This category includes people who may be in a traditional alcohol and drug treatment setting but who have additional psychiatric needs, such as individuals with histories of emotional, psychological, or sexual trauma and those with mild-to-moderate depression or anxiety disorders.

Such people are able to participate in traditional approaches to the treatment of their addiction but may need medication for psychiatric symptoms and additional psychotherapy.

If these conditions are not properly identified and addressed during the course of treatment, relapse often occurs soon after discharge.

As these people continue in aftercare, they may still suffer from depression, anxiety, or problems coping, and they don’t realize the benefits of sobriety. Often they will give up and return to the addiction as a result.

This is one reason why aftercare and follow-up are so important, especially during the first year or so of sobriety.

Many difficult issues arise during that time, and it’s not uncommon for additional psychiatric problems to be identified.

A person who has not begun to feel better and to function more capably after three or four months of abstinence should be evaluated for the presence of a coexisting disorder by a psychiatrist or psychologist familiar with addiction.

Elizabeth Connell Henderson, M.D.

Glossary

Appendix A: Regulation of Addictive Substances

Appendix B: Sources of Additional Information