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Official websites use. Share sensitive information only on official, secure websites. Please send correspondence and reprint requests to: Douglas M. These reports document the need for best practice recommendations that can be translated into routine clinical care. Although efforts are underway to synthesize literature in this area, few focused recommendations are available that include expert opinion and evidence-based findings on the management of specific co-occurring disorders, such as schizophrenia and addiction.
In response to the need for user-friendly recommendations on the treatment of schizophrenia and addiction, a consensus conference of experts from academic institutions and state mental health systems was organized to 1 frame the problem from clinical and systems-level perspectives; 2 identify effective and problematic psychosocial, pharmacological, and systems practices; and 3 develop a summary publication with recommendations for improving current practice.
The results of the consensus meeting served as the foundation for this publication, which presents a broad set of recommendations for clinicians who treat individuals with schizophrenia. Specific recommendations are provided concerning screening for substance use disorders in patients with schizophrenia, assessing motivation for change, managing medical conditions that commonly occur in patients with dual diagnoses e. Finally the article reviews programmatic and systemic changes needed to overcome treatment barriers and promote the best outcomes for this patient population.
An algorithm summarizing the consensus recommendations is provided in an appendix to the article. Keywords: dual diagnosis, schizophrenia, substance use disorders, comorbidity, integrated treatment, consensus recommendations, psychosocial interventions, Dual Recovery Therapy, cognitive-behavioral therapy, motivational enhancement therapy, Substance Abuse Management Module, pharmacotherapy, antipsychotics.
Many individuals with schizophrenia have a co-occurring substance use disorder, 1 - 3 often involving the use of alcohol, tobacco, or other drugs.