C03 - Management of Substance Use Disorders and Concurrent Disorders: An Evidence-Based Integrated Treatment Review
Friday, 23 October
13:30 – 16:45 (3 hrs plus 15 min break)
Valerie Primeau*, MD, FRCPC; Wiplove Lamba, MD, FRCPC
Supported by the Addiction Psychiatry Section
At the end of this session, participants will be able to: 1) Describe the different treatment modalities for each substance use disorder through case vignettes and discussion; 2) Describe the treatment strategies of psychiatric comorbidities when substance use is present; and 3) Recognize the importance of a trauma-informed, concurrent, and integrated approach for the treatment of mental health and addictions.
In any given year, one in five Canadians experiences a mental health or addiction problem. People with a mental illness are twice as likely to have a substance use disorder, compared to the general population. At least 20% of people with a mental illness have a co-occurring substance use disorder. For people with schizophrenia, the number may be as high as 50%. Similarly, people with substance use disorders are up to three times more likely to have a mental illness. More than 15% of people with a substance use disorder have a co-occurring mental illness. Unfortunately, despite the high prevalence of concurrent mental illness and substance use disorders in clinical practice, psychiatrists are not always familiar with the available evidence-based treatments for substance use disorders, as well as psychiatric comorbidities, and there is significant variability in the treatments offered to patients. Many psychiatrists are not comfortable prescribing anti-craving medications or opioid replacement therapy. Some psychiatrists may feel it is best to wait for substance abstinence before treating the underlying mental illness.
This course will provide a comprehensive evidence-based review of the treatment of substance use disorders and the management of the concurrent mental illnesses. Clinical vignettes will be used to help clinicians think through real-life scenarios and generate rich discussion, as the presenters go through evidence-based approaches for alcohol, opioid, and other substance use disorders, as well as psychiatric comorbidities and drug-induced psychosis.
Health Quality Ontario Opioid Use Disorder Standards https://www.hqontario.ca/portals/0/documents/evidence/quality-standards/qs-opioid-use-disorder-clinician-guide-en.pdf.
The American Psychiatric Association Practice Guideline for the Pharmacological Treatment of Patients with Alcohol Use Disorder