Also known as having a co-occuring disorder, people who have a mental illness diagnosis as well as an addiction to alcohol or drugs are candidates for dual diagnosis treatment.

The population receiving the most attention these days is those deemed “severely mentally ill,” which can be a misleading term. While everyone with a diagnosed mental illness, combined with addiction, is dually diagnosed, not all are considered to be severe. The mental illnesses that fit into this category are usually schizophrenia, severe anxiety disorders, severe depression or bipolar disorder, combined with substance abuse and addiction.

In most cases, the substance abuse itself may be the causal factor in mental illness. Whether the illness is a by-product of substance abuse or if substance abuse stems from the user’s desire to medicate aspects of their mental illness can be uncertain.

Other types of dual diagnoses may include less severe depression, anxiety disorders and personality disorders, along with substance abuse and addiction. Many of these people can be medicated appropriately and become functional, which renders them less severely mentally ill. Others may continue their use and abuse of substances and never receive proper treatment. Many of the latter population are those who suffer from mental illness brought about by trauma, such as post-traumatic stress disorder. Symptoms are managed by use of drugs and/or alcohol and then that substance which “helped” them becomes an addiction. This may further their symptoms into a severely mentally ill status, without proper treatment.

The challenge in all of these situations is to properly treat the individual, no matter the severity of their condition. For many, substance abuse becomes the point where awareness comes from the public sector. They may get arrested for crimes having to do with either procuring illegal substances or from crimes committed while under the influences. While incarceration may decrease their criminal activity, it does nothing to address the causal factors for the behavior. Treatment will give them incentive to remain drug and alcohol abstinent, but their underlying (or perhaps initial) mental illness remains untreated.

Treatment for severe mental illness may involve drugs that are difficult to gauge. While some people will respond well to a drug to treat their condition, others with the same (or similar) symptoms will have terrible side effects and responses to the same medication. Therefore, it is important to seek a specialist in dual diagnosis who can closely monitor the treatment recommended.

Kelly McClanahan has an MSW in clinical social work, with a specialization in substance abuse treatment. Having worked in this field for over 20 years, she is currently working on her certification as an addictions’ counselor.

Only fifty percent of drug rehabs offer a dual diagnosis programs. Furthermore, according to Substance Abuse and Mental Health Services Administration Treatment Episode Data Set, most of the drug addiction treatment centers that offer comprehensive dual diagnosis programs are privately owned, not state funded and of that number not all comprehensive programs are integrated sufficiently.

Until the last decade or so, dual diagnosis was typically not recognized by treatment professionals. Today, the number of people entering treatment with a mental health disorder continues to grow. In 2002, it was estimated that 40 percent of alcohol abusers also suffered from an independent mood disorder, and 60% of drug abusers suffered from a form of mood disorder. It has been noted that more women suffer from a mental health disorder and substance abuse than men.

A drug rehab that offers comprehensive dual diagnosis programs should have a multidisciplinary team of addiction certified physicians and behavioral health nurses with expert knowledge of mental health disorders. Therapists must be experienced in mental health disorder treatment protocols as well as addiction treatment protocols or best practices.

The ability of a person suffering from both a mental health disorder (such as PTSD, anxiety, or panic disorder for example), and a substance abuse problem to succeed in long term abstinence and recovery will be much more likely if both health issues are properly diagnosed and treated simultaneously.

A comprehensive dual diagnosis program will provide the patient with:
• Regular psychiatric evaluations
• Individualized treatment plan
• Dual diagnosis education
• Medication management education
• Group and Individual counseling (using a variety of therapies)
• Addiction education
• Life skills training
• Exercise and nutritional counseling
• Spiritual workshops or 12 Step meetings
• Individualized after care plan

Without addressing the problems and symptoms of the mental health disorder and without a thorough understanding of drug and alcohol triggers, the person in a drug rehab for dual diagnosis is at greater risk for relapse and a worsening of the mental health disorder symptoms.

There is an endless cycle of addiction. For example, the addict is depressed and longs to be free of those feelings. In desperation, the addict uses drugs or alcohol to alleviate the symptoms. After a short period of time, the alcohol or drugs no longer provide relief and the body has grown accustomed to the drugs and alcohol and demands more, and the symptoms of the depression worsen.

This cycle is repeated until the cycle of addiction is broken, drug use is abandoned, the patient receives a medically supervised detox, proper diagnosis of the mental health disorder is made, stabilizing medication is prescribed if needed, and addiction treatment is obtained.

It is a complex process to accurately diagnose someone who has both a mental health disorder and a substance abuse problem. This is why it is important for the patient to choose a drug treatment center that is able to manage his or her mental health disorder. The first step is always to stop using substances through the aid of a medically supervised detox unit.

This article was contributed by Lakeview Health Systems, a nationally recognized treatment center located in Jacksonville, Florida.

Dual Diagnosis is the term used when referring to a person who has a diagnosis such as depression, or bi-polar disorder, in addition to having a drug addiction diagnosis. Treating dual diagnosis patients (sometimes referred to as a co-occurring disorder) in drug rehab is complicated. Treatment of the patient’s addiction and their mental health disorder must happen simultaneously from the moment they enter the addiction treatment facility.

Any drug rehab advertising that they treat dual diagnosis patients should have qualified staff within their treatment facility available to handle the difficulties associated with treating dual diagnosis patients. When treating dually diagnosed patients, or patients with co-occurring mental health disorders, the staff at the drug rehab should have full-time doctorate level, and at the very least, masters level clinicians interacting with the patients on a daily basis. Some drug rehabs attempt to treat dually diagnosed patients with unqualified, or insufficient, clinical staff.

Sometimes patients enter drug treatment without a dual diagnosis, but after the clinical assessment process patients are assigned a diagnosis such as depression, anxiety disorder, or bi-polar disorder in addition to their diagnosis of drug and/or alcohol addiction. Once the patient is given a co-occurring disorder diagnosis in drug treatment, a treatment plan that addresses both the addiction and the co-occurring disorder is formulated and put into action immediately by the clinical team at the drug treatment facility.

The treatment plan for people with a dual diagnosis in drug rehab often consists of weekly therapy in addition to weekly addiction counseling. At Sovereign Health of California, for example, each client entering drug rehab with a dual diagnosis is given two workbooks. The first workbook addresses their drug or alcohol addiction, the second addresses their particular mental health disorder. After the patient is instructed to complete the assignments in the workbooks, the therapist/psychologist in addition to the addiction counseling professional will then work with the patient to address both issues concurrently throughout the patient’s addiction treatment episode.

Treating dual diagnosis in drug rehab is a complicated process and ensuring that the drug rehab you choose has the necessary elements needed to address both the addiction and the mental health disorder is paramount in determining which place is best for you or your loved one.

Author: Brendan Bickley
Sovereign Health of California

The need for drug rehab to heal alcoholism and drug addiction goes far beyond physical reliance. There are often much deeper, underlying psychological issues that contribute to drinking and these factors need to be rooted out and addressed for recovery to be successful.

The psychological need or craving for drugs and alcohol is the most difficult part of the recovery process to treat. Oftentimes there is chemical imbalance present that may create mood disorders and a person will self-medicate with drugs and alcohol in order to stabilize their emotions. For instance, someone who is depressed may turn to stimulants to boost their mood while someone who suffers from anxiety may take a drink or a Xanax to calm down. Individuals may not even be aware they are using drugs and alcohol to balance out a chemical imbalance. In the process of self-medicating, they become addicted to drugs and alcohol. For this reason, it’s necessary for an individual to be properly diagnosed with a clinical evaluation for successful treatment in drug rehab and dual diagnosis.

Drug Rehab: Clinical Evaluation

A clinical evaluation is generally given by a psychologist using proven diagnostic tests to determine whether an underlying chemical imbalance is present that could be contributing to the addiction. If an individual is diagnosed with bi-polar disorder or anxiety in addition to alcoholism or drug addiction, this is referred to as dual diagnosis in drug rehab or co-occurring disorders. Once this is diagnosed, drug rehab and dual diagnosis treatment has a better chance at being successful.

Drug Rehab: Treating Dual Diagnoses

People come to rely on drugs and alcohol because of the way it makes them feel. If they are self-medicating an underlying mood disorder, this needs to be treated through therapy and possibly even medication in order for drug and alcohol treatment to be successful.

Clinical therapy can help root out underlying issues that could be contributing to alcoholism and drug addiction. Family dynamics, childhood or adult trauma or abuse (physical, verbal, emotional), post-traumatic stress disorder (PTSD) are all symptomatic of traumatic or life-threatening situations that have created a strong fear of harm and/or preservation. Individuals need to work through these issues and release them in order to also release the need for alcohol and drugs to numb or escape. This is not an overnight process.

As a last resort, medication may be prescribed to help individuals through the most traumatic events or depressive episodes. Working through clinical therapy, the goal is to release the need for medication, drugs or alcohol and live a life free of emotional pain. Finding a drug rehab for dual diagnosis can make all the difference in a person’s recovery.

It’s very common for people who have problems with drugs and alcohol to have underlying chemical imbalance that results in mood disorders. People may be using alcohol and drugs to self-medicate in an attempt to control mood swings resulting from depression, anxiety, bi-polar disorder or post-traumatic stress disorder. Someone who has a chemical imbalance and is simultaneously addicted to drugs or alcohol is said to have “Dual Diagnosis,” also known as co-occurring disorders. If you’re not sure if you have dual diagnosis, its important to attend get a clinical diagnosis and tailored treatment at a drug rehab for dual diagnosis.

Drug Rehab Programs and Dual Diagnoses

Drug rehab for dual diagnosis treatment is necessary. It’s estimated that approximately 70% of people who struggle with alcohol and drug addiction have mood disorders. People may drink or take drugs in an effort to balance out the highs and lows associated with these disorders. Consistent and prolonged use of alcohol or drugs results in change to brain chemistry that further aggravates the problem. For this reason, when seeking treatment for alcohol or drug addiction it’s important to find a drug rehab for dual diagnosis.

Drug Rehab Treatment and Dual Diagnosis

When you research drug rehab treatment, find out if they have the proper staff personnel to evaluate whether you may have dual diagnoses. If you’ve never been diagnosed, the time to find out is before or when you enter drug rehab for treatment. If you don’t find out whether you have an underlying mood disorder that could be contributing to your alcohol or drug addiction, you may not remain sober.
Chemical imbalance requires management so extreme mood swings don’t knock you off balance. A clinical therapist or psychologist on staff at a drug rehab for dual diagnosis is qualified to give you a clinical evaluation that determines whether you have dual diagnosis. This then allows for a treatment plan to be developed specifically for you that may include prescribed medication or extra therapy sessions in order to assist you in managing symptoms without the use of drugs and alcohol.