake is professor of psychiatry in the Department of Psychiatry at, Dartmouth Medical School, in Lebanon, New Hampshire
*
Robert E. Drake, MD, PhD, Psychiatric Research Center, Department of Psychiatry, Dartmouth Medical School, 2 Whipple Place, Lebanon, NH 03766. E-mail: Robert.E.Drake@dartmouth.edu.
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Abstract

Substance use disorder is the most frequent and clinically significant comorbidity among schizophrenia patients today. All schizophrenia patients should be assessed and monitored carefully regarding their substance use. Those with any regular use of alcohol or other drugs should be considered at risk for multiple adverse effects. As therapies for co-occurring substance use disorders have evolved over the past 20 years, medication management, psychosocial interventions, and rehabilitation models have increasingly emphasized the integration of mental health and substance abuse treatments, attention to group and residential interventions, matching interventions to stage of treatment, comprehensiveness, and long-term perspectives on recovery. Clinicians should understand the implications of each of these principles of care.

Type
Research Article
Information
CNS Spectrums , Volume 12 , Issue S17 , 2007 , pp. 27 - 32
Copyright
Copyright © Cambridge University Press 2007

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References

1.Dixon, L. Dual diagnosis of substance abuse in schizophrenia: prevalence and impact on outcomes. Schizophr Res. 1999;35(suppl):S:93–100.CrossRefGoogle ScholarPubMed
2.Mueser, KT, Noordsy, DL, Drake, RE, Fox, L. Integrated Treatment for Dual Disorders: A Guide to Effective Practice. New York, NY: The Guilford Press; 2003.Google Scholar
3.Drake, RE, Brunette, MF. Complications of severe mental illness related to alcohol and other drug use disorders. In: Galanter, M, ed. Recent Developments in Alcoholism. vol. 14. New York, NY: Plenum Publishing Company; 1998:285–299.CrossRefGoogle Scholar
4.Diagnostic and Statistical Manual of Mental Disorders. 4th ed. Washington, DC: American Psychiatric Association; 1994.Google Scholar
5.Minkoff, K. An integrated treatment model for dual diagnosis of psychosis and addiction. Hosp Community Psychiatr. 1989;40(10):1031–1036.Google ScholarPubMed
6.Ridgely, MS, Goldman, HH, Willenbring, M. Barriers to the care of persons with dual diagnoses: Organizational and financing issues. Schizophr Bull. 1990;16(1):123–132.CrossRefGoogle Scholar
7.Drake, RE, Osher, FC, Noordsy, DL, Hurlbut, SC, Teague, GB, Beaudett, MS. Diagnosis of alcohol use disorders in schizophrenia. Schizophr Bull. 1990;16(1):57–67.CrossRefGoogle ScholarPubMed
8.McHugo, GJ, Drake, RE, Burton, HL, Ackerson, TH. A scale for assessing the stage of substance abuse treatment in persons with severe mental illness. J Nerv Ment Dis. 1995;183(12):762–767.CrossRefGoogle ScholarPubMed
9.Rosenberg, SD, Drake, RE, Wolford, GL, et al.The Dartmouth Assessment of Lifestyle Instrument (DALI): A substance use disorder screen for people with severe mental illness. Am J Psychiatry. 1998;155(2):232–238.CrossRefGoogle Scholar
10.Drake, RE, Mueser, KT, Brunette, MF, McHugo, GJ. A review of treatments for people with severe mental illness and co-occurring substance use disorder. Psychiatr Rehabil J. 2004;27(4):360–374.Google Scholar
11.Green, AI, Noordsy, DL, Brunette, MF, O'Keefe, C. Substance abuse and schizophrenia: Pharmacotherapeutic intervention. J Subst Abuse Treat. In press.Google Scholar
12.Owen, RR, Fischer, EP, Booth, BM, Cuffel, BJ. Medication noncompliance and substance abuse among patients with schizophrenia. Psychiatr Serv. 1996;47(8):853–858.Google ScholarPubMed
13.Deegan, PE, Drake, RE. Shared decision making and medication management in the recovery process. Psychiatr Serv. 2006;57(11):1636–1639.Google Scholar
14.Mueser, KT, Corrigan, PW, Hilton, DW, et al.Illness management and recovery: a review of the research. Psychiatr Serv. 2002;53(10):1272–1284.Google Scholar
