Dual Diagnosis Drug Treatment

By definition a dual diagnosis is the presence of a mental illness in conjunction with a drug addiction, substance abuse problem or alcohol problem. It suffices to say that when a person is in active addiction it is difficult at best to properly diagnose whether the mental health symptoms area direct result of the person’s drug addiction or are actually the result of a psychitric problem.

Drug Detox Program - The First Step

In order to provide an accurate diagnosis, the person must first enter a drug detox program to rid the body of all addictive substances. After the individual has completed the drug detox program and all symptoms of drug or alcohol withdrawal have subsided, the psychiatrist will have an opportunity to properly address the possibility of a dual diagnosis. Anyone in the field of dual diagnosis treatment knows how the symptoms associated with drug addiction and drug withdrawal can mimic the presence of psychiatric symptoms. The drug detox program should be located within a drug rehab to allow for 24 hour support and effective medication management in the case of dual diagnosis treatment is warranted.

Dual Diagnosis Treatment and Evaluation

Now that the individual is no longer under the effects of drugs or alcohol, the physician can make a more accurate diagnosis. If symptoms of depression or anxiety do not subside or mood swings do not begin to stabilize, the drug rehab staff knows they may be dealing with a dual diagnosis and dual diagnosis treatment is waranted. In a dual diagnosis treatment program, both the drug addiction, alcoholism and psychiatric illness is addressed. Recovery is gradual as the dual diagnosis treatment staff generally employs a combination of medication and therapy to address the dual diagnosis.

There are many dual diagnosis treatment programs in the United States so take your time when making that choice. Research has shown that some of the better dual diagnosis treatment programs are located in Florida. For information to these dual diagnosis treatment programs call the dual diagnosis treatment helpline at 1-800-511-9225.

Bookmark to:

For those struggling with a dual diagnosis, there are most certainly many challenges to diagnosis and dual diagnosis treatment. First and foremost, even identifying both conditions presents problems. One study found that only 2 percent were detected of those with a substance problem among severely mentally ill patients seen in a university hospital emergency room. The state hospital did only slightly better, detecting 15 percent (Wolford, et al., 1999). This problem occurs for a number of reasons. Emergency rooms are just not often able to do structured interviews about drug and alcohol use. Patients tend to underestimate the problems caused by the drugs, and they rarely disclose that they have a problem with substance abuse (Wolford, et al., 1999). Practitioners should also keep in mind that illicit drugs and alcohol can cause the development, the reemergence, or even worsen the severity of mental disorders. These drugs can also present symptoms that parallel those of mental disorders or even cover them up. Furthermore, Dr. Brady points out that “acute intoxications as well as withdrawal states can mimic affective illness” (1992).

In addition to these hurdles, there are many physical complications to dual diagnosis treatment itself. Douglas Polcin outlines some major challenges in his article entitled “Issues in the Treatment of Dual Diagnosis Clients Who Have Chronic Mental Illness.” He cites poor dual diagnosis treatment response, high rates of re-hospitalization, aggravated psychotic thoughts, and changes in neurophysiology. He also notes that those dually diagnosed are often less responsive to medications than those who do not abuse substances, specifically stating that cocaine users have problems with lithium (Polcin, 1992).

Another issue with dual diagnosis treatment is that “systems have not been well designed with this population in mind. Typically a community has treatment services for people with mental illness in one agency and treatment for substance abuse in another. Clients are referred back and forth between them in what some have called ‘ping-pong’ therapy” (NAMI). Often the very treatment approach of one service may cause problems for the other side of the condition. For example, substance abuse workers traditionally consider the use of medications to be a crutch for those struggling with addiction. However, psychiatrists rely on prescriptions to treat the mental illness, and while psychiatrists rarely give much credence to spiritual or self-help approaches, those working with addictions place a great deal of emphasis here (Polcin, 1992). Poor communication is yet another problem. Those struggling to reach stability with their mental illness and to achieve sobriety are, more often than not, shuffled between different practitioners. Even when these counselors and doctors work within the same facility, there is seldom good, if any, communication between offices (Zweben, 1993).

The US Department of Health and Human Services outlined some specific areas for research. The first area relates to decision-making with regard to dual diagnosis treatment plans. Second is the use of psychotropic medications. Accurate diagnostic tools is another area greatly needing research (Zweban, 1993). There is currently no good instrument for detecting or classifying substance use disorders in the mentally ill, in that those available were developed for use in the general population (Wolford, et. al., 1999).

In conclusion, a final question needs to be considered. With these facts and figures, the outlook for those with dual diagnosis seems grim. What is the long-term prognosis? Is there any hope for stability and sobriety? The lifetime prevalence of substance use disorders is as much as seven times greater for those with bipolar disorder than those in the general population (Knowlton, 1995). However, Linda, a member of our Forum Community, shares a ray of hope in this message: “My life is quite manageable today with the proper medication, therapy, a wonderful support program and recovery program. And no booze … not a drop. Works the best I have ever had it.”

Bookmark to:

Dual Diagnosis is a major issue

The realization that mental illness and substance abuse can be linked is quite recent, so research is scant. Estimates on the scale of dual diagnosis in America vary, but include:

About 25 per cent of people with anxiety disorders, affective disorders and drug abuse disorders also have another mental disorder.
Around 64 per cent of psychiatric in-patients may have a current or previous drug abuse problem.
Around 75 per cent of people with alcohol and drug abuse problems may have a mental illness.
About 90 per cent of males with schizophrenia may have a drug abuse problem.

Integrated dual diagnosis treatment can be difficult

Effective management of either drug abuse disorders or mental health disorders is challenging. Dual diagnosis can mean an increase in challenging behaviors including self-harm and aggression, avoidance of services, and resistance to or non-compliance with dual diagnosis treatment and recovery programs.

Research suggests that people with a dual diagnosis respond well to integrated dual diagnosis treatment programs that address both their mental illness and their drug abuse. However, these dual diagnosis treatment programs were uncommon until recent years. Some of the reasons for this include:

Diagnosis can be difficult, because it isn’t always clear which problem has the more severe symptoms. Health services are now becoming more able to recognize dual diagnosis.
Mental health services are usually reserved for people with severe problems, so dual diagnosis clients with less severe mental health problems may not get dual diagnosis treatment. They should, however, be referred to a suitable service.
A person with a mental illness may receive treatment, but their drug abuse problem could be dismissed as a minor side effect of their illness.
The number of workers trained in dual diagnosis treatment is slowly increasing. The services for mental health and drug abuse generally don’t overlap, so professionals in one field aren’t knowledgeable about the issues in the other field. It is hard to find professionals who are skilled in treating both drug abuse and mental illness.

Bookmark to:

Dual Diagnosis: Drug Addiction And Mental Illness

Families who have mentally ill relatives whose problems are compounded by drug addiction or alcohol abuse face problems of enormous proportions. Mental health services are not well prepared to deal with patients having both afflictions (dual diagnosis). Often only one of the two problems is identified. If both are recognized, the individual may be bounced back and forth between services for mental illness and those for drug addiction treatment, or they may be refused treatment by each of them.

While the picture regarding dual diagnosis has not been very positive at this point, there are now signs that the problem is being recognized and there is an increasing number of dual diagnosis treatment programs trying to address the treatment needs of people with both problems. Research studies are beginning to help us understand the scope of the dual diagnosis treatment problem. It is now generally agreed that as much as 50 percent of the mentally ill population also has a drug addiction of alcohol abuse problem. The drug most commonly used is alcohol, followed by marijuana and cocaine. Prescription drugs such as tranquilizers and sleeping medicines may also be abused.

The incidence of abuse is greater among males and those in the age bracket of 18 to 44. People with mental illnesses may abuse drugs covertly without their families knowing it. It is now reported that both families of mentally ill relatives and mental health professionals underestimate the amount of drug dependency among people in their care. There may be several reasons for this. It may be difficult to separate the behaviors due to mental illness from those due to drugs. There may be a degree of denial of the problem because we have had so little to offer people with the combined illnesses. Care givers might prefer not to acknowledge such a frightening problem when so little hope has been offered.

Drug addiction or alcoholism complicates almost every aspect of care for the person with mental illness. First of all, of course, these individuals are very difficult to engage in drug addiction treatment. Diagnosis is difficult because it takes time to unravel the interacting effects of drug addiction and the mental illness. They may have difficulty being accommodated at home and may not be tolerated in community residences of rehabilitation programs. They lose their support systems and suffer frequent relapses and hospitalizations.

Violence is more prevalent among the population with a dual diagnosis. Both domestic violence and suicide attempts are more common, and of the mentally ill who wind up in jails and prisons, there is a high percentage of drug abusers. Given severe consequences of drug abuse for the mentally ill, it is reasonable to ask: “Why do they do it?” Some of them may begin to use drugs or alcohol for recreational use, the same as many other people do. Various factors may account for their continued use. Probably many people continue their use as a misguided attempt to treat symptoms of the illness or the side effects of their medications. They find that they can reduce the level of anxiety or depression — at least for the short term. Some professionals speculate that there may be some underlying vulnerability of the individual that precipitates both mental illness and substance abuse. They believe that these individuals may be at risk with even mild drug use.

Social factors may also play a part in continued use. People with mental illnesses suffer from what has been called “downward drift.” This means that as a consequence of their illness they may find themselves living in marginal neighborhoods where drug use prevails. Having great difficulty developing social relationships, some people find themselves more easily accepted by groups whose social activity is based on drug use. Some may believe that an identity based on drug addiction is more acceptable than one based on mental illness.

We realize that this overview of the problem of drugs and mental illness (dual diagnosis) is not a very positive one. However, we believe there are some encouraging signs that better understanding of the problem and potential dual diagnosis treatment programs are on the way. Just as families have faced other very troublesome problems in the past and developed adequate responses to them, we believe that they can learn to deal with this one in a way that their lives become less troubled and their relatives begin receiving better treatment.

Bookmark to:

Dual Diagnosis and Drug Addiction: Help Through Drug Rehabs

Dual diagnosis in alcoholics and drug addicts has found a better solution for dual diagnosis treatment through the drug rehabs. Recent statistics at the National level of research on drug rehab programs has brought forward this report. Dual diagnosis treatment is a part of long-term drug rehab program. The basic time period required for this type of dual diagnosis treatment is approximately 45 days. But in some cases the span might have to be expanded.

Dual diagnosis treatment begins with the drug detox process. No drug rehab program can be completed in a single step. Once the nervous system and the organs are prone to the use of drugs and alcohol, it is just next to impossible to deprive the body from that pleasure without intense uncomfortably. The drug detox program will minimize the withdrawal symptoms. This is the juncture where the drug rehab programs especially the dual diagnosis treatment begins.

There are psychological symptoms that bar the patient’s physical stability. Medicinal help is mandatory in this situation. Thus dual diagnosis at one hand regulates the dual diagnosis treatment at the psychological level with various modes of counseling. On the other hand the patient is helped to gain a bodily stability by substituting his drug dose with medicinal inputs.

Diet and exercises are two major concerns not to be ignored at any level. Drug addicts and alcoholics are easy victims of low appetizers. Thus by every means the body has to be substantiated with enough calories and energy boost. The addict must not feel low at any level. Psychological depression is much a result of physical ailment. A balance has to be created at both the level. The drug rehab program with the dual diagnosis approach enhances its focus on these aspects in particular.
If you require addiction information on dual diagnosis or dual diagnosis treatment please review the information at www.dual-diagnosis-treatment-center.com.

Bookmark to:

If a Person Has Both an Alcohol/Drug Problem and an Emotional Problem, Which Should Be Treated First?

Ideally, both problems should be treated simultaneously. For any substance abuser, however, the first step in treatment must be drug detox or alcohol detox- a period of time during which the body is allowed to cleanse itself of alcohol or drugs. Ideally, drug detox or alcohol detox should take place in a medical detox program located in a drug rehab or alcohol treatment program. It can take a few days to a week or more, depending on what substances the person abused and for how long.

Until recently, alcoholics and drug addicts dreaded drug detox and alcohol detox because it meant a painful and sometimes life-threatening “cold turkey” withdrawal. Now, doctors are able to give hospitalized substance abusers carefully chosen medications which can substantially ease withdrawal symptoms. Thus, when drug detox or alcohol detox is done in a medical detox program, it’s safer and less traumatic.

What Is Next After Drug Detox or Alcohol Detox?

Once drug detox or alcohol detox is completed, it’s time for dual diagnosis treatment; rehabilitation for the alcohol or drug problem and treatment for the psychiatric problem.

Drug rehab for a substance abuse problem usually involves individual and group psychotherapy, education about alcohol and drugs, exercise, proper nutrition, and participation in a 12-step recovery program such as Alcoholics Anonymous. The idea is not just to stay off booze and drugs, but to learn to enjoy life without these “crutches.”

Treatment for a psychiatric problem depends upon the diagnosis. For most dual disorders, individual and group therapy as well as medications are recommended. Expressive therapies and education about the particular psychiatric condition are often useful adjuncts. A support group of other people who are recovering from the same condition may also prove highly beneficial. Adjunct treatment, such as occupational or expressive therapy, can help individuals better understand and communicate their feelings or develop better problem-solving or decision-making skills.

Must a Dual Diagnosis Patient Be Treated in a Hospital?

Not necessarily. The nature and severity of the dual diagnosis the associated risks or complications, and the person’s treatment history are some of the facts considered in determining the appropriate level of dual diagnosis treatment. There are several different levels or intensities of dual diagnosis treatment including full hospitalization or inpatient treatment, partial hospitalization, and outpatient treatment.

Bookmark to: