Psychosis in the Context of Substance Use: Primary Diagnosis or Substance Effect?

Course Description

Distinguishing substance-induced psychosis from a primary psychotic disorder can be one of the most challenging aspects of psychiatric assessment, with important implications for treatment and long-term outcomes. This session will review substances commonly associated with psychotic symptoms and discuss the features that help differentiate substance-induced psychosis from primary psychotic disorders. Participants will examine evidence-based treatment strategies, including pharmacologic management and considerations for initiating, monitoring, and discontinuing antipsychotic therapy in the context of substance use. Attendees will leave with practical approaches to improving care and a deeper understanding of the psychiatric pharmacist’s role in evaluating, managing, and supporting patients experiencing psychosis related to substance use.

Learning Objectives

  1. Identify substances that cause substance-induced psychosis.
  2. Choose appropriate treatment strategies for managing psychotic symptoms in the context of substance use.
  3. Assess the role of a clinical pharmacist in managing patients with psychosis from substance use.

Target Audience

If you are a pharmacist, nurse practitioner, or other health care professional involved in the comprehensive medication management of individuals living with mental health and/or substance use disorders, we invite you to participate in this online course.

Faculty

Aaron Salwan, PharmD, MPH, BCPP
Abraham Thengampallil, MD, MPH
View biographical information

Aaron Salwan, PharmD, MPH, BCPP    
Assistant Clinical Professor    
Rutgers Ernest Mario School of Pharmacy    
Pscataway, NJ

Dr. Aaron Salwan is a Clinical Assistant Professor at the Rutgers Ernest Mario School of Pharmacy and practices at Carrier Clinic in Belle Meade, New Jersey, a 300-bed hospital caring for patients with serious mental illness and substance use disorders. Before joining Rutgers, he was a Clinical Pharmacy Specialist in Psychiatry at Montefiore Nyack Hospital in Nyack, New York, where he founded the hospital's PGY2 Psychiatric Pharmacy Residency. He also serves as volunteer faculty in the Department of Psychiatry at East Tennessee State University.

A 2017 graduate of the Ohio Northern University Raabe College of Pharmacy, Dr. Salwan completed a research fellowship in addiction and social and behavioral health at East Tennessee State University, where he earned his Master of Public Health. He then completed a specialty residency in neuropsychiatry at Rutgers. In his current role, he leads psychoeducational groups that help patients understand the role substances may play in their illness, and he leads psychotropic stewardship efforts at his institution. 

Dr. Salwan has authored or co-authored more than a dozen publications on harm reduction, psychopharmacology, and pharmacist-led mental health services. Most recently, he co-authored the International Consensus Recommendations for Clozapine Care Delivery and Emerging Clinical Considerations, published in Pharmacotherapy.  He cares deeply about young people experiencing psychosis, for whom an accurate early diagnosis and a supportive, nonjudgmental care team can change the course of a life. He strongly believes in interdisciplinary care that helps people with serious mental illness and substance use disorders recover and live fulfilling lives.

Abraham Thengampallil, MD, MPH
Psychiatrist & Medical Director/New York State Office of Mental Health        
Orangeburg, NY

"Abraham Thengampallil, MD, MPH (known as “Dr. T” to patients and their families) is a board-certified psychiatrist and preventive medicine specialist. Dr. Thengampallil currently works as an attending psychiatrist and medical director at the Rockland Psychiatric Center (part of the New York State Office of Mental Health) and specializes the diagnosis and treatment of mental illnesses in young adults.

Dr. Thengampallil co-leads the Turning Point first-episode psychosis program at the Rockland Psychiatric Center. Following graduation from medical school at State University of New York (SUNY), Downstate Medical Center - College of Medicine he did pediatrics training at Cincinnati Children’s Hospital Medical Center, a residency in General Preventive Medicine and Public Health at SUNY Stony Brook University Medical Center, and a psychiatry residency at Columbia University (New York Presbyterian Hospital/Columbia Campus/New York State Psychiatric Institute). He also received a Masters degree in Public Health from the Mailman School of Public Health at Columbia University. He is a member of several professional societies including the American College of Preventive Medicine (ACPM), American Medical Association (AMA), and the American Psychiatric Association (APA). He is a diplomate of the American Board of Preventive Medicine (ABPM) and the American Board of Psychiatry and Neurology (ABPN).

Dr. Thengampallil is currently the President of the Rockland Psychiatric Center medical staff and serves on various hospital committees. He is also a visiting scientist and member of the Institutional Review Board/IRB at the Nathan Kline Institute for Psychiatric Research, Dr. Thengampallil is a dedicated teacher, mentor, and academic. He serves as an Assistant Clinical Professor for the Department of Psychiatry at the Columbia University medical school (College of Physicians & Surgeons). Dr. Thengampallil supervises psychiatric resident physicians and is a clinical preceptor for medical students at Columbia University/New York Presbyterian Hospital; he was also the clinical preceptor and advisor of the Columbia-Harlem Homeless Medical Partnership and course director for the Harlem Hospital Center psychiatry residency program. He has given many invited lectures and international presentations and has written numerous peer reviewed papers, journal articles, books, and editorials. He is the recipient of several honors and awards including the Laughlin Foundation Award for Outstanding Psychiatric Resident and the American Cancer Society’s Physician Training Award in Preventive Medicine. Dr. Thengampallil also volunteers as a New York State Disaster Mental Health Responder and is a board member at the Rockland County Department of Mental Health. Most of all, he is a dedicated clinician, committed to his patients and their families.
 

Course Requirements

To receive ACPE credit for this session, you must:

  • Register for this course.
  • Review the full content of the activity and reflect upon its teachings.
  • Complete the evaluation at the end of the activity.
  • Provide the necessary details in your profile to ensure correct reporting by AAPP to CPE Monitor.

Continuing Education Credit and Disclosures

Activity Dates: 4/6/2027-4/6/2030
ACPE Contact Hours: 1.0
ACPE Number: 0284-0000-##-###-###-P (Application)
Nursing Credit Reminder: Note that ACPE credit is accepted for ANCC Certification Renewal and AANPCB advanced practice provider content. For specific questions related to your organization's acceptance of ACPE continuing education units, please contact your organization directly.

ACPEThe American Association of Psychiatric Pharmacists is accredited by the Accreditation Council for Pharmacy Education as a provider of continuing pharmacy education.

AAPP Disclaimer: Participants have an implied responsibility to use the newly acquired information to enhance patient outcomes and their own professional development. Any procedures, medications, or other courses of diagnosis or treatment discussed or suggested in this activity should not be used by clinicians without evaluation of their patient’s conditions and possible contraindications on dangers in use, review of any applicable manufacturer’s product information, and comparison with recommendations of other authorities. Please refer to the official prescribing information for each product for discussion of approved indications, contraindications, and warnings.

Unlabeled Use Disclosure: Faculty of this CE activity may include discussions of products or devices that are not currently labeled for use by the FDA. The faculty have been informed of their responsibility to disclose to the audience if they will be discussing off-label or investigational uses (any uses not approved by the FDA) of products or devices. The faculty, planners, and American Association of Psychiatric Pharmacists do not endorse the use of any product outside of the FDA labeled indications. Medical professionals should not utilize the procedures, products, or diagnosis techniques discussed during this activity without evaluation of their patient for contraindications or dangers of use. 

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