15.Rubio, G, Martínez, I, Ponce, G, Jiménez-Arriero, MA, López-Muñoz, F, Alamo, C. Long-acting financial risperidone compared with zuclopenthixolin the treatment of schizophrenia with substance abuse comorbidity. Can J Psychiatry. 2006;51(8):531–539.Google Scholar
16.Brunette, MF, Noordsy, DL, Xie, H, Drake, RE. Benzodiazepine use and abuse among patients with severe mental illness and co-occurring substance use disorders. Psychiatr Serv. 2003;54(10):1395–1401.Google Scholar
17.Siris, SG, Mason, SE, Bermanzohn, PC, Shuwall, MA, Aseniero, MA. Adjunctive imipramine in substance-abusing dysphoric schizophrenic patients. Psychopharmacol Bull. 1993;29(1):127–133.Google ScholarPubMed
18.Petrakis, IL, O'Malley, S, Rounsaville, B, et al.Naltrexone augmentation of neuroleptic treatment in alcohol abusing patients with schizophrenia. Psychopharmacology (Berl). 2004;172(3):291–297.CrossRefGoogle ScholarPubMed
19.Petrakis, IL, Nich, C, Ralevski, E. Psychotic spectrum disorders and alcohol abuse: a review of pharmacotherapeutic strategies and a report on the effectiveness of naltrexone and disulfiram. Schizophr Bull. 2006;32(4):644–654.CrossRefGoogle Scholar
20.Osher, FC, Kofoed, LL. Treatment of patients with psychiatric and psychopactive substance use disorders. Hosp Community Psychiatry. 1989;40(10):1025–1030.Google Scholar
21.Drake, RE, O'Neal, E, Wallach, MA. A systematic review of research on interventions for people with co-occurring severe mental and substance use disorders. J Subst Abuse Treat. In press.Google Scholar
22.Drake, RE, Wallach, MA, Alverson, HS, Mueser, KT. Psychosocial aspects of substance abuse by clients with severe mental illness. J Nerv Ment Dis. 2002;190(2):100–106.CrossRefGoogle ScholarPubMed
23.Drake, RE, Wallach, MA, McGovern, MP. Future directions in preventing relapse to substance abuse among clients with severe mental illness. Psychiatr Serv. 2005;56(10):1297–1302.Google Scholar
24.Alverson, H, Alverson, M, Drake, RE. An ethnographic study of the longitudinal course of substance abuse among people with severe mental illness. Community Ment Health J. 2000;36(6):557–569.Google Scholar
25.McCoy, ML, Devitt, T, Clay, R, et al.Gaining insight: who benefits from residential, integrated treatment for people with dual diagnoses? Psychiatr Rehabil J. 2003;27(2):140–150.Google Scholar
26.McHugo, GJ, Bebout, RR, Harris, M, et al.A randomized controlled trial of integrated versus parallel housing services for homeless adults with severe mental illness. Schizophr Bull. 2004;30(4):969–982.CrossRefGoogle ScholarPubMed
27.Sengupta, A, Drake, RE, McHugo, GJ. The relationship between substance use disorder and vocational functioning among persons with severe mental illness. Psychiatr Rehabil J. 1998;22:41–45.Google Scholar
28.Drake, RE, McHugo, GJ, Xie, H, Fox, M, Packard, J, Helmstetter, B. Ten-year recovery outcomes for clients with co-occurring schizophrenia and substance use disorders. Schizophr Bull. 2006;32(2):464–473.Google Scholar
29.George, TP, Ziedonis, DM, Feingold, A, et al.Nicotine transdermal patch and atypical antipsychotic medications for smoking cessation in schizophrenia. Am J Psychiatry. 2000;157(11):1835–1842.CrossRefGoogle ScholarPubMed
30.Evins, AE, Cather, C, Deckersbach, T, et al.A double-blind placebo-controlled trial of buproprion sustained smoking or smoking cessation in schizophrenia. J Clin Psychopharmacol. 2005;25(3):218–225.CrossRefGoogle ScholarPubMed
31.McLellan, AT, Lewis, DC, O'Brien, CP, Kleber, HD. Drug dependence, a chronic medical illness: implications for treatment, insurance, and outcomes evaluation. JAMA. 2000;284(13):1689–1695.CrossRefGoogle ScholarPubMed
32.Xie, H, Drake, RE, McHugo, G. Are there distinctive trajectory groups in substance abuse remission over 10 years? An application of the group-based modeling approach. Adm Policy Ment Health. 2006;33(6):423–432.CrossRefGoogle ScholarPubMed
33.McHugo, GJ, Drake, RE, Teague, GB, Xie, H. Fidelity to assertive community treatment and client outcomes in the New Hampshire dual disorders study. Psychiatr Serv. 1999;50(6):818–824.Google Scholar