Dual diagnosis or Co-occurring Disorders, refer to drug addiction which is accompanied by an emotional or psychiatric illness. Either type of disorder is complex on its own, together; a dual diagnosis will affect the individual socially, spiritually, physically, and psychologically. The interaction of the different components of dual diagnosis can interact so that diagnosis, treatment and recovery are made more difficult.
In addition, accurately assessing the extent of emotional or psychological illness while drug or alcohol addiction are present can become very difficult for the healthcare provider, thereby making an effective treatment plan more difficult to compile. This does not mean however, that treatment for dual disorders is ineffective or unheard of. When treating an individual with a dual disorder, it is necessary to focus on both issues. Only trying to fix one problem will most likely not result in improvement of either arena.
How Often Do Severe Mental Illnesses Occur Concurrently with Addiction?
- 37% of alcohol abusers and 53 % of drug abusers have at least one mental illness.
- Of all people diagnosed as mentally ill, 29% abuse either alcohol or drugs.
- About 50 % of people with mental disorders are affected by substance abuse.
Has Research Been Done Regarding Co-Occurring Disorders?
Yes. Research has been conducted by many different government organizations and universities. The National Co-morbidity Study for instance, found that about half of the individuals participating in their survey met criteria for a substance use disorder at some point also met criteria for one or more lifetime mental disorders. The same was true of those who met mental illness criteria, meaning, at some point they met the criteria for a substance use disorder. Even though there are these very high rates of co-occurring disorders, there isn’t a lot of conclusive evidence collected.
Though this is the case, the studies conducted reveal patterns of behavior among this population. Some of those trends include the following:
- 70-80% of individuals with co-occurring disorders didn’t obtain any substance abuse or mental health treatment in the last year.
- Integrated care or both types of care (substance abuse and mental health treatment) were only reported to be utilized by 8% of the population in the last year.
- For those individuals that used one of the two services, mental health treatment was three times as common as use of substance abuse treatment.
- Co-occurring disorders were correlated with an increased likelihood that the individual would receive substance abuse treatment