Session IV: BIRDS OF A FEATHER FLOCK TOGETHER:
CONCURRENT PERSONALITY DISORDERS AND SUBSTANCE USE DISORDERS
Tuesday, May 17, 2022 – 7:30 pm - 9:30 pm ET
Format: Virtual Event
Dr. Ron Fraser
Personality disorders (PDs) and substance use disorders (SUDs) have a long history of being recognized as intimately linked, sharing many common clinical features, and frequently co-occurring in individuals seeking treatment for one or the other disorder. Equally important, it has long been recognized that the presence of one disorder has a significant and negative impact on the prognosis of the other disorder. Individuals with concurrent PD and SUD typically have worse addiction severity and greater impairment in functioning. Clinicians’ inability or reluctance to accurately diagnose PDs in a timely manner in SUD patients may inadvertently have a negative impact on their recovery and clinical prognosis. Individuals with concurrent PD and SUD have been observed to present with greater severity of symptoms, to be more resistance to treatment, and have an increased risk of relapse. Unfortunately, despite the significant prevalence of concurrent PDs and SUDs, there is a scarcity of evidence-based treatment approaches for this population. Ideally, these individuals would be offered highly structured integrative care and evidence-based relapse prevention pharmacotherapy for addictive disorders, as there is very limited effective pharmacotherapy for personality disorders. This presentation explores the interface between SUDs and PDs, attempting to highlight the complex interaction of the respective disorders and how this might inform treatment choices, specifically the need for comprehensive approaches for patients suffering from PDs and addiction, a population who tend to be stigmatized and marginalized.
By the end of this presentation, participants will be able to
- Understand the interface between personality disorders and substance use disorders in individuals with concurrent conditions
- Appreciate the resulting treatment implications
- Apply best practice recommendations in order to optimize clinical outcomes
Ronald Fraser, MD, CSPQ, FRCPC is director of the extended care clinic for the treatment of severe and persistent borderline personality disorder at the McGill University Health Centre. Dr. Fraser also serves as head of the inpatient detoxification service of the MUHC Addictions Unit. Presently, he is an associate professor at the McGill Faculty of Medicine in the Department of Psychiatry and has a joint appointment at Dalhousie University. He has won a number of teaching awards at both the postgraduate and undergraduate level, including teacher of the year multiple times, and was named to the McGill Faculty of Medicine Honor List for Educational Excellence. He makes his home in rural Nova Scotia, with his lovely wife and beloved labradoodles.