Treatment of Dual Diagnosis in Denmark

Treatment for dual diagnosis in Denmark is divided between a medically based psychiatric treatment system and a socially oriented substance use treatment system; consequently, in order to deliver the most effective treatment to people with dual diagnosis, the two need to cooperate. A number of projects have been initiated to try out different models for cooperation, yet, on a larger, societal scale, we have not solved the puzzle of how it can be made to work in practice. My focus in this article is to suggest some reasons why it is so difficult to introduce cooperation between psychiatry and addiction treatment despite the many projects directed explicitly towards this. I suggest that at least part of the answer lies in the unequal power relations between psychiatry and substance use treatment.

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Digital Phenotyping to Enhance Substance Use Treatment During the COVID-19 Pandemic

JMIR Mental Health ◽

10.2196/21814 ◽

2020 ◽

Vol 7 (10) ◽

pp. e21814

Author(s):

Michael Hsu ◽

David K Ahern ◽

Joji Suzuki

Keyword(s):

Substance Use ◽

Addiction Treatment ◽

Electrodermal Activity ◽

Clinical Care ◽

Machine Learning Algorithms ◽

Treatment Programs ◽

Substance Use Treatment ◽

Barriers To Access ◽

Digital Phenotyping ◽

Relapse Prediction

Due to the COVID-19 pandemic, many clinical addiction treatment programs have been required to transition to telephonic or virtual visits. Novel solutions are needed to enhance substance use treatment during a time when many patients are disconnected from clinical care and social support. Digital phenotyping, which leverages the unique functionality of smartphone sensors (GPS, social behavior, and typing patterns), can buttress clinical treatment in a remote, scalable fashion. Specifically, digital phenotyping has the potential to improve relapse prediction and intervention, relapse detection, and overdose intervention. Digital phenotyping may enhance relapse prediction through coupling machine learning algorithms with the enormous amount of collected behavioral data. Activity-based analysis in real time can potentially be used to prevent relapse by warning substance users when they approach locational triggers such as bars or liquor stores. Wearable devices detect when a person has relapsed to substances through measuring physiological changes such as electrodermal activity and locomotion. Despite the initial promise of this approach, privacy, security, and barriers to access are important issues to address.

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Dual diagnosis: a paradigm shift for addiction treatment

Mexican Journal of Medical Research ◽

10.29057/mjmr.v5i9.2787 ◽

2017 ◽

Vol 5 (9) ◽

Author(s):

Rafael A. Gómez Benumea

Keyword(s):

Substance Use ◽

Dual Diagnosis ◽

Mixed Models ◽

Paradigm Shift ◽

Addiction Treatment ◽

Public Health Problem ◽

Progressive Increase ◽

The Family ◽

Drugs And Crime ◽

Physical Spaces

Dual diagnosis is defined as the comorbidity of a substance use problem and a psychiatric disorder of a person. Drug addiction is a growing public health problem. The United Nations Office on Drugs and Crime (UNODC) reported a progressive increase in the prevalence of a substance use problem from 3.5% to 5.7% from 2008 to 2010; a new increase from 5.7% to 7% between 2010 and 2012, which represents 324 million consumers worldwide. About 60% to 80% of this population presents this dual diagnosis. Prevalence of a personality disorder and a substance use problem comprises 20% to 50%. Prevalence between a depressive disorder and a substance use problem goes from 12% to 88%. Prevalence between anxiety disorders and substance use problems is from 10% to 24% and between bipolar disorder and substance use from 51% to 60%. The importance of the paradigm shift in the addiction treatment includes mixed models of intervention where substance use disorders and comorbid psychiatric disorders are contemplated. They are necessary because they help preventing a relapse, the increase of costs for the family, that the attention gets divided in different physical spaces, the application of different therapeutic techniques and that the pharmacological treatment is not oriented to treat substance use disorder as it is oriented to treat psychiatric comorbidities. Therefore it is necessary to implement a comprehensive vision and a specific approach for each disorder of the patient.

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Digital Phenotyping to Enhance Substance Use Treatment During the COVID-19 Pandemic (Preprint)

10.2196/preprints.21814 ◽

2020 ◽

Cited By ~ 2

Author(s):

Michael Hsu ◽

David K Ahern ◽

Joji Suzuki

Keyword(s):

Substance Use ◽

Addiction Treatment ◽

Electrodermal Activity ◽

Clinical Care ◽

Machine Learning Algorithms ◽

Treatment Programs ◽

Substance Use Treatment ◽

Barriers To Access ◽

Digital Phenotyping ◽

Relapse Prediction

UNSTRUCTURED Due to the COVID-19 pandemic, many clinical addiction treatment programs have been required to transition to telephonic or virtual visits. Novel solutions are needed to enhance substance use treatment during a time when many patients are disconnected from clinical care and social support. Digital phenotyping, which leverages the unique functionality of smartphone sensors (GPS, social behavior, and typing patterns), can buttress clinical treatment in a remote, scalable fashion. Specifically, digital phenotyping has the potential to improve relapse prediction and intervention, relapse detection, and overdose intervention. Digital phenotyping may enhance relapse prediction through coupling machine learning algorithms with the enormous amount of collected behavioral data. Activity-based analysis in real time can potentially be used to prevent relapse by warning substance users when they approach locational triggers such as bars or liquor stores. Wearable devices detect when a person has relapsed to substances through measuring physiological changes such as electrodermal activity and locomotion. Despite the initial promise of this approach, privacy, security, and barriers to access are important issues to address.

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Harm reduction programs the opportunity for psychiatric and substance use treatment

European Psychiatry ◽

10.1016/s0924-9338(11)71790-4 ◽

2011 ◽

Vol 26 (S2) ◽

pp. 79-79

Author(s):

N. Martínez-Luna

Keyword(s):

Substance Use ◽

Harm Reduction ◽

Psychiatric Treatment ◽

Methadone Maintenance ◽

Substance Use Treatment ◽

Harm Reduction Program ◽

Reduction Program ◽

Methadone Maintenance Program ◽

Drug Problems ◽

Outpatient Drug

IntroductionAt least one-half of patients in substance use treatment have been diagnosed with comorbid psychiatric disorders. High prevalence of severe mental disorders co-occurring with substance use have been described. Harm reduction refers to policies, programs and practices that aim to reduce the harms associated with the use of illegal drugs in people unable or unwilling to stop.ObjectivesTo describe attendance and integration of patients with substance use disorders in a harm reduction program, to psychiatric treatment.AimsFind the importance and profitability of Harm Reduction Programs as an access door to psychiatric treatment in people with drug addiction.MethodsData was gathered from the first interview survey made to patients that contacted the Harm Reduction Program or attending the Outpatient Drug Clinic Vall d’Hebron in Barcelona between January 2005 until September 2010.ResultsA total of 348 patients (males = 71%, European community origin = 92%, mean age = 28,18 years). 63,8% of patients were under medical and psychiatric treatments, 55,4% attended the Methadone Maintenance Program, 7,4% other psychiatric treatments, and other treatments without specification 30,7%. The residential status was: 38% squatters, homeless 9,7%, hostel 3,4%, home 43%, lodging 2%, others 3%.ConclusionsMore than fifty percent of harm reduction program patient's were in a psychiatric treatment, it is an advantage that in the outpatient drug clinic of Vall d’Hebron both programs are included: harm reduction and psychiatric assessment. Access to integral treatment is important for people with drug problems, but many people with drug problems are unable or unwilling to get treatments.

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