Depression and substance abuse problems are each challenging disorders in their own right. But when both are present simultaneously, treatment challenges are compounded. And it is common for individuals with depressive disorders to use alcohol or other mood altering substances as a way of coping with their depressive symptoms.
Using alcohol and illicit drugs worsens the course of depression and makes treatment more difficult. Patients with both a depressive disorder and a substance use disorder face greater emotional and psychosocial obstacles in seeking, engaging in, and continuing with treatment. When substance use disorders and depressive disorders occur together, it is often difficult to ascertain which preceded the other. Regardless of which condition develops first, it is essential that the depression and substance use are treated effectively.
Harvard Pilgrim Health Care provides clinical tools — including the Patient Health Questionnaire, or PHQ-9 for primary care physicians — to assist clinicians by providing an analytical framework for the evaluation and treatment of common problems. The PHQ-9 is a nine-question screening tool used to measure the severity of depression.
Additionally, the Substance Abuse and Mental Health Services Administration (SAMHSA) offers screening tools for drug and alcohol use to be used during regular screenings in primary care and other healthcare settings. SBIRT (Screening, Brief Intervention, and Referral to Treatment) is one such tool. SBIRT is a comprehensive public health approach to the delivery of early intervention and treatment services for people with substance abuse disorder. Visit the SBIRT website for more information and resources.
How Optum/UBH can help your patients—For complex clinical situations, Optum/UBH is available to provide consultative assistance. Practitioners can call the Optum/UBH Physicians Consultation Service at
800-292-2922. To refer a patient for behavioral health services and to facilitate the coordination of care, call Optum at 888-777-4742.