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.

Dual diagnosis aka Co-Occurring mental health conditions and substance abuse disorders affect nearly 14 million Americans each year. Of those only 19% receive the appropriate treatment for both conditions, with the vast majority bounced among different treatment systems and facilities that treat one of the conditions but not the other. Few treatment programs specialize in treating complex co- occurring or dual diagnosis disorders. Nationally, research continues to reveal that people with co-occurring or dual diagnosis disorders need a specialized form of treatment, referred to as integrated services.

Treatment systems for mental health and addiction have historically been and will continue to be separated systems of care. While many research studies have been performed on mental health issues and addictions separately, it has only been within recent years that a few studies have emerged on people who struggle with both conditions in unison. This emerging research identifies that traditional separated systems of care not only alienate the patient from the treatment, but they also result in much poorer outcomes than those experienced by patients with single disorders.

According to researchers and ever more surprising, we are just now learning from these studies that treatment programs designed to treat a specific disorder only are actually only capable of treating the minority of those in need where, in fact, up to 65.5% of patients with a substance abuse disorder had at least one mental disorder as well and 51% of patients with a mental disorder had at least one substance abuse disorder. We are also learning that these poorer outcomes result as much from these separate and contradictory systems of care as from the diagnoses themselves with people who have co-occurring conditions comprising the majority of the 10 percent of people using over 70 percent of the country’s healthcare resources

Addiction treatment is not uniform across different drug rehabs, yet the basic foundation of all drug rehabs is virtually the same.  Addiction treatment has become a big industry and more addiction treatment facilities are surfacing every day across the United States.  One thing all dug rehabs have in common is that their primary purpose is to help alcoholics and addicts recover from their addiction.  The manner in which each treatment facility accomplishes this task varies from one treatment facility to the next.

The basic elements of addiction treatment, whether the drug rehab is a primary inpatient addiction treatment facility or a residential addiction treatment facility, are the same.  Almost all addiction treatment facilities rely on the 12-Step philosophy to treat their patients.  While there have been many philosophies and therapies developed since the creation of the 12-Step philosophy (DBT, CBT, Motivational Interviewing, etc.) to treat drug addiction and alcoholism, no one to date has been able to develop a treatment method more successful in helping an addict or alcoholic recover from their addiction.

What has transpired over the years is that the more sophisticated and progressive addiction treatment centers have incorporated Dialectical Behavior Therapy (DBT), Cognitive Behavior Therapy (CBT), and the more popular and recent Motivational Enhancement Therapy, into their program matrix.  Many dual diagnosis addiction treatment facilities rely heavily on these therapeutic philosophies to help treat co-occurring mood and personality disorders.  But, the most successful addiction treatment facilities in the nation will continue to focus on the 12-Step Philosophy as their core curriculum when it comes to treating drug addiction and alcoholism.

The primary difference between the 12-Step philosophy and other psychologies is its focus on a higher power and the inability of the individual to control his or her addiction on their own.  Other therapies attempt to help a person control their behavior, whereas the 12-Step philosophy emphasizes the lack of control the individual has in controlling their drinking and drug use and helps them rely on a “power greater than themselves” to help them overcome their malady.  So, the primary difference between 12-Step philosophy and other psychologies is its spiritual dimension.  Psychology is PSYCHOLOGY, because it has purposely discarded the spiritual element of human behavior and thought.  In fact the development of psychology began as a purposeful exclusion of spirituality and religion.  Since then, many therapists and psychologists have utilized spiritual elements in their practice and both psychology and spirituality have melded quite nicely over the years, but the 12-Step philosophy, developed by a bankrupt stockbroker and proctologist, remains the best and most effective combination of spirituality and psychology ever developed to treat addiction and alcoholism.

By Brendan Bickley, Doctoral Candidate