Are Psychiatric Medications Overused in Addiction Treatment?

Addiction treatment can be complex and challenging, mainly when underlying mental disorders exist. As a result, psychiatric drugs like antidepressants, antipsychotics, and mood stabilizers are often prescribed to individuals with addiction to help manage these conditions and improve their chances of recovery. However, the use of psychiatric medications in addiction treatment is a controversial topic.

Some argue that these drugs are often used as a substitute for other treatments or to control behavior. There are also cases of overuse, especially when patients receive drugs for conditions they aren't suffering from.

Psychiatric medications can be effective in managing symptoms of mental disorders. But there's a growing concern about their potential for misuse or abuse and their side effects. With that said, the decision to use psychiatric drugs in addiction treatment should be made on a case-by-case basis. Treatment providers should carefully weigh the potential benefits and risks of these drugs and use them in conjunction with other evidence-based treatments, such as behavioral and group therapy.

What Are Psychiatric Medications?

Psychiatric medications are prescription drugs used to treat various mental health conditions, such as depression, anxiety, bipolar disorder, and schizophrenia. They work by altering the chemicals in the brain that are associated with these conditions.

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In addiction treatment, psychiatric medications help manage the symptoms of underlying mental health conditions that may be contributing to the addiction. According to SAMSHA, mental health and substance use disorders often co-occur, with each condition leading to the other about 50% of the time. Someone with depression or anxiety may turn to drugs or alcohol to cope with their symptoms, and vice versa. A comprehensive approach to dual diagnosis can help ensure both conditions are addressed, helping patients manage their addiction more effectively.

Use of Psychiatric Drugs in Addiction Treatment

Psychiatric drugs can be effective in helping individuals manage the underlying mental health conditions that contribute to their addiction. They can:

Help individuals manage their cravings and withdrawal symptoms, making it easier for them to stay sober.
Help improve an individual's overall quality of life. For example, antidepressants may help those with treatment-resistant depression manage symptoms and improve their mood and quality of life.
Manage symptoms of anxiety disorders and reduce the risk of relapse. In some cases, antipsychotic medications may be prescribed to patients with psychotic disorders, such as schizophrenia, to help manage their symptoms and improve their ability to engage in other aspects of treatment.
Manage underlying mental health conditions, helping individuals maintain sobriety and prevent relapse.

Overuse of psychiatric drugs in addiction treatment

While these medications can effectively treat symptoms and improve the quality of life for some patients, there are concerns about overprescribing and potential side effects. Studies show that many Americans take prescribed medication that may be inappropriate or not work for their mental health problems.

Prescription medications are not always the safest or most effective route for patients. Atypical antipsychotic drugs like Chlorpromazine, Fluphenazine, Haloperidol, etc., have been shown to cause deviations in blood pressure and Tardive Dyskinesia, a movement disorder characterized by abnormal, uncontrollable, and repetitive movements of the torso, face, and other body parts.

They also cause common side effects like blurred vision, confusion and agitation, erectile dysfunction, hallucinations, and drowsiness. Yet, many Americans go to their primary health care providers and leave with a prescription drug without knowledge of other evidence-based treatments that might be more effective and without the side effects.

According to the CDC, many patients are now receiving psychotropic medications without proper evaluation by mental health professionals. This is concerning as proper evaluation and diagnosis by a mental health professional is essential to determine the appropriate course of treatment for a patient's specific condition. Additionally, overreliance on medication as the sole treatment option can overlook other critical interventions, such as therapy or lifestyle changes, that can improve a patient's mental health and well-being.

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In addition, some medications used to treat mental health conditions, such as benzodiazepines or stimulants, can have the potential for dependence and withdrawal symptoms if not properly managed. And to worsen the situation, some withdrawal symptoms can mask mental health conditions, leading to misdiagnosis and overprescription of medication. Such cases can cause life-threatening consequences, exacerbate underlying conditions, increase the risk of self-harm and suicidal thoughts, and compound mental health issues.

Overusing psychiatric medicines may create neurobiological changes that affect long-term mental health recovery. According to research, these permanent changes can turn transient symptoms into chronic and lifelong mental disorders.

Alternative Treatment Options to Psychiatric Drugs

While psychiatric medications can effectively manage certain mental health conditions, they should not be the only treatment option offered to patients. Instead, a comprehensive approach to treatment that includes therapy, counseling, and lifestyle changes should be considered alongside medication use.

Behavioral therapies, such as cognitive-behavioral therapy (CBT) and dialectical behavior therapy (DBT), can help individuals develop coping skills and strategies to manage symptoms of mental health conditions and addiction.
Holistic approaches like yoga and mindfulness can help reduce stress and improve mental well-being. These approaches can be used with psychiatric medications or as an alternative treatment approach.
Support groups, such as Alcoholics Anonymous (AA) and Narcotics Anonymous (NA), can provide individuals with addiction a sense of community and support.

