PubMed · 15341384
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Elizabeth Brewin. Sharing the knowledge.. https://pubmed.ncbi.nlm.nih.gov/15341384/
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BACKGROUND: Norway has recently established a nationwide system for methadone-assisted rehabilitation of opiate users, but few studies have been undertaken to investigate outcome. MATERIAL AND METHODS: 75 opiate users in Oslo were interviewed at start of treatment and at follow-ups one and two years later in 1999-2002. The main instruments at all three points were EuropASI and SCL-25. MCMI-II was additionally used at the start. RESULTS: Five patients (7%) died during the two-year observation period; 24 patients (34%) dropped out of treatment. A significant and stable reduction in the use of opiates, as well as for criminality and prostitution, was found. No changes in the use of other substances, economic status and employment status were found. Depressive symptoms increased significantly during the last year. INTERPRETATION: The data indicate that the speed at which new patients started treatment came at the sacrifice of psychosocial rehabilitation.
Tobacco dependence among individuals with a mental illness or an addiction is a tremendous problem that goes largely ignored. Studies of genetics, neuroimaging, and nicotinic receptors support a neurobiological link between tobacco use and alcohol dependence, drug dependence, schizophrenia, depression, attention-deficit hyperactivity disorder (ADHD), and anxiety disorders. This paper summarizes the recent literature on this topic and discusses how treatment for tobacco can no longer be ignored in mental-health and addiction-treatment settings. More research is needed as well as a national organized effort to address tobacco in this large segment of smokers.
Approximately half of patients with schizophrenia have a lifetime diagnosis of substance abuse disorders. These dual diagnosis patients are more likely to have poorer outcomes, including more severe psychiatric symptoms with increased hospitalizations, higher utilization of services and frequent homelessness. Assessment and treatment of dually diagnosed patients has evolved over the last twenty years. To date, the strongest evidence for effective management of dual diagnosis patients has been utilization of integrated treatment services, which combines both mental health and substance abuse treatments concurrently. Strategies commonly used include a combination of pharmacological treatment, intensive case management, motivational interviewing, individual and group psychotherapy, and family participation. This chapter summarizes the treatment options available for this population.