Diagnosis and Treatment: Disease Tracking, Reduction, and Remission

R. Andrew Chambers; Kevin G. Masterson

doi:10.1017/9781009501439.006

5 - Diagnosis and Treatment: Disease Tracking, Reduction, and Remission

Published online by Cambridge University Press: 03 April 2025

R. Andrew Chambers and

Kevin G. Masterson

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R. Andrew Chambers: Affiliation:
Indiana University School of Medicine, Indianapolis
Kevin G. Masterson: Affiliation:
Linden Oaks Hospital, Naperville

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Summary

Addiction is a chronic-progressive disease marked by phases of relapse and recovery. Patients with moderate to severe addictions typically have mental illness of some form (they are dual-diagnosis patients) reflecting how mental illness and addiction are biologically and bidirectionally causally interlinked. Addiction psychiatrists are formally cross-trained in the diagnosis and treatment of both addiction and mental illness. They conduct diagnostic workups that fully embrace complex addiction–mental illness comorbidities while longitudinally tracking illness evolution and recovery trajectories. As implemented in the 2 × 4 model blueprint of integrated addiction psychiatry care, repeated diagnostic evaluations guide individualized treatment planning that attends to patient’s stages of change while integrating psychotherapeutic, experiential, medication, and/or neuromodulator treatments. Multiple mental illness and addiction subtypes are simultaneously or sequentially targeted over the course of detoxification-withdrawal treatments, harm reduction, and full remission strategies. The advancing frontier of addiction psychiatry will involve the growth of inpatient and outpatient teams composed of addiction psychiatrists, nurses, and therapists that reject fragmented/siloed/split-care models that segregate addiction from mental illness treatment and professional training. Addiction psychiatry teams will be important for researching new integrative treatments in full recognition of addiction and mental illness as highly neurobiologically interconnected and clinically interrelated brain diseases.

Keywords

Integrated dual-diagnosis treatment The 2 × 4 model Drug testing Prescription Drug Monitoring Program (PDMP)Psychotherapies Motivational enhancement therapy (MET)Medications Detox-withdrawal treatment (DWT)Harm reduction (HR)Full remission (FR)

Type: Chapter
Information: Introduction to Addiction Psychiatry , pp. 170 - 247

DOI: https://doi.org/10.1017/9781009501439.006 [Opens in a new window]

Publisher: Cambridge University Press

Print publication year: 2025

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