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SAMHSA Position on Treatment for Individuals with Co-Occurring Addictive and Mental Disorders

"The many service delivery systems which are affected by and involved in the delivery of services to people with co-occurring disorders must work together, in respectful partnership, to achieve the changes that are needed. Improvement will not be achieved without recognition of the strengths each sector brings to the table and respect for the values, professional standards and achievements each sector has developed."


"There is no single set of treatment interventions that constitute integrated treatment for people with severe co-occurring addictive and mental disorders. Integrated treatment includes an array of appropriate substance abuse and mental health interventions identified in a single treatment plan based on individual needs and appropriate clinical standards and provided or coordinated by a single treatment team. Integrated treatment embodies several key principles in the delivery of services to people with co-occurring disorders. These principles include the following:

  1. Integrated services for people with co-occurring disorders should take a “no wrong door approach” to services. That is, services must be available and accessible no matter how or where an individual enters the system.

  2. Question: How does HB837 assure that referral for Co-Occurring Patients to obtain Addictive Disorder Treatment and Mental Health Treatment will be seemless, respected and effective?

  3. Individuals should have access to a comprehensive array of services appropriate to their needs. Treatment for co-occurring disorders should be individualized to accommodate the specific needs of different subtypes and different phases of treatment for all established diagnoses. Recent scientific evidence suggests that assertive outreach and motivational interventions (i.e.; to engage people in treatment and keep them in treatment) for substance abuse are necessary components of effective integrated treatment programs for individuals with co-occurring disorders.1

  4. Question: How does HB 837 assure that the "necessary components of effective integrated treatment programs" to "engage people in treatment and keep them in treatment" will be in place for Co-Occurring Patients to obtain integrated Addictive Disorder Treatment and Mental Health Treatment?

  5. Services should be consumer-focused and consumer-family centered. Services should be provided in a manner that welcomes individuals with co-occurring disorders and their families at every level.

  6. Question: How does HB 837 assure that services will be consumer-focused and consumer-family centered when the Jindal administration is on a campaign to effectively streamlined government efficiency? As it is now, services and the ability to provide them to the population are stretched beyond rebound.

  7. Staff in settings providing integrated treatment should be fully oriented in each other’s disciplines. Individuals with co-occurring disorders should be able to receive services from primary providers and case managers who are cross-trained and able to provide integrated treatment themselves.

  8. Question: Does HB 837 assure that services will be provided by professionals in the Addiction and Mental Health disciplines who also hold certifications and credentials such as "Certified Co-Occurring Disorders Professionals"? NO it does not

  9. Administrative functions should not become a barrier to the integration of treatment.

  10. The approaches to providing integrated treatment will of necessity be varied due to the diversity of clients who need services and the unique characteristics of the communities in which they are delivered."

    1 Drake, et al. “Review of Integrated Mental Health and Substance Abuse Treatment for Patients with Dual Disorders.” Schizophrenia Bulletin. Vol. 24. No. 4. 1998. pp. 589-607.

    HB 837 is understood as being of honorable intent.

    Quality of care is contingent upon our ability to incorporate the efficient and effective strategies already outlined by our profession's leaders at the federal level.

    Imagine the probable domino effect on the state's economy, safety, corrections, health and welfare, family services, and child welfare of choosing not to do so.

    Effective Collaboration and utilization for the effective treatment of the problems of addiction (without co-occurring issues) and addiction (with co-occurring issues) cannot be achieved through dissolvement of, but only the maintaining and respect of the Experienced, Professional and Competency Based Leadership of the Addictive Disorder Regulatory Authority working in collaboration with the Office of Mental Health, respecting one another's honest and credible appraisal and working diligently to uphold and streamline the meeting of one another's critical areas of specialization. Effective integration occurs when both, already established for decades, disciplines work together to increase the quality of their services, offering and utilizing each other's strengths when indicated.

    And, both functioning together under a more efficient and streamlined Office of Behavioral Health could be grand if only done in a manner that deserves "to once again believe in Louisiana".

    Disclaimer Note: The above position is the position of the webmaster who has been working in the addiction field since 1984 and is independent of the organizations that the said webmaster associates with and supports.


    Thanks to your attention and commitment to your critically important professional, demanding, rigorous and specialized education and training for the specialized skills needed to illicit change and rebirth in addicted populations (including but not limited to the following):

    The Evidence Based Techniques and Best Practice Standards of Addiction Counseling Professionals; Intervention; Working with Families of Addicted Persons; Co-Occurring Disorder Identification, Treatment Plan Integration and Monitoring, Consultation, and Referral to, and with, the Appropriately Licensed Professionals; Alcohol and Drug Abuse / Dependence Screening, Intake, Assessment and Treatment Planning; Orientation; Client Education; Report and Record Keeping; Motivational Interviewing; American Society of Addiction Medicine (ASAM) Clinical Justification Implementation; Clinical Supervision; Counselor Training; Implementation of all of Our 12 Core Functions of Addiction Professionals; Mastery of the Therapeutic Modalities and Techniques specific to Addicted Populations; and Specialization Advocacy

    lives are being saved, families are being brought back together and your community is being returned productive, contributing members that may have otherwise perished to the grips of their addictions.

    THANK YOU: precious lives and souls continue to rely on your commitment to your specialized skill base.

    "Stay the Course"
    -The Patriot - 2000

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