What aspect of treatment is often hindered by the presence of personality disorders in individuals with substance use disorders?

Individuals with personality disorders often face significant challenges in engagement in care, particularly when they also have substance use disorders. Personality disorders can lead to difficulties in interpersonal relationships, emotional regulation, and impulse control. These characteristics may result in resistance to treatment, a lack of trust in healthcare providers, and challenges in adhering to treatment plans. As a result, forming a therapeutic alliance can be particularly complex, as patients may struggle with feelings of abandonment or may have a history of chaotic relationships that inhibit their willingness to participate fully in treatment.

Engagement in care is crucial for effective management of substance use disorders, as it encompasses not just the initial decision to seek help but also ongoing participation in therapy, medication adherence, and following through with support systems. In contrast, while issues related to access to medications, availability of support groups, and awareness of treatment options are important elements of substance use treatment, they are less directly impacted by the interpersonal and emotional struggles that clients with personality disorders typically experience. Therefore, the primary concern becomes the ability of these individuals to engage actively and constructively in their treatment process.