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Management of Other Substance Use Co-occurring wit ...
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In this video, Edward "Ned" Nunes from Columbia University Medical Center and New York State Psychiatric Institute discusses the management of substance use disorders that co-occur with opioid use disorder. He specifically focuses on benzodiazepines, cocaine and amphetamines, and cannabis. Nunes explains that people with opioid use disorder are at risk for misusing other substances such as benzodiazepines, cocaine, methamphetamine, cannabis, and alcohol. He emphasizes the importance of evaluating the DSM-5 criteria for substance use disorder, as well as screening for co-occurring psychiatric disorders like depression, PTSD, and ADHD. Nunes suggests using a general approach to intervention, including screening, brief intervention, treatment planning, and considering pharmacological and behavioral interventions.<br /><br />When it comes to benzodiazepine use disorder, Nunes suggests evaluating the quantity, pattern, and type of use, as well as screening for benzo misuse or diversion. He mentions that treatment options for benzodiazepine use disorder include tapering, evaluating for co-occurring mood and anxiety disorders, and considering the level of care needed based on severity.<br /><br />Nunes also discusses the evaluation, treatment, and levels of care for cocaine, methamphetamine, and cannabis use disorder. He explains that behavioral treatments such as motivational interviewing and cognitive-behavioral therapy are the mainstay of treatment for these substances, and that medication options are limited in their effectiveness.<br /><br />In conclusion, Nunes emphasizes the importance of evaluating and treating co-occurring substance use disorders in patients with opioid use disorder, and highlights the resources available through the PCSS mentor program for healthcare professionals seeking guidance in managing these cases.
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Keywords
substance use disorders
opioid use disorder
benzodiazepines
cocaine
amphetamines
cannabis
DSM-5 criteria
co-occurring psychiatric disorders
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Funding for this initiative was made possible by cooperative agreement no. 1H79TI086770 and grant no. 1H79TI085588 from SAMHSA. The views expressed in written conference materials or publications and by speakers and moderators do not necessarily reflect the official policies of the Department of Health and Human Services; nor does mention of trade names, commercial practices, or organizations imply endorsement by the U.S. Government.
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