Pediatric Half and Half MAT Waiver Training-Co-Occurring Disorders

Co-Occurring Disorders

Pdf Summary

Co-occurring disorders (CODs), which refer to the simultaneous presence of a substance use disorder and another mental health disorder, are common. This module focuses on the challenges of managing patients with psychiatric diagnoses complicating opioid use disorders. It is important for primary care providers to become comfortable with screening for common psychiatric disorders, particularly safety concerns and substance-induced symptoms. A mnemonic called SPASMM (Substances, Psychosis, Anxiety, Safety, Mood, Medical) can be helpful in organizing thoughts during screening. Laboratory testing, including substance use screening, should be done during the initial evaluation. Knowing when to send a patient for an emergency evaluation is crucial. Treatment of co-occurring disorders should be approached simultaneously, and providers should be aware of local availability of mental health services. Three cases are presented in this module: one involving ADHD, one involving anxiety disorders, and one involving depression. In the case of ADHD, medication treatment should continue, but alternatives may need to be considered if parents cannot monitor the medication. For anxiety disorders, treatment should include therapy and potentially medication, while monitoring for substance use. Treatment for depression should be continued even if substance use is identified, and therapy and medication should be used simultaneously. It is important to screen for potential medical causes of depressive symptoms and to educate parents and patients about manic symptoms. Treatment for depression and substance use disorders should continue for 6-12 months after remission of depression symptoms to prevent relapse.

Keywords

Co-occurring disorders

Substance use disorder

Mental health disorder

Opioid use disorders

Primary care providers

Screening

Treatment

ADHD

Anxiety disorders

Depression