藥酒癮與心理疾病共病的評估診斷與處遇－－從盛行率到矯正實務現況

Screening, Assessment and Intervention of Co-Occurring Disorders with Substance Use Disorders: Prevalence and Practices in the Criminal Justice System

1999年美國藥物濫用研究所(NIDA)所出版的有效藥癮治療13點原則中，就已經注意到許多藥酒癮者同時也會併有其他身心疾病，對戒癮處遇、個別疾症的治療進程都會彼此影響；當然也會因為某一個特定疾病的惡化，連帶使得其他不同共病疾病(特別是心理疾病)的病情加劇。
因此，本文除了簡要說明國內外藥酒癮相關身心疾病共病的盛行率外，更希望聚焦在心理疾病部分，藉由雙重診斷、多重評估及處遇模式的介紹說明，讓藥酒癮及心理疾病共病的心理衡鑑、心理治療的重要性得以被重視。畢竟，透過淸楚明確的評估診斷，在矯正機關中的我們才能進一步考慮究竟如何來提供最優療程、最佳療效或配合不同特定族群的合宜處遇策略，讓藥酒癮患者得以獲益。

In 1999, National Institute on Drug Abuse published“Principles of Drug Addiction Treatment”, which indicates that drug/alcohol abuse and addiction both of which also have mental disorders, often co-occur with other illnesses. When the problems above co-occur, treatment should take all comorbidity illnesses into consideration, and the effect of designed intervention and treatment for drug/alcohol abusers will be interfered. The reason is that one (or more) disorder may cause abusers to experience one or more symptoms of another illness (especially mental illness), and even exacerbate.
In this paper, the aim is to describe the prevalence of comorbidities related to physical and mental illnesses of drug/alcohol abuse, with focus on mental illnesses in the criminal justice system. The importance of treatment of drug/alcohol abuse and mental comorbidities are stressed by description of dual- and multi- diagnosis. The correct and effective interventions of crisis management, suitable treatment, the strategy for the recovery stage, would be provided in this paper. Finally, we summarize some related research into prognosis, which allows us to make the most of treatment planning.