One of the most common questions we receive in admissions is “Do you work with both mental health and substance use?” The answer to that is “yes.” Then the follow up question usually becomes “Well, how does that work?”
Research shows that there is a great deal of overlap in the neurobiologic systems involved in the pathophysiology of psychiatric disorders and substance use disorders. Neuroadaptations in brain stress as well as the reward pathways associated with chronic stress may predispose or unmask a vulnerability to psychiatric disorders, substance use disorders, or both. A trial conducted on a large sample of adults in 2009 highlighted the prevalence of comorbid psychiatric and substance use disorders; in particular, associations with substance use coinciding with anxiety, mood and personality disorders (Hartwell, Tolliver, Brady, 2009). Of course this is not the case in every situation. Many clients experiencing anxiety, mood disorders and struggling with trauma have no history of using substances. Yet, this information better helps us approach each client by utilizing a trauma lens.
The trauma lens is often referred to as “trauma informed care.” It is based on 5 principles and offers a clear, compassionate and rewarding approach.
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References
Hartwell, K. J., Tolliver, B. K., & Brady, K. T. (2009). Biologic Commonalities between Mental Illness and Addiction. Primary psychiatry, 16(8), 33–39.
Purkey, E., Patel, R., & Phillips, S. P. (2018). Trauma-informed care: Better care for everyone. Canadian family physician Medecin de famille canadien, 64(3), 170–172.
- Bear witness to the patient’s experience of trauma.
- Help patients feel they are in a safe space and recognize their need for physical and emotional safety.
- Include patients in the healing process.
- Believe in the patient’s strength and resilience.
- Incorporate processes that are sensitive to a patient’s culture, ethnicity, and personal and social identity.
