People with both an addiction issue and a mental health issue are sometimes described as having a dual diagnosis or a co-occurring disorder. These are terms medical professionals use to describe people who have two medical issues impacting them at the very same time.
Doctors sometimes struggle with these patients and debate how to deal with both issues at once. In the past, people with addictions and mental health issues received less than optimal care as a result of these struggles. Sometimes, they received care for just one issue, while the other issue was allowed to grow stronger. Sometimes, they received care from two separate sets of providers, and those providers might not have shared information properly. As a result, many of these patients did not succeed in their treatment programs.
Now, more advanced treatment providers offer an integrated treatment model to help this set of patients. With integrated treatment, addiction and the mental illness are addressed at the same time, by the same medical provider. This allows the entire medical, emotional and social life of the patient is taken into account and amended, if needed. It’s a complete form of care that can make a real difference in the life of someone with a dual diagnosis.
Co-occurring Mental Health Concerns
While almost any mental illness can run alongside an addiction (co-occurring issues), there are some mental illnesses that are more commonly associated with substance abuse. According to Medical Clinics of North America, some common psychiatric disorders associated with substance abuse include:
- Bipolar disorder
It may be difficult to determine if a person’s thought or behavior are related to mental illness or substance use disorder, as both conditions may have similar symptoms. It can also be difficult to determine if and when a mental health concern began, or determine if the root cause of a mental health concern is tied to an unrelated physical illness. At The Canyon, dual diagnosis treatment begins with a full health assessment, and every treatment plan is unique because every addiction is unique.
In some cases, it is not always clear that there are more than one issues in a patient. While some people with a dual diagnosis see their doctors because they’d like to rid themselves of their addictions, many others do not wish to control their substance use.
Many people may want to gain control over their mental health concerns, but they may not realize thatsubstance use can play a role in mental illnesses. In most cases, substance use begins or continues in an effort to self-medicate, or to simply feel better. It’s quite possible that the reverse is also true; some people may want control over their addictions, not realizing their mental illness also needs to be addressed.
Making an Assessment
Putting together an integrated treatment plan requires the doctor to do a bit of detective work. The doctor will need to know more about:
- Current and past substance use
- Any mental health concerns or diagnoses
- Why the person wants treatment, or what goals he or she has
- What life challenges or difficulties the person has had to overcome
- Medical history information
This is a significant amount of information, to be sure, and sometimes it takes more than a simple interview for the medical professional to answer all of these questions. Sometimes other family members or friends must also chip in and answer questions so the doctor can put together a good plan of action.
Integrated Treatment at The Canyon
An integrated treatment model will address all of these issues at the same time in order to help each person gain control not just of the addiction, but also over the factors that might play into the addiction.
The National Institute on Drug Abuse reports that this model of integrated treatment should be used to help all people who are struggling with issues of substance abuse. By crafting a plan that addresses many issues at the same time, doctors can do their part to help patients rebuild their lives. With a strong and healthy foundation, a relapse is less likely.
According to the National Alliance on Mental Illness, integrated treatment for dual diagnosis programs often include a more comprehensive approach than traditional substance use treatment. Counselors and doctors go above and beyond traditional treatment to offer a whole-mind and whole-body approach to recovery.
The Substance Abuse and Mental Health Services Administration reports that some people with dual diagnosis issues also have several social or environmental issues at the same time. They may not have a stable place to call home, and they may not have a job or a means of making money. They may have poor connections with their families, or they may have difficulty socializingor be isolated from healthy friends or family. In an integrated treatment model, these issues are also addressed in a caring and sensitive way, so the person can move forward and get back on track.
Treatment for Co-Occurring disorders
Counseling is a helpful tool in the treatment of addiction, and this doesn’t change in an integrated treatment model. No matter how engaged the person is in therapy, and no matter how healthy his other social life might be, the person still needs to gain insight on addiction and learn how to control the urge to use.
Treatment methods for co-occurring disorders is more comprehensive than traditional treatment. The Journal of Substance Abuse Treatment outlines a tactic known as “motivational interviewing”, a type of treatment that works very well in a dual diagnosis treatment setting.
- Get to know the patient well so that he or she can better connect with and support that person’s recovery
- Listen reflexively to ensure that the patient feels comfortable and free to talk
- Praise accomplishments, yet help the patient stay firm on goals
- Integrate information about the mental illness into feedback given
These minor adjustments transform a traditional addiction model into a more supportive, open model that can be encouraging for people who have a dual diagnosis.
Medications might play a role in treating both conditions. While some addiction programs might use an abstinence-only policy, where the patients aren’t allowed to use any substances whatsoever, an integrated treatment program realizes that dealing with a mental issue might mean taking some medications.
Similarly, some addictions are treated with medications like suboxone. These medications might interact with medications the person takes for mental illness. By receiving care in an integrated model from one provider, the risk of medication interactions can be reduced. This sole provider can check the medications, ensure they’re safe to take together, and help prevent problems before they occur.
Success Rates of Integrated Treatment
The integrated model is relatively new, but it has been proven as an effective method in many scientific studies. For example, a study in the Journal of Substance Abuse Treatment found that people who participated in the integrated model had a lower incidence of psychotic episodes and arrests compared to people who did not participate. Their therapy seems to have allowed them to achieve a level of stability, and this resulted in fewer crises.
The integrated treatment model has also been effective in addiction treatment. A study in the journal Hospital and Community Psychiatry found that of 17 people who received inpatient dual diagnosis care, 12 reported continued drug and alcohol abstinence one month later.
It’s clear that integrated treatment models have the capacity to help people gain control over their addictions, their mental illnesses and the other important aspects of their lives. The lessons they learn in therapy can stay with them for the rest of their lives, as they continue to manage both of these chronic conditions over the long term. Relapse is sometimes an issue for these people, as these conditions are powerful and long-term change is hard to sustain; however, therapy provides a strong foundation that can be readdressed as issues occur.
At The Canyon, we provide ongoing support to all of our patients, helping them if a relapse occurs or just checking in with them regularly. For dual diagnosis patients, this service can be a great help, and we’re happy to provide it.