Proactive, Stigma-Free Approaches to Comorbid Substance Use

In this Q&A, Psych Congress Network talked with Brittany Badinger, FNP-C, CARN-AP, CEO, Pathways Addiction Recovery, New Orleans, Louisiana, about key takeaways from her session "Comorbid Substance Use and How It Influences Psychiatric Care," presented at the 2024 Psych Congress NP Institute Meeting. 

Badinger emphasizes the prevalence of substance use among mental health patients and urges practitioners to employ simple screening tools, fostering early identification and referral. She also also dispels misconceptions, emphasizing the intertwined nature of substance use with mental health and advocating for proactive intervention.

For more breaking news and insights from the 2024 Psych Congress NP Institute Meeting, visit our newsroom here on Psych Congress Network.

Editor’s note: This interview has been lightly edited for length and clarity.

Psych Congress Network: What are a couple of key takeaways from your session on comorbid substance use and how it affects psychiatric care?

Brittany Badinger, FNP-C, CARN-AP: Regardless of whether psychiatric practitioners think they see substance use or want to treat it, they see it all the time, and should be aware of at least how to identify these patients by implementing simple screening tools in practice. 

We know this because of the prevalence and frequency of comorbidities of MH disoders and substance use disorder (SUD). That is THE key takeaway. I hope to compel practitioners to be aware of SUD, to screen for it, and to do so in a stigma-free way. If someone is not going to treat, then at least be able to screen and refer these patients to appropriate levels of care.

Psych Congress Network: Which screening tools are available for mental health clinicians to assess for substance use disorders? 

Ms Badinger: There are a plethora of screening tools that can be easily implemented into practice. The Alcohol Use Disorders Identification Test (AUDIT) and Drug Abuse Screening Test (DAST) are probably the most commonly used and easiest to remember. There are tools that can be directly accessed by the practitioner in real time while present with the patient, and when completed which will yield risk scores and appropriate recommendations. If  a practitioner is unsure what to ask or do, they can go to the National Institute on Drug Abuse (NIDA) and start with a broad assessment such as this one. Many more screeners are available on NIDA's website.

Psych Congress Network: How can mental health clinicians build the trust that is necessary for patients to be honest and forthcoming with you about their substance use patterns?

Ms Badinger: Language matters. Stigma is real.  Many patients are afraid of being judged and are afraid of care being terminated if they are honest; by maintaining a nonjudgmental stance, understanding that SUD is relapsing disease, and not being punitive, patients will feel more comfortable opening up about their struggles with substances.

Psych Congress Network: Which misconceptions surrounding substance use and psychiatric care would you like to clarify for our audience?

Ms Badinger: SUD doesn’t exist in a silo. It is comorbid with many mental health and physical disorders. There is lots of need, but potential patients are often afraid to be honest about their struggles with SUD  because of stigma, feeling judged, etc.  You are in a critical position to make a lifesaving difference for these patients. The federal government has lifted many of the restrictions on treating SUD because of the immense need; there are many tools and medications to treat, many places to refer, but it all starts with a question from one caring provider who is not afraid to ask.  

Brittany Badinger, FNP-C, CARN-AP, is a compassionate Nurse Practitioner with 15 years of healthcare experience. She is the owner of Pathways Addiction Recovery and NOLA Par Intensive Outpatient Program, both located in Metairie, LA. Ms. Badinger has dedicated the majority of her time as a Nurse Practitioner to providing unparalleled care to those battling substance use disorders. She also has a background in primary care, alternative & holistic medicine, and aesthetics. Ms. Badinger completed both her Bachelor of Science and Masters in Nursing at Louisiana State University; she is board certified in Family Practice by the American Association of Nurse Practitioners and received her CARN-AP board certification from the Addiction Nursing Certification Board. She is also a SMART Recovery Facilitator and a Non-violent Crisis Intervention Instructor. Prior to becoming a nurse practitioner, she worked as a registered nurse in a variety of settings ranging from intensive care to home health, with each contributing valuable experience in providing the best possible care for others.