Dual Diagnosis: Mental Illness and Substance Abuse

DUAL DIAGNOSIS:
MENTAL ILLNESS AND SUBSTANCE ABUSE

Dual diagnosis is a term used to describe a person who is diagnosed with a mental illness and a substance use or abuse
disorder at the same time. More than half of persons who have a serious mental illness also have a substance use or abuse
disorder. Dual diagnosis is sometime referred to as co-occurring disorders or comorbidity. The term “comorbidity”
describes two or more disorders occurring in the same person. They can occur at the same time or one after the other.
Comorbidity also implies interactions between the illnesses that can worsen the course of both. It can be difficult to find
treatment for someone who has a mental illness and also uses drugs or alcohol. Many programs that treat people with
mental illness are not well prepared to treat substance abusers, and programs for substance abusers are not geared for
people with mental illness. Individuals with dual diagnoses often bounce from one program to another, or are refused
treatment by single-diagnosis programs. Gradually, specialized MISA (Mental Illness and Substance Abuse) programs
are being established. These programs have staff trained to deal with both the mental illness and the substance abuse
problem. IDDT (Integrated Dual Disorder Treatment) is an evidence-based treatment by a multidisciplinary team. IDDT
team members collaborate regularly about the client’s progress and are not merely component parts.
Quick Facts about Dual Diagnosis • Valuables disappearing from the household
• The more severe the mental illness, the greater the • Long periods of time in the bathroom
likelihood that the person will also use or abuse an • Dilated or pinpointed pupils
illicit substance. • Needle marks
• The drug most commonly used is alcohol, followed • Drug paraphernalia in the house
by marijuana and cocaine.
• Males ages 18 to 44 are at greatest risk. What’s the Difference between Use, Abuse, and
• Adolescents with serious behavioral problems are Addiction?
7 times more likely to have used or abused alcohol “Use” refers to experimentation or low frequency,
or a drug in the past month. typically irregular, use of alcohol or illicit drugs.
• Substance abuse complicates almost every aspect “Abuse” refers to regular and/or compulsive use of
of care for the person with a mental illness. alcohol or illicit drugs. These terms distinguish on the
basis of whether the use of alcohol or drugs has or has
Why do These Disorders Often Co-occur? not become a significant feature of the person’s
Research suggests the following possibilities for this lifestyle. Clinicians diagnose substance abuse if, in a
common co-occurrence: twelve-month period, a person is in one or more of the
• Overlapping genetic vulnerabilities. Predisposing following situations related to drug use:
genetic factors may make a person susceptible to • Fails to meet obligations, such as missing work or
both addiction and other mental disorders or to school
having a greater risk of a second disorder once the • Engages in reckless activities, such as driving
first appears. while intoxicated
• Overlapping environmental triggers. Stress, trauma • Encounters legal troubles, such as getting arrested
(such as physical or sexual abuse), and early • Continues to use despite personal problems, such
exposure to drugs are common environmental as a fight with a partner.
factors that can influence the development of Addiction implies physiological dependence, is more
addiction and other mental illnesses. severe and involves tolerance (increased need for the
substance in order to achieve the desired altered state
Is Drug Addiction a Mental Illness? of consciousness) and withdrawal (mental or physical
Yes. Addiction changes the brain in fundamental ways, symptoms after stopping drug use).
disturbing a person’s normal hierarchy of needs and The behavioral patterns are:
desires and substituting new priorities connected with • Being unable to stop once using starts
procuring and using the drug. The resulting compulsive • Exceeding self-imposed limits
behaviors that weaken the ability to control impulses, • Curtailing time spent on other activities
despite the negative consequences, are similar to • Spending excessive time using or getting drugs
hallmarks of other mental illnesses. • Taking a drug despite deteriorating health
Signs of Drug or Alcohol Abuse
• Sudden onset of financial problems
1
How Does Dual Diagnosis Affect Families and attempts decrease. The patient’s denial is a central part
Friends? of the problem. Dually diagnosed clients do not fit
Dual diagnosis means the condition is especially well into most Alcoholic Anonymous or Narcotics
complex and difficult to manage. Families with a Anonymous groups. Clients who develop positive
dually diagnosed member may experience twice the social networks have a better chance of controlling
problems of those whose family member has only one their illnesses. Healthy recreational activities and peer
disorder. relationships are extremely important.
Is Dual Diagnosis Common? What’s the First Step in Treatment?

The combination of mental illness and substance abuse The presence of both disorders must be established by
is so common that many clinicians who work with the careful assessment. This may be difficult because the
mentally ill now expect to find it. Studies show that symptoms of one disorder can mimic the symptoms of
50% of persons with mental illness also have a the other. Once an assessment has confirmed a dual
substance abuse problem. And more than half the diagnosis of mental illness and substance abuse,
persons with a substance abuse diagnosis also have a professionals and family members should work
diagnosable mental illness. together on a strategy for integrating care and
motivating the client.
What Causes These Disorders?
Mental health and addiction counselors understand that What Do Model Programs for Treating Mental
mental illness and substance abuse are biologically and Illness and Substance Abuse Look Like?
physiologically based. Families may feel angry at the There are a growing number of model programs using
person and blame him for being foolish and weak- the Integrated Dual Diagnosis Treatment (IDDT)
willed. They may feel hurt when the person breaks strategies. Among other modalities, they have support
trust by lying or stealing. But it’s important to realize groups similar to Alcoholics Anonymous and
that mental illness and substance abuse are diseases Narcotics Anonymous. Members support each other as
and that the person cannot take control of the problem they learn about the role of alcohol and drugs in their
without help. lives. They learn social skills and how to replace
substance use with new thoughts and behaviors. They
What Kind of Treatment Works? get help with concrete situations that arise because of
People with such difficult problems do not respond to mental illness. Several programs also have support
simplistic advice like “just say no” or “snap out of it.” groups for family members and friends.
Psychotherapy, medication and sometimes electro-
convulsive therapy combined with appropriate self- To download NIDA’s (National Institute of Drug
help and other support groups help, but these Addiction) “The Science of Addiction”
individuals are still highly prone to relapse. Treatment http://m.drugabuse.gov/publications/science-addiction
programs designed only for substance abusers are not
recommended for people who also have a mental For more information on mental illnesses – contact:
illness. Confrontation without adequate support and
encouragement for the use of appropriate medications The Alliance on Mental Illness
compound the problems of mentally ill patients and NAMI CHICAGO
may produce stress levels that make symptoms worse 1536 West Chicago Avenue, Chicago, IL 60642
or cause relapse. Research has strongly indicated that 312-563-0445 – Fax: 312-563-0467
to recover fully, a consumer with co-occurring disorder www.namichicago.org
needs treatment for both problems -- focusing on one info@namigc.org
does not ensure the other will go away. Dual diagnosis
services integrate assistance for each condition, helping
people recover from both in one setting, at the same
time.
What is a Better Approach?

Increasingly, the psychiatric and drug counseling
communities agree that both disorders must be treated
at the same time. Studies show that when mental
illness and substance abuse are treated by the same
treatment team, psychotic episodes and suicide
7/12
2

Dual Diagnosis: Mental Illness and Substance Abuse

Uploaded by

Copyright:

Available Formats

Dual Diagnosis: Mental Illness and Substance Abuse

Uploaded by

Document Information

Original Title

Copyright

Available Formats

Share this document

Share or Embed Document

Sharing Options

Did you find this document useful?

Is this content inappropriate?

Copyright:

Available Formats

Dual Diagnosis: Mental Illness and Substance Abuse

Uploaded by

Copyright:

Available Formats

DUAL DIAGNOSIS:

MENTAL ILLNESS AND SUBSTANCE ABUSE

Is Dual Diagnosis Common? What’s the First Step in Treatment?

What is a Better Approach?

You might also like

Pfad - The Proxy pFad of © 2024 Garber Painting. All rights reserved.