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Treatment of Comorbid Substance Use and Anxiety Disorders: A Case Study

Ries, Richard MD; Wolitzky-Taylor, Kate B. PhD; Operskalski, Joachim T. BA; Craske, Michelle G. PhD; Roy-Byrne, Peter MD

doi: 10.1097/ADM.0b013e318233d64b
Clinical Case Conference

Abstract: This case study of combined anxiety with both alcohol and benzodiazepine dependence illustrates key issues in presentation, differential diagnosis and management. The case is discussed from a biopsychosocial perspective with each of the discussants focusing on their particular area of experience and expertise, then the treatment package is presented in an integrated fashion. Of particular interest is how social anxiety disorder may become a significant barrier to engagement and retention, and thus outcome in persons presenting for addiction treatment, and how a treatment plan for such patients can be built.

From the University of Washington, Seattle, WA (RR, JTO, PRB); and University of California-Los Angeles, Los Angeles, CA (KBW, MGC).

Send correspondence and reprint requests to Richard Ries, MD, Dept. of Psychiatry 359911, Harborview Medical Center, Seattle, WA 98104. E-mail:

Received April 11, 2011

Accepted August 21, 2011

© 2011 American Society of Addiction Medicine