Back [[Framework to understand addiction management challenges]] ## Clinical Complexity - **Co-occurring conditions**: Mental illness (depression, anxiety, PTSD), trauma history, polysubstance use, chronic pain - **Medical complications**: Withdrawal risk, infectious diseases, organ damage, medication interactions - **Psychosocial instability**: Housing insecurity, unemployment, financial problems, legal issues ## Treatment Engagement - **Motivation**: Low treatment readiness, denial, ambivalence about change - **Dropout patterns**: Repeated no-shows, early disengagement, non-adherence to medication - **Relapse**: Cycling in and out of treatment, returning to substance use after periods of abstinence ## Behavioral Challenges - **Safety concerns**: Intoxication, aggression, aggression risk, suicidality - **Boundary issues**: Diversion, manipulation, over-reliance on staff, testing limits - **Family dynamics**: Partner/family substance use, family conflict, custody concerns