This course will review the current research on the intersection of substance use and mental health, starting with a review of research on the neurobiology of substance use disorder, followed by substance specific trainings and a look at specific case examples.
The New Neurobiology of Addiction and Implication for Treatment
From a neurobiological perspective, addiction is the hijacking of the pleasure-reward pathways of the brain and a weakening of its executive function. In 2021, the fundamental model has been expanded to include newer concepts such as motivational circuitry and anti-reward pathways. These 21st century discoveries inform clinical innovations that are now changing the landscape of the pharmacological and psychosocial treatments of substance use and co-occurring disorders.
Alcohol: from Brief Interventions to Current Medications
Despite alcohol’s legal status and social acceptability in many countries, it remains a potentially dangerous, toxic substance. Withdrawal from alcohol can be fatal, and medically managed withdrawal is often necessary to ensure patient safety. Three medications are approved for the treatment of alcohol use disorder—acamprosate, naltrexone, and disulfiram—while selection of a treatment is dependent largely on individual circumstances and preference.
Alcohol use frequently co-occurs with anxiety disorders, which require coordinated management and complex psychopharmacology in order to ensure stabilization and recovery.
Opioids: from a Medical Mistake in the 80s to the Epidemic in 2021
Opioids are an indispensable tool in our medical armamentarium. They are very effective at relieving physical (and emotional) pain, yet regular use can lead to physical dependence within days. Given that they are prescribed medications, a low perception of harm has driven widespread recreational misuse. In 2021, buprenorphine is the first-line treatment of opioid use disorders. Methadone and naltrexone are alternate pharmacologic treatments.
Opioid use frequently co-occurs with pain syndromes, which require coordinated management and complex psychopharmacology in order to ensure stabilization and recovery.
Stimulants: from Caffeine to Crystal Methamphetamine and beyond
Street stimulants range from caffeine to cocaine, ecstasy, crystal methamphetamine, and more recently bath salts. The psychotic syndromes which result from stimulant intoxication can be difficult to distinguish from a manic episode or exacerbation of a primary psychosis as might be seen in bipolar disorder or schizophrenia. Behavioral interventions form the core treatment modalities for stimulant use disorders and include motivational interviewing, contingency management, cognitive behavioral therapy, group counselling, and recently mindfulness. Research on pharmacotherapy for stimulant use disorders has largely yielded mixed or preliminary results. Stimulant use frequently co-occurs with depressive disorders, which require coordinated management and complex psychopharmacology in order to ensure stabilization and recovery.
Advanced Clinical Practicum
This final session in the series addresses complex clinical cases brought for discussion by the participants and the moderator. We will synthesize assessment, diagnosis, psychosocial interventions, psychopharmacology, prevention, and public health with special emphasis on addressing conundrums of co-occurring addiction with other psychiatric disorders.
How it Works
This course consists of 5 video lessons. After watching each video presentation by Dr. Petros Levounis, you will be required to take a short quiz. Upon receiving a grade of 80% or higher, you will be directed to the next lesson. After you complete all 5 lessons, you will be directed to the course evaluation. After you complete the evaluation, you will be able to download a .pdf certificate to get your course credit.
- Video Presentations (5 lessons, 6 hours total)
- Exit quiz requiring a score of at least 80% to earn contact hours
- Evaluation of the training
The videos for this course were recorded in February, 2021.
About the Presenter
Petros Levounis, MD, MA Dr. Levounis serves as professor and chair of the Department of Psychiatry at Rutgers New Jersey Medical School, and chief of service at University Hospital in Newark, New Jersey. Dr. Levounis came to Rutgers from Columbia University where he served as director of the Addiction Institute of New York from 2002 to 2013. Read more
Certificates will be issued upon completion of an online course evaluation.
No partial credit will be given.
- 6 CONTACT HOURS for nurses
- CCSME Provider Unit is an approved provider of continuing nursing education by the Northeast Multi-State Division (NE-MSD), an accredited approver by the American Nurses Credentialing Center’s Commission on Accreditation.
Accreditation status does not imply endorsement by ANCC, NE-MSD or CCSME Provider Unit.
- 6 CONTACT HOURS for social workers, licensed professional clinical counselors, psychologists, continuing health education specialists, and behavioral healthcare workers.
- This course may be used for 6 contact hours for MHRT-C Domain X
Disclosure: Neither the presenter nor the program planners (CCSME) have any commercial interest or conflict of interest to disclose.
Disclaimer: This course is intended for educational purposes only. The views, opinions, and content expressed in this presentation do not necessarily reflect the views, opinions or policies of the Co-Occurring Collaborative Serving Maine (CCSME).