Anxiety & Addiction The Dual Disorders that occur in humans

How would you incorporate psychopharmacological treatment when working with a client suffering from anxiety and addiction?

According to Dr. Minkoff 2005, There is no one correct approach (including psychopharmacologic approach) to individuals with co-occurring disorders,” (Para 7). It is necessary to have an organized evidence based approach to assessment and treatment of individuals who present with co-occurring conditions of any type. Because treatment of the substance abuse will not cure the anxiety they must be treated together. A well-established, highly effective, and lasting treatment is cognitive-behavioral therapy, or CBT, which focuses on identifying, understanding, and changing thinking and behavior patterns. I would also suggest the client join a group therapy program along with individual therapy, (Anxiety and Depression of America Association).

 What types of medication would you expect the client to be prescribed?

Making sure to use the lowest possible addictive drug for the anxiety is paramount to helping reduce relapse circumstances. The drug I think they would use would be SSRIs such as Zoloft, Paxil, or Prozac. Because of the addiction the client must be monitored closely over long-term therapy.

What medications should not be prescribed?

Xanax (alprazolam)

Klonopin (clonazepam)

Valium (diazepam)

Ativan (lorazepam)

The reason I chose these is because the client needs long-term treatment and these medications are highly addictive and never should be used for long-term care as this patient will need. Another reason is many people report being like in a zombie state on these drugs because the slow the nervous system down rapidly (30 minutes or less). If the person must function outside the home these drugs can cause problems for the patient, e.g., driving, or working. These medications can have a hangover effect that last well into the next day depending on the client’s tolerance levels. The side effects of these drugs include issues such as slurred speech, dizzy, memory issues, confusion, headaches, and stomach problems. All of these I would suspect would just irritate the anxiety disorder already present, and the client already has an addiction problem so the likelihood of these drugs creating another addiction in the client is a high risk.

Reference

Anxiety and Depression Association of America 2017. Substance Use Disorders. Retrieved from https://adaa.org/understanding-anxiety/related-illnesses/substance-abuse#