Dr. Steve Delisi, Chief Medical Officer at YourPath Inc., Co-Associate Director at UC-Irvine School of Medicine's 'Train New Trainers' Primary Care - Training and Education in Addiction Medicine Fellowship, Adjunct Professor at Hazelden Betty Ford Graduate School of Addiction Studies, discusses the fundamentals of substance use disorder, the neurobiology and clinical use of translational neuroscience, the relationship between trauma and substance use, best practices for building a therapeutic alliance, and future research on substance use disorders.
Substance Use Disorder involves complex neurobiological processes associated with rewards, reinforcement, and emotions.
Establishing trust and safety with individuals when assessing for Substance Use Disorder is vital.
Avoiding judgmental language and reframing relapse as a reemergence of symptoms can shift the focus toward recovery and adjusting treatment plans.
Deep dives
Importance of Substance Use Disorder Diagnosis
Substance Use Disorder is often separated from other psychiatric diagnoses both clinically and forensically. It is important to recognize the commonness and impact of Substance Use Disorder, which affects millions of people in the United States. Substance Use Disorder not only affects the individual but also has a profound impact on families and communities.
Understanding the Neurobiology of Substance Use Disorder
Substance Use Disorder involves complex neurobiological processes associated with rewards, reinforcement, and emotions. The release of dopamine and activation of reward pathways contribute to the reinforcing effects of substances. Understanding the neuroscience behind Substance Use Disorder can help in reducing stigma and promoting treatment.
Assessment and History-Taking with Substance Use Patients
When conducting an assessment for Substance Use Disorder, it is important to establish trust and safety with the individual. Initiating the conversation with open-ended questions about their reasons for seeking help and the story of their initial substance use can provide vital information for diagnosis and treatment planning. Using destigmatizing language and displaying empathy during the assessment process can facilitate engagement and promote positive therapeutic relationships.
Language and Treatment Approaches
The language used when discussing Substance Use Disorder is vital in reducing stigma and empowering patients. Avoiding judgmental language and reframing relapse as a reemergence of symptoms can shift the focus toward recovery, healing, and adjusting treatment plans. Recognizing the impact of executive functioning deficits and addressing the unique needs of each individual can enhance treatment outcomes.
Self-Care and Wellness for Clinicians
Clinicians should prioritize their own self-care and wellness when working with individuals with Substance Use Disorder. Compassion fatigue, burnout, and other challenges can arise in this demanding field. Seeking support from colleagues, supervisors, and mentors, as well as maintaining one's own mental health, is crucial for providing effective care.
Dr. Steve Delisi, Chief Medical Officer at YourPath Inc., Co-Associate Director at UC-Irvine School of Medicine's "Train New Trainers" Primary Care - Training and Education in Addiction Medicine Fellowship, Adjunct Professor at Hazelden Betty Ford Graduate School of Addiction Studies, walks through the fundamentals of substance use disorder.
We discuss the neurobiology of substance use disorder and explore the clinical use of "translational neuroscience." You'll also learn about the relationship between trauma and substance use, hear best practices for building a therapeutic alliance with this patient population, and catch a glimpse into future research on substance use disorders.
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