The post-test for this issue is available for one year after the publication date to subscribers only. By successfully completing the test you will be awarded a certificate for 2 CME credits.

Patients with co-occurring disorders (COD, also known as “dual diagnosis”) are often regarded as among the most challenging patients to treat. You need to track two conditions that interact in unpredictable ways, with patients who may not be inclined to follow your recommendations. It’s no surprise that such patients typically have poorer outcomes than those with either disorder in isolation. And these patients are far from rare.

Despite an increased awareness of co-occurring disorders, there remains a fair amount of confusion about how to treat a mental health issue and a substance abuse issue at the same time without causing more harm. To further complicate the issue, when patients first walk in you often don’t know whether they are dealing with two conditions concurrently. Charles Atkins’ book, Co-Occurring Disorders: Integrated Assessment and Treatment of Substance Use and Mental Disorders, addresses these problems. We turned to him for some practical guidance.

The post-test for this issue is available for one year after the publication date to subscribers only. By successfully completing the test you will be awarded a certificate for 1 CME credit.

Everyone knows about Alcoholics Anonymous (AA), the original 12-step group. There are more than 60,000 weekly AA meetings in the U.S. alone. Despite this near-monopoly, however, many patients object to some of the most basic tenets of 12-step groups. This article presents alternatives, such as SMART Recovery.

Online programs to provide substance abuse treatment? Phone apps that can measure someone’s blood alcohol level? Welcome to the future­—in some cases, the very near future. Dr. Nunes, the deputy director for intervention studies at the Center for Technology and Behavioral Health, sheds light on technology-assisted care.

Contingency management (CM) programs are often effective, but they can be expensive, with typical incentives costing $900–$3,000 for a 12-week program. Expensive CM programs are referred to as “high magnitude.” In this new study, researchers tested an “ultra-low magnitude” program (basically, a very cheap program) to see if offering inexpensive reinforcers would be effective for an opioid-abusing clientele.

The post-test for this issue is available for one year after the publication date to subscribers. By successfully completing the test you will be awarded a certificate for 2 CME credits.

Naltrexone is an opioid blocker that is FDA-approved for the treatment of alcoholism. However, it is also effective off-label for treating opioid use disorder. The medication comes in two forms: an oral pill (brand name ReVia) and an injectable version (XR naltrexone, or Vivitrol). XR naltrexone is composed of 380 mg of naltrexone, given as an intramuscular injection once a month. During that month, patients who try to use opioids will feel little if any high. This works well to prevent relapse if patients keep getting the shot.

While the age-old tradition of smoking cannabis remains very common, several other options for preparing the drug are becoming widely available and frequently used. In this article, we’ll update you on the modern preparations and routes of administration.