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Psychotropic drugs can be beneficial in addiction treatment and can be life-saving for some patients. However, it is essential for a mental health professional to prescribe psychiatric medications after proper evaluations that include a patient's family history of mental health conditions and any past experiences with medication.

At More Than Rehab, we take a holistic approach to addiction treatment, utilizing evidence-based therapies and medications as appropriate and prioritizing individualized care that addresses the root causes of addiction. Our team of mental health professionals is dedicated to ensuring that medications are used responsibly and appropriately as part of a comprehensive treatment plan.

We recognize that psychotropic drugs can have significant side effects and potential for dependence and therefore prioritize careful evaluation and monitoring of each patient's medication use. Ultimately, our goal is to help patients achieve lasting recovery and improved quality of life through a personalized approach to addiction treatment.

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Misdiagnosis of Withdrawal Symptoms as Mental Health Issues

Withdrawal symptoms are a natural and expected part of quitting addictive substances. They occur because the body and brain have become accustomed to the presence of the substance and have adapted to its effects. When the substance is removed, the body and brain need time to readjust, which can result in emotional, psychological, and social symptoms. The misdiagnosis of withdrawal symptoms, which include sweating, nausea, tremors, seizures, anxiety, depression, irritability, and hallucinations, can often mimic symptoms of mental health disorders.

For example, withdrawal from meth can cause extreme paranoia, anxiety, and hallucinations, which might be mistaken for symptoms of schizophrenia or other mental health conditions. Meth use can also cause long-term changes in the brain, which might lead to signs and symptoms that resemble mental health disorders even after the drug use has stopped.

Similarly, withdrawal from opioids such as heroin or prescription painkillers can cause anxiety, depression, and irritability, which can be misdiagnosed as generalized anxiety disorder or major depressive disorder.

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These symptoms may persist for weeks or even months after the drug use has stopped, making it difficult to distinguish between withdrawal symptoms and underlying mental health conditions. In such cases, a doctor might prescribe an antidepressant to treat symptoms. But this only worsens the situation since depression isn't the primary issue. Eventually, the patient might end up with issues like emotional blunting after stopping antidepressants.

The Negative Impact of Misdiagnosed Mental Illness

Misdiagnosing withdrawal symptoms as mental health can lead to psychological and physical health issues. It can:

Exacerbate the underlying condition

If a person is misdiagnosed with a mental health disorder and prescribed medication to treat that disorder, the medicine may not address the underlying issue of withdrawal, and the person's symptoms may persist or worsen. Moreover, when misdiagnosed with a mental health disorder, they may be prescribed medications that can worsen their withdrawal symptoms or cause new ones.

For example, benzodiazepines, often used to treat anxiety, are addictive and can worsen withdrawal symptoms if a person is already experiencing them. Misdiagnosis can also delay or prevent patients from receiving appropriate attention for their withdrawal, leading to worsening the underlying condition.

Potentially life-threatening consequences

Some withdrawal symptoms, such as seizures, delirium tremens, and respiratory depression, can be life-threatening if left untreated. But when these symptoms are misdiagnosed, and appropriate treatment is delayed or not given, the patient may end up with potentially life-threatening complications, including coma or even death.

Increase the risk of suicidal thoughts and self-harm scenarios

Withdrawal symptoms can lead to intense emotional distress and increase the risk of suicidal thoughts and self-harm scenarios. And the risk is even higher when healthcare providers misdiagnose the symptoms as mental health issues and offer inappropriate medication.

Psychological consequences

Misdiagnosis can also have psychological consequences, leading to a feeling of hopelessness and frustration for the individual. Patients with misdiagnosed mental conditions can end up feeling deflated, confused, and frustrated when they notice that the treatment prescribed is not working. Sometimes, they might feel hopeless or like failures and turn to drugs or alcohol to self-medicate. In extreme cases, they may self-harm or even commit suicide.

Increased risk to self-medicate

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Mental health issues often co-occur with substance use disorders. In fact, according to the National Institute of Mental Health, people with Drug abuse issues may also struggle with mental health issues like bipolar disorder, ADHD, schizophrenia, and personality disorders. This is mainly because these co-occurring disorders share the same contributing factors, including environmental and biological factors.

A misdiagnosis, coupled with a lack of access to the proper psychiatric treatment can further drive one to addiction as they self-medicate to mask the symptoms, trying to make themselves feel better. Conditions like marijuana, cocaine, and opioid use disorder are common because they bring euphoria and escape from the reality of an undiagnosed mental issue.

Causes of Misdiagnosis of Withdrawal Symptoms

There are several potential causes of misdiagnosis of withdrawal symptoms, including:

Lack of knowledge: Some healthcare providers may not be fully aware of the symptoms that can arise during withdrawal or may not be familiar with certain drugs or substances that can cause withdrawal.
Misinterpretation of symptoms: Withdrawal symptoms can often mimic other medical conditions or psychiatric disorders, leading to misinterpretation of symptoms and incorrect diagnosis.
Incomplete patient history: A thorough patient history is essential to accurately diagnose withdrawal symptoms, as a patient's history of substance use or prior withdrawal episodes can provide important clues.
Co-occurring disorders: Patients experiencing withdrawal may also have co-occurring medical or psychiatric conditions that complicate the diagnosis process.
Bias or stigma: Healthcare providers may hold biases or stigmas against patients with a history of substance use, leading to dismissiveness or inaccurate diagnoses. According to the World Health Organization, people with mental health disorders, which include addiction, often face discrimination.
Limited diagnostic tools: Limited diagnostic tools are available for withdrawal symptoms, making it challenging to differentiate between different causes of symptoms.

Prevention and Treatment

Misdiagnosing withdrawal symptoms as mental health issues can significantly affect a patient's health and well-being. However, there are steps that healthcare professionals can take to prevent misdiagnosis and provide appropriate treatment.

One of the most critical steps to prevent misdiagnosis of withdrawal symptoms is to increase education and awareness among healthcare professionals. Healthcare professionals should receive education and training on the common symptoms of withdrawal to improve their understanding and ability to recognize them. This education can help reduce the number of misdiagnosed cases.
Open communication between healthcare professionals and patients is also essential. Patients should disclose their history of substance abuse and the extent of their withdrawal symptoms. This information can help healthcare professionals make a proper diagnosis.
Proper assessment and diagnosis of withdrawal symptoms are crucial to providing the correct treatment. Healthcare professionals should assess and diagnose withdrawal symptoms properly. This assessment can help identify the root cause of the symptoms, leading to proper treatment.

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Once a patient is correctly diagnosed, the appropriate treatment can be administered. Treatment for withdrawal symptoms may include medications to manage physical symptoms, such as nausea, vomiting, and seizures. Behavioral therapies may also address psychological symptoms and help individuals manage their cravings and triggers. Patients can also try out natural remedies for antidepressant withdrawal.

At More Than Rehab, we offer comprehensive, evidence-based treatments to address withdrawal symptoms and support long-term recovery. Our treatment plans are personalized to meet each individual's unique needs and may include a combination of medications, behavioral therapies, and other supportive services. Therapies are especially critical in managing withdrawal as it helps patients handle stress better.

We offer a comprehensive assessment and evaluation process for misdiagnosed clients to determine the underlying causes of their addiction or related issues. This process involves gathering information about the individual's medical and psychiatric history, as well as their substance use, related behaviors and known side effects. If a client has been misdiagnosed, we work with them to re-evaluate their diagnosis and develop an appropriate treatment plan that addresses the underlying causes of their addiction or related issues.

We aim to provide personalized, compassionate care to help individuals achieve and maintain recovery. We are committed to providing the best substance abuse treatment and ongoing support and care to promote long-term success. Call us today. We are available to help 24/7.

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Examining Racial Disparities in Addiction Treatment

Recent research has shed light on racial disparities in addiction treatment, highlighting the need for a more culturally competent and socially-aware approach in the addiction treatment industry. While many acknowledge drug abuse is a leading public health crisis in the country, racial disparities in addiction treatment are too widespread to ignore.

According to SAMHSA, more than 41 million Americans had a substance use disorder in 2020, yet only 2.7 million received treatment. Of those who needed treatment, white people got help 23.5% of the time, while blacks and Hispanics were 18.6% and 17.6%, respectively.

Another study revealed that Black people were 70% less likely to get a buprenorphine subscription at their visit when controlling for age, sex, and payment method. Most of them have to queue at public clinics every morning for a methadone dose. Buprenorphine is a great alternative to methadone as it can be prescribed by a healthcare provider and taken in the comfort of a private home. No stigma, distrust, or standing in line.

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There's also a health equity study of privately insured people who had an overdose and were treated at an ER. The study found that Black people were half as likely to receive overdose treatment compared to white patients. And with the opioid crisis spreading among other ethnic groups like Hispanics and Blacks, this finding is particularly concerning.

The evidence presented in the research demonstrates racial disparities in addiction treatment in the United States. White people are more likely to receive addiction treatment than Black and Hispanic people, which is troubling, as it suggests that certain groups are being underserved and overlooked in the healthcare system. Here's a look at drivers of racial disparities.

Systemic Racism in Healthcare

Although disparities in treatment are multifaceted, race ethnicity is a common theme all through. Systemic racism in healthcare and society at large may contribute to the disparities in addiction treatment outcomes. For example, structural barriers such as limited access to quality healthcare and social determinants of health may disproportionately affect communities of color, leading to greater challenges in accessing and completing addiction treatment.

Inadequate Health Insurance

Inadequate insurance coverage is another major contributor to health disparities. Despite significant efforts to expand access to mental healthcare, many individuals, especially those from racial minority groups, still do not have adequate insurance coverage. Medicaid is the largest payer of mental health services in the United States, and the Affordable Care Act (ACA) expanded Medicaid eligibility to cover more individuals.

However, 12 states are yet to adopt ACA Medicaid expansion. Of these 12 states, 7 are in the southeast region, where most of the US Black population resides. States like Florida and Mississippi have a Black population of 15% and 37%, while the US has a population of 12.4%. This lack of insurance coverage in these states disproportionately affects Black individuals, limiting their access to addiction treatment and other mental healthcare services.

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Older Americans Seeking Help and Blacks Being Terminated from Treatment

Current research also highlights two often overlooked aspects of substance use disorder trends. These aspects include facts that Americans 50+ years are increasingly seeking substance treatment and that older Black citizens starting treatment have higher rates of being terminated from treatment and not finishing treatment compared to their white counterparts.

Lack of Culturally Competent Healthcare Providers

A lack of cultural competency among treatment providers may result in an inadequate understanding of black patients' unique challenges and needs, leading to suboptimal treatment approaches.

The Need to Ensure that Care is Ethnically, Racially, and Culturally Appropriate

The addiction treatment industry needs to be more socially aware of systemic racism and its impact on treatment outcomes and people's lives. Substance use disorders affect individuals from all racial and ethnic backgrounds, but access to care and treatment outcomes are unequal across these groups. Historically, communities of color have faced significant barriers to accessing addiction treatment, including a lack of culturally appropriate care and systemic racism in healthcare systems.

To ensure that care is ethnically, racially, and culturally appropriate, the addiction treatment industry must recognize and address systemic racism in healthcare systems. This means increasing diversity among treatment providers and staff, acknowledging and addressing implicit biases, and providing training and education to ensure that providers have the cultural competence necessary to provide effective care to all patients. This includes healthcare training at schools of medicine across the country.

Cultural competence is the ability of healthcare providers to understand and address the unique needs and perspectives of patients from different cultures and backgrounds. In addiction treatment, cultural competence means understanding how addiction and substance use disorders impact different communities and developing treatment plans tailored to each patient's individual needs and preferences.

Research has shown that culturally appropriate care can improve treatment and health outcomes for patients of color. Studies have found that patients are more likely to remain engaged in addiction treatment when they receive care from providers who understand their cultural experiences and can provide culturally appropriate care in addition to the standard of care. Besides, other steps like partnering with local leaders and organizations that aim to reduce inequalities have increased trust and minimized stigma against treatment, which is essential in mental health and addiction treatment.

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In addition to improving treatment outcomes, providing culturally appropriate care is a matter of social justice. The addiction treatment industry must recognize that systemic racism and other forms of oppression play a significant role in addiction and substance use disorders and work to address these issues in their policies, practices, and treatment approaches.

MICRA (Motivational Interviewing and Community Reinforcement Approach) is an example of a culturally responsive intervention that has been successful. MICRA is an evidence-based treatment approach for SUD developed specifically for American Indian and Alaskan Native populations. It incorporates cultural values and traditions into the treatment process.
The IMANI Breakthrough Recovery Program is another example of a culturally responsive intervention that has been successful. This faith-based initiative addresses substance use disorders (SUD) in Black and Brown communities by providing culturally tailored and trauma-informed support through wellness coaches and group meetings held in local churches.

The addiction treatment industry must take a socially-aware approach to ensure that care is ethnically, racially, and culturally appropriate.

This requires acknowledging and addressing systemic racism in healthcare systems, increasing diversity among treatment providers and staff, and providing training and education to ensure that providers have the cultural competence necessary to provide effective care to all patients. By doing so, the addiction treatment industry can improve treatment outcomes and promote social justice for all patients.

At More Than Rehab, we support this approach to addiction treatment and strive to provide culturally competent care to all our patients. We recognize the importance of addressing racial disparities in addiction treatment and are committed to promoting equity in our services. We believe every patient deserves to be treated with respect, dignity, and compassion, regardless of race, ethnicity, or cultural background.

Our team of highly trained and diverse professionals is dedicated to providing individualized care that considers each patient's unique needs and circumstances. We believe that by taking a socially-aware approach to addiction treatment, we can make a positive impact on our patients' lives and contribute to creating a more just and equitable society.