How to Integrate Pharmacotherapy for Alcohol Use at Your Mental Health Clinic

Mental health professionals smiling and laughing during a staff training meeting, Photo by Luis Alvarez


How to Integrate Pharmacotherapy for Substance Use Disorders at Your Mental Health Clinic

A step-by-step guide for screening and treating adults with co-occurring mental illness and alcohol and/or opioid use disorders with pharmacotherapy in mental health clinics

Start providing pharmacotherapy for people with co-occurring disorders. Start improving client outcomes.

Most people with co-occurring substance use and mental health disorders (COD) never get the high-quality care that they need to recover.

But as a mental health clinic leader, you can change that.

Break down care silos

Integrating medications for COD at your clinic can help more clients achieve better outcomes.

There are many reasons clients with COD don’t receive comprehensive help for their problems, including logistical barriers, undiagnosed substance use disorders (SUDs), lack of access to evidence-based treatments, and stigma.

And although research shows that medications can be an effective treatment for mental health clients with co-occurring alcohol or opioid use disorder, pharmacotherapy is still significantly underused.

By integrating pharmacotherapy with high-quality psychosocial treatment, you can provide access to effective treatments for members of a vulnerable and underserved population in a setting where they are most likely to access care.

Change the COD landscape

This toolkit has two goals:

  1. to support the delivery of effective, evidence-based pharmacotherapy for adult clients with co-occurring mental illness and alcohol use disorder and/or opioid use disorder
  2. to support COD pharmacotherapy and supportive care implementation processes at your clinic.

We define COD-alcohol as co-occurring alcohol use and mental health disorder. Similarly, we define COD-opioid as co-occurring opioid use and mental health disorder. For the sake of brevity, we refer to these as co-occurring alcohol use disorder (COD-alcohol) and co-occurring opioid use disorder (COD-opioid) throughout this toolkit.

This toolkit does not include care processes for other SUDs, such as cocaine or methamphetamine use disorders, because evidence-based pharmacotherapy treatments for other SUDs do not yet exist.

To get started, we recommend that you familiarize yourself with the steps and resources available throughout this toolkit. Then, follow the four steps outlined in the toolkit to help your clinic create a vision, develop a workflow, implement care, and measure your program’s quality.

Along the way, we’ll provide the resources you need to stay organized, on track, and motivated to make a difference.

  • Who

    This toolkit is a guide specifically for mental health Clinic Leaders to create an infrastructure for COD screening and treatment at your clinic.

  • What

    There are 9.2 million people living with COD in the United States, and nearly 92 percent of people with COD do not get treatment for both disorders.

  • Why

    A holistic treatment plan that includes pharmacotherapy is the best chance clients have at recovery. Your clinic can make that happen.

Learn more about COD pharmacotherapy and supportive care

The Process

This four-step process is designed to help you successfully integrate an evidence-based COD pharmacotherapy and supportive care program at your clinic.

Because providing pharmacotherapy requires properly identifying, diagnosing, and providing psychosocial and recovery support to people with COD, this toolkit includes processes for implementing these workflows at your clinic.

  1. Step 1 Envision. Inspire your staff to make COD pharmacotherapy and supportive care a reality

    Learn how to motivate staff, identify key personnel to oversee program implementation, and empower your staff to understand their roles in identifying and diagnosing people with COD and to deliver COD pharmacotherapy and supportive care.

    Learn more about Step 1
  2. Step 2 Learn and Adapt Understand the COD-alcohol and COD-opioid care processes and adapt them for your clinic

    Get to know what COD pharmacotherapy and supportive care could look like at your clinic, learn which staff members will be responsible for each step of the process, and collect resources that will help your team execute these services.

    Choose a workflow:

  3. Step 3 Prepare. Take steps to ensure that your clinic is ready for COD pharmacotherapy and supportive care

    Gather all of the resources needed to make COD care work at your clinic, assign staff to each workflow task, and train staff on workflow elements relevant to their roles.

    Learn more about Step 3
  4. Step 4 Launch. Begin treating clients with CODs, and monitor your success

    Determine which metrics your clinic will monitor to gauge success, develop an ongoing monitoring plan, and launch COD pharmacotherapy and supportive care at your clinic.

    Learn more about Step 4

The Team

COD care is everyone’s responsibility at your clinic. These members of your Treatment Team will play important roles in the day-to-day delivery of COD care at your clinic.

  • Clinic Leaders

    Provide resources and insight to make COD-alcohol care a reality

  • Primary Clinicians

    Guide the client from intake to follow-up

  • Prescribers

    Contribute to the client’s treatment plan and prescribe medication

  • Nursing Staff

    Assess for withdrawal and may deliver medications prescribed to clients

  • Substance Use Disorder Counselors

    Support the client by providing resources and counseling

  • Peer Support Specialists

    Speak from personal experience to support the client

Learn more about team roles and responsibilities
a picture of the COD workflow map

The Workflows

Get to know the fundamentals of providing COD pharmacotherapy and supportive care, including the tasks involved, staff roles, and step-by-step instructions for delivering effective treatment for both COD-alcohol and COD-opioid. Adapt the workflow to meet the specific needs of your clinic.

Choose a workflow to learn and adapt: