diagnostic assessment of substance use disorder and …“diagnostic assessment of substance use...

Substance Use Disorder Trends in Minnesota“Diagnostic Assessment of Substance Use Disorder and Coding”

5/7/2018 Minnesota Department of Human Services | mn.gov/dhs 1

Brytanie Mertes, MS

Rick Moldenhauer, MS, LADC, ICADC, LPCC

Teleconference call information is available in the Event info section of the WebEx.

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We have a new name….Behavioral Health Division!

We have combined the Alcohol and Drug Abuse and Mental Health Divisions. All with the goal of offering the right services to people as effectively and efficiently as possible.

• We believe “Behavioral Health” is:

• Consistent with national trends and is in common use across the country,

• Clear, not an acronym or jargon, and • To the point, emphasizing that mental health or substance use disorder

is “health” and no different than any other chronic disease.


Certificate of Attendance

• Available for those that attend the full presentation

• Will be using the email address you registered with

• Look for those in about two weeks.


Substance Use Disorder Trends in Minnesota“Diagnostic Assessment of Substance Use Disorder and Coding”

Rick Moldenhauer, MS, LADC, ICADC, LPCC |Human Services Rep. 2 State Opioid Treatment Authority Representative | Behavioral Health Division, DHS

Tachyphylaxis

ED50

LD50

TW3x2x1x

T1/2

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Intoxication/Withdrawal


DSM-5 has 10 major class of substances

• Inhalants

• Opioids

• Sedative, Hypnotic and Anxiolytics

• Stimulants

• Tobacco

• Other

• Alcohol

• Caffeine

• Cannabis

• Hallucinogens

-Phencyclidine

-Other hallucinogens

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Substance Use Disorder, DSM-5 pgs 483-590

Substance Induced Disorders:

1) intoxication

2) withdrawal

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Criterion for Intoxication:

A)Reversible substance specific syndrome due to recent ingestion

B) Problematic behavioral/psychological changes attributable to recent use of substance

C) Symptoms not explained by another mental disorder

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Criterion for Withdrawal:

A)Substance specific problematic behavioral change with physiological and cognitive concomitants due to recent cessation or reduction of use

B) Cause distress and impairment in social occupational, other important areas of life

C) Symptoms not explained by another mental disorder

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Substance Use Disorder, DSM-5pgs 483-590

Symptoms are divided into four major groupings:

1) Impaired control

2) Social impairment

3) Risky use

4) Pharmacological criteria

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Impaired Control grouping:

Criterion 1: Taking larger amount of substance or over a longer period than planned

Criterion 2: Multiple, unsuccessful attempts to reduce or stop use

Criterion 3: Spend a great deal of time obtaining, using, or recovering from the use

Criterion 4: Craving

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Social Impairment grouping:

Criterion 5: Recurrent use result in failure with obligations at work, school home

Criterion 6: Continued use despite recurrent social or interpersonal problems related to use

Criterion 7: Important social, occupation or recreational activates are reduced or given up because of substance use

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Risky Use grouping

Criterion 8: Recurrent used in situations that are physically hazardous

Criterion 9: Continued use despite knowledge of physical or psychological problem caused or exacerbated by use

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Pharmacological grouping

Criterion 10: Tolerance; markedly increased dose to achieve desired effect or reduced effect when same dose is used

Criterion 11: Withdrawal; when blood/tissue concentrations decline after prolonged use

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Diagnosis:

Substance Use Disorder (SUD)

Mild: presence of 2-3 symptoms

Moderate: presence of 4-5 symptoms

Severe: presence of 6 or more symptoms

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“Speedballing”“Your livin' harder, yeah, harder

than you know

Tell me, how fast,

Can ya burn?,

And how far can ya go?”

-Zakk Wylde “What You’re Look’n For”

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DAANES Admission Recording

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of the admission form..

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DSM-5/CCDTF Tool/DAANES coordination

• Caffeine (DSM-5)

-not assessed for in CCDTF

Not recorded in DAANES

• Alcohol (DSM-5)

-Alcohol Use D/O (CCDTF)

(01) Alcohol-DAANES

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• Hallucinogens (DSM-5)-Hallucinogen Use D/O (CCDTF)

(08) PCP-DAANES

(09) Other Hallucinogens/Psychedelics-DAANES

(17) Ketamine

(18) Ecstasy/other club drugs

• Cannabis (DSM-5)

-Cannabis Use D/O (CCDTF)

(04) Marijuana/Hashish-DAANES

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• Opioids

(DSM-5)

-Opioid Use D/O (CCDTF)

(05) Heroin-DAANES

(06) Non-prescription methadone-DAANES

(07) Other Opiates/Synthetics-DAANES

• Inhalants

(DSM-5)

-Inhalant Use D/O (CCDTF)

(19) Inhalants-DAANES

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• Stimulants(DSM-5)

-Stimulant Use D/O (CCDTF)

(02) Cocaine powder-DAANES

(03) Crack-DAANES

(10) Methamphetamine-DAANES

(11) Other Amphetamines-DAANES

(12) Other Stimulants-DAANES

• Sedative, Hypnotic and Anxiolytics (DSM-5)

-Sedative, Hypnotic or Anxiolytic Use D/O (CCDTF)

(13) Benzodiazepines-DAANES

(14) Other Tranquilizers-DAANES

(15) Barbiturates-DAANES

(16) Other sedatives/hypnotics-DAANES

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• Other (DSM-5)

-Other Use D/O (CCDTF)

(21) Other-DAANES

• Tobacco (DSM-5)

-Tobacco Use D/O (CCDTF)

(22) Nicotine/Tobacco (secondary or tertiary only)-DAANES

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DAANES “leftovers”

• (20) Other-The-Counter Medications

• (98) No secondary or tertiary substance

• (99) unknown

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Q and A


Contact Info

Presented by Rick Moldenhauer, MS, LADC, ICADC, LPCC

Human Services Representative 2/State Opioid Treatment Authority

P: (651) 431 2474

F: (651) 431 7449

Alcohol and Drug Abuse Division, DHS

PO Box 64977

St Paul, Minnesota 55164-0977

[email protected]

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Certificate of Attendance

• For those that attended the presentation

• Sent by email to the email you registered with

• Will be going out in the next two weeks


Next SUD WebEx:

June 7th

Ways to Stay Informed

• Visit our website to:• Subscribe for email updates (e-Memo) to receive updates

• SUD Resources and presentations are posted on the SUD Reform Page at our website: DHS Website

• Learn more about substance use disorder policies and procedures, initiatives, workgroups, training and conferences, grant announcements, access forms and more

Look for ADAD “Friday’s Digest” E-memo!

• We want to hear from you about YOUR substance use disorder system. Send input to: [email protected]


mailto:[email protected]

Thank you for joining usAlcohol and Drug Abuse Division



“The staff in the Alcohol and Drug Abuse Division are eager to work with our partners and providers to create an efficient and effective system of

prevention, early intervention, treatment and recovery that values a person’s dignity, is accessible, utilizes best practices and optimizes value. It is our hope that collaboration with all entities that are affected by, pay

for, or provide addiction services will result in a redesigned chemical health system that will become a watershed moment for the citizens of

Minnesota.”

− Brian Zirbes, Deputy Director, Alcohol and Drug Abuse Division (Stakeholder Engagement Invitation 2016)

diagnostic assessment of substance use disorder and …“diagnostic assessment of substance use...

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