Objectives: The aim of this paper is to review current treatment guidelines regarding the treatment of common co-occurring disorders including evidence for the use of psychotherapeutic techniques and concurrently administered integrated treatment, and to highlight areas for future study.
Methods: A PubMed search was conducted between 6/2017 to 2/2018 to identify published articles examining the treatment of co-occurring substance use and primary psychiatric disorders. Search terms included ‘co-occurring’, ‘dual diagnosis’, ‘amphetamines, ‘methamphetamines’, ‘alcohol’, ‘cocaine’, ‘cannabis’, ‘post-traumatic stress disorder/PTSD’, ‘Major Depressive Disorder/MDD’, ‘Bipolar Disorder’, ‘Borderline Personality Disorder’, ‘Schizophrenia’, ‘psychosis,’ ‘treatment’, ‘therapy’, ‘pharmacotherapy’, ‘psychotherapy’, ‘medications’. As the focus is specifically on treatment, articles that did not address treatment were excluded as were any articles that did not address integrated treatment.
Results: Review of available literature base is consistent with the notion that patients with co-occurring substance use and psychiatric disorders represent unique subpopulations requiring targeted care, supports a concurrent, combined approach to treatment as opposed to treating one disorder first, and emphasizes the importance of psychotherapeutic techniques.
Conclusion: Although many gaps exist in the current literature and considerable additional research is necessary, available evidence supports concurrent integrated treatment, questions traditional treatment practices that treat each disorder in isolation and emphasizes the importance of psychotherapeutic techniques in addition to Medication-Assisted Treatment. Clinical practice should take these results into consideration and modify treatment protocols accordingly.
