A Unique Malady
A dual diagnosis occurs when an individual has an alcohol or drug problem along with a psychiatric or emotional problem at the same time. These conditions happen together frequently. In particular, drug and alcohol problems tend to occur in individuals with personality disorders, schizophrenia, anxiety disorders and depression.
Sometimes, the mental problem happens first. This can lead an individual to use drugs and alcohol to make them feel a bit better temporarily. On some occasions, the substance abuse happens first. This can lead to mental and emotional problems. According to the statistics compiled by the National Survey on Drug Use and Health, nearly 8.9 million Americans are affected by this condition every year.
Although many people do not know about this mental condition, it is surprisingly common. According to statistics submitted from the Journal of the American Medical Association, 53 percent of drug abusers and 37 percent of alcohol abusers have at least one very serious mental illness.
At the same time, 29 percent of respondents who abuse either drugs or alcohol have a dual diagnosis. Of all these individuals, only 7.4 percent receive appropriate treatment. The vast majority of these patients bounce among treatment systems with opposing or incompatable treatment structures.
There are some theories that explain the relationship between substance abuse and mental illness. These include the following.
This theory suggests that certain kinds of substance abuse may lead to mental illness. This is true in the case of cannabis. This drug can cause affective and mild psychotic experiences.
This theory proposes that certain people who have severe mental problems also have psychological and biological vulnerabilities. This is usually caused by early environmental and genetic life events.
This suggests that individuals who have mental conditions misuse drugs or alcohol as medication. This is an attempt to relieve a specific group of symptoms. They can also misuse substances to counter the side effects of antipsychotic medications.
Alleviation of dysphoria theory
This theory suggests that individuals who have severe mental problems have a bad self-image. This makes them prone to utilizing psychoactive substances to relieve these feelings.
People who have this condition are very hard to diagnose. This is especially true in initial examinations. This is because a number of symptoms of severe alcohol or drug abuse mimic other mental and psychiatric conditions.
Due to this, a person must undergo withdrawal and treatment from drugs and alcohol before being assessed. This is done in order for the physician to accurately determine whether they have an underlying psychiatric problem.
Drug or Emotional Problem
Ideally, both the addiction and mental problem should be treated simultaneously. However, detoxification is the first step in treatment for any individual who has been abusing illegal substances. This is a time period where the body is allowed to clean itself of drugs and alcohol. Detoxification should also be done under medical supervision.
Individuals must also remember that detoxification can take a number of days or even weeks or months. This depends on what substances the individual abused and for how long. Until recently, drug addicts and alcoholics dreaded detoxification. This is because it often involved a painful cold turkey withdrawal.
Today, medical practitioners are able to provide hospitalized substance abusers with carefully chosen medications. These medicines are formulated to help ease withdrawal symptoms. This is the main reason why detoxification under medical supervision is less traumatic and safer.
Once detoxification has been completed, it is time for dual treatment. This therapeutic regimen includes curing the psychiatric issue and rehabilitation for the drug or alcohol problem.
Rehabilitation for an individual who has a substance abuse disorder usually involves several treatment modalities. This includes the following.
- Proper Nutrition
- Education about Drugs and Alcohol
- Group and Individual Psychotherapy
- Participation in a 12-step Recovery Regimen
The main point of this therapy is not just to stay away from drugs and booze but also to learn how to enjoy life without the use of these crutches.
The treatment for a person who has psychiatric problems varies depending on the diagnosis. For a majority of disorders, group and individual therapy along with medication is recommended. Education and expressive therapies about a particular psychiatric problem are useful additions.
A support group composed of other people may also be effective. These individuals are also recovering from the same psychiatric problem. Adjunct treatments that include expressive or occupational therapy can also help individuals better communicate and understand their feelings. It also aids them in developing better decision-making or problem-solving skills.
The Importance of Family
The patient’s family has an important role in their recovery. This is because a patient whose family has a better understanding of the condition has a higher chance of achieving a long-lasting recovery. At the same time, they must learn to stop enabling.
This attitude involves encouraging the person to continue their habit of getting high or drinking. For example, a man whose wife routinely gets high might call in sick for that person when they are too high to get to work. Likewise, friends or family members who give the addict money that is used to purchase drugs because they are either afraid or feel sorry for them are also enabling.
When friends and family members participate in the rehabilitation program, they also learn how to stop enabling. Individuals who act on what they have learned will help the recovering substance abuser avoid a relapse into taking drugs or drinking. This is because relapse rates for addictive problems are in the range of 50 to 90 percent. At the same time, drug and alcohol addiction are chronic relapsing disorders.
People who have a dual diagnosis are not necessarily hospitalized. The severity and nature of the disease along with the complications and associated risks and the individual’s treatment history are used to determine the appropriate level of treatment. There are several intensities and levels of care used in treatment today.
- Partial hospitalization
- Full impatient or hospitalization treatment
- Outpatient treatment