A review of the complexities of working effectively with people being prescribed both antipsychotic medications and opioid substitution therapy

Abstract

Aims: This review considers the complexities of working effectively with people being prescribed both anti-psychotic medication and opioid substitution therapy (OST). While various helping professionals are often at the vanguard of direct practice with people with comorbidities, training programmes may struggle to find ways to incorporate sufficient material to prepare students to work effectively with people being simultaneously prescribed both anti-psychotics and OST. For that reason, consideration of students’ training needs is also included in the discussion. Findings: While National Institute for Health and Clinical Excellence (NICE) guidelines support integrated interprofessional practice with coexisting Severe Mental Illnesses (SMIs) and Substance Use Disorders (SUDs) effective practice with people being simultaneously prescribed OST and psychotropic medication necessitates an array of knowledge and skills. This review seeks to address some of the gaps in the standard knowledge base, especially for students who may find working with this population particularly challenging. Conclusions: Comorbid SMIs and SUDs often pose complex challenges for good practice. Integrated treatment is essential, but also demanding. The authors argue that including specific content about comorbidities is essential in order for students to be equipped with the levels of knowledge and confidence needed to do their best work, and to make a positive difference with this challenging population, beginning with professional training and degree programmes.

Keywords:

• Anti-psychotic medication
• comorbidity
• opioid substitution therapy (OST)
• severe mental illness (SMI)
• substance use disorders (SUDs)

Declaration of interest

There were no funding sources or conflicts of interest to report.