Integrated treatment of substance use and psychiatric disorders
Open accessAbstract
Epidemiological studies find that psychiatric disorders, including mental disorders and substance use disorders, are common among adults and highly comorbid. Integrated treatment refers to the focus of treatment on two or more conditions and to the use of multiple treatments such as the combination of psychotherapy and pharmacotherapy. Integrated treatment for comorbidity has been found to be consistently superior compared to treatment of individual disorders with separate treatment plans. This article focuses on a review of the risks for developing comorbid disorders and the combinations of treatments that appear to be most effective for clients with particular comorbid disorders.
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Combined interventions for psychiatric disorders and SUDs may be more effective, less burdensome, and less costly than separate treatment plans.
“Combined interventions for psychiatric disorders and SUDs may therefore be more effective, less burdensome, and less costly than separate treatment plans, so integrated treatments that address opioid use and common co-morbidities may enhance long-term retention 6.”
From Effects of a trauma-informed mindful recovery program on comorbid pain, anxiety, and substance use during primary care buprenorphine treatment: A proof-of-concept study (2023) · cites this paper as [6]
The Introduction says integrated treatment is superior to separate, single-focused treatment for co-occurring psychiatric and substance use disorders. The passages do not establish that it is less burdensome or less costly; searches for cost and burden found no supporting passage. No page numbers were supplied in our copy. (LLM, conf=0.88)
Experimental — accuracy not yet measuredPrevious reviews have found integrated treatments more effective than parallel or single disorder options.
“We anticipated that integrated versus non-integrated treatments would be a significant moderator of anxiety and substance use as previous reviews have found integrated treatments more effective then parallel or single disorder options.(Kelly & Daley, 2013; Mangrum et al., 2006; Mueser, 2003; Torchalla et al., 2012; van Wamel et al., 2015; Yule & Kelly, 2019)”
From A systematic review and meta-analysis of psychosocial interventions for persons with comorbid anxiety and substance use disorders (2024) · cites this paper as Kelly & Daley, 2013
Modafinil activates glutamatergic circuits while inhibiting GABA.
“Modafinil also activates glutamatergic circuits while inhibiting GABA.130,131”
From The ASAM/AAAP Clinical Practice Guideline on the Management of Stimulant Use Disorder (2024) · cites this paper as [131]
The section on neurological and psychological interactions discusses dopamine, serotonin, and endocannabinoids, but does not address modafinil’s effects on glutamatergic circuits or GABA. Searches for modafinil and for glutamate/GABA returned no passage supporting the claim; our copy does not settle it. (LLM, conf=0.72)
Experimental — accuracy not yet measuredThe exact mechanism of modafinil is unclear, but in vitro studies show that it modulates multiple neurotransmitter systems, including dopamine, serotonin, and norepinephrine reuptake, as well as histamine and hypocretin signaling.
“The exact mechanism of action of modafinil is unclear, though in vitro studies have shown that it modulates multiple neurotransmitter systems, including dopamine, serotonin, and norepinephrine reuptake, as well as histamine and hypocretin signaling.”
From The ASAM/AAAP Clinical Practice Guideline on the Management of Stimulant Use Disorder (2024) · cites this paper as [131]
The section “Neurological and Psychological Interaction of SUD and Non-SUD Psychiatric Disorders” discusses dopamine in drugs of abuse and serotonin in alcohol and ecstasy, not modafinil. Searches for modafinil, its proposed in vitro mechanism, histamine, and hypocretin found no passage addressing the claim in our copy; page numbers were unavailable. (LLM, conf=0.76)
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- Weiss RD Connery HS 2011 Integrated group therapy for bipolar disorders and substance abuse New York, NY Guilford Press
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- Authors
- Kelly, T. M., & Daley, D. C.
- Affiliations
- University of Pittsburgh Medical Center (US)
- ORCID
- Kelly, Thomas M.
- Venue
- Social Work in Public Health
- Publisher
- Informa UK Limited
- Published
- 2013-05
- Volume
- 28
- Issue
- 3-4
- Pages
- 388-406
- ISSN
- 1937-190X (ISSN-L)
- 1937-1918
- PMC
- PMC3753025
- OpenAlex
- W2039958472
- Cited by
- 378
- References
- 147
- Citations by year
- 2026: 39 · 2025: 47 · 2024: 50 · 2023: 40 · 2022: 52 · 2021: 44 · 2020: 32 · 2019: 38 · 2018: 15 · 2017: 11 · 2016: 5 · 2015: 4 · 2014: 1
- FWCI
- 2.43
- Type
- journal article
- Language
- en
- Open access
- green
- europepmc.org
- Locations
- Social Work in Public Health (publishedVersion)
- PubMed (publishedVersion)
- Europe PMC (PubMed Central) (acceptedVersion)
- PubMed Central (acceptedVersion)
- Funders
- National Institutes of Health (5u10da020036-10)
- National Institute on Drug Abuse (U10-DA020036)
- Topics
- Health Sciences › Medicine › Epidemiology › Substance Abuse Treatment and Outcomes
- Social Sciences › Psychology › Social Psychology › Mental Health Treatment and Access
- Social Sciences › Psychology › Clinical Psychology › Psychiatric care and mental health services
- Keywords
- integrated treatment, substance use disorders, mental illness, comorbidities, psychotherapy, pharmacotherapy, treatment effectiveness
- MeSH terms
- Adult, Mental Disorders, Combined Modality Therapy, Humans, Psychotherapy, Delivery of Health Care, Integrated, Substance-Related Disorders
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