Effectively treating stimulant-abusing schizophrenics: mission impossible?

The development of effective treatment programs for dual diagnosis patients is in its initial stages, hampered by a variety of clinical, theoretical, administrative, and even sociopolitical obstacles. These patients are difficult to engage and treat effectively using standard systems of care. The Dual Diagnosis Treatment Program at the Brentwood VA Hospital integrates treatment for both stimulant abuse and chronic psychosis within one comprehensive program, emphasizing continuous treatment teams, optimal pharmacological management, behavior-shaping strategies, skills-training techniques, and assertive case management. The combination of these treatment approaches within one program appears to have helped some patients in our preliminary, one-year experience. Future publications will describe results from controlled outcome comparisons of DDTP with customary VA care.