Comprehensive Continuous Integrated System of Care (Ccisc) Psychopharmacology Practice Guidelines for Individuals with Co-Occurring Psychiatric and Substance Use Disorders (Cod) Essay

4832 WordsDec 16, 201320 Pages
Comprehensive Continuous Integrated System of Care (CCISC) Psychopharmacology Practice Guidelines for Individuals with Co-occurring Psychiatric and Substance Use Disorders (COD) January, 2005 Developed by Kenneth Minkoff, MD Clinical Assistant Professor of Psychiatry, Harvard Medical School Senior Systems Consultant, ZiaLogic With invaluable assistance from Terry Schwartz, MD, Jeff Rowe, MD, and other members of the Psychopharmacology Committee of the San Diego County CCISC Project Based on the psychopharmacology guidelines in Minkoff (2001), Service Planning Guidelines for Co-occurring Psychiatric and Substance Disorders Illinois Behavioral Health Recovery Management Project www.bhrm.org ©2005 Kenneth Minkoff, MD 100 Powdermill Road, #319 Acton, MA 01720 KMinkov@apl.com www.kenminkoff.com Background Individuals with co-occurring psychiatric and substance disorders (COD) represent a challenging population associated with poorer outcomes and higher costs in multiple domains. In addition, the prevalence of comorbidity is sufficiently high that we can say that comorbidity is an expectation, not an exception throughout the system of care. Consequently, individuals with cod cannot be adequately served with only a few specialized programs; rather, the expectation of comorbidity must be addressed throughout the system of care. The Comprehensive Continuous Integrated System of Care (CCISC) (Minkoff & Cline, 2004) is a model for system design which permits any system to address this problem in an organized manner within the context of existing resources. The basic premise of this model is that all programs become dual diagnosis programs meeting minimal standards of Dual Diagnosis Capability, and all clinician (including psychopharmacology prescribers) become dual diagnosis clinicians meeting minimal standards of dual diagnosis competency, but each program and

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