Alcohol and Substance Use Disorders in Medical Rehabilitation

Abstract

The Diagnostic and Statistical Manual of Mental Disorders, 5th Edition (DSM-5), broadly defines substance use disorders as occurring when an individual continues to use a substance despite the occurrence of significant problems related to it. In this chapter, we will refer to alcohol use disorders (AUD) and substance use disorders (SUD) broadly for simplicity. Recovery from AUD-SUD is a complex, lifelong process with setbacks, detours, and successes. Patients with AUD-SUD in medical rehabilitation face even more significant challenges along the way. Mental and physical health, biology, and the social environment all impact the process. Lifetime abstinence may be only one potential goal; many people can have positive outcomes with moderated, safe use. Furthermore, the risks of potential abuse may be outweighed in some cases by the risks of poorly treated pain and medical conditions, which can increase risk for AUD-SUD. Regardless, be vigilant for the effects of stigma on patients' health and providers' clinical decision making. Have frank dialogues with patients about balancing treatment with acceptance and maintenance of functioning. Finally, remember that all patients including those with AUD-SUD deserve the best treatment. With your existing knowledge and competencies in treating the "whole person," rehabilitation practitioners are uniquely poised to help these patients maintain or improve their quality of life. (PsycINFO Database Record (c) 2017 APA, all rights reserved) (Source: chapter)