Dual Diagnosis Treatment and Substance Abuse

Substance abuse often co-occurs with severe mental illness. Research shows that there is a 60% lifetime incidence of severe mental illness and co-occurring substance abuse (Dual Diagnosis). Another way of saying this is that 6 out of 10 individuals with a severe mental illness will have substance abuse problems some time during their life. Unfortunately, severe mental illness and co-occurring substance abuse is associated with a variety of negative outcomes including:

• Hospitalization
• Suicide
• Work/school problem
• Problems with relationships
• Non-compliance with treatment

Psychosocial approaches to dual diagnosis have been limited in their success. The majority of approaches are adopted from programs that address substance abuse problems without co-occurring mental illness. These approaches are yet to be proven for dually diagnosed individuals. However, the research literature does support the following:

• A Substance abuse problem is the rule not the exception

Substance abuse treatment should be fully integrated into the dual diagnosis treatment for severe mental illness

• Motivational enhancement strategies should be utilized for dual diagnosis treatment

• Behavioral skills training is effective for individuals with a dual diagnosis problem

• 12-Step recovery is problematic for some individuals with severe mental illness

• Dual diagnosis treatment should be long term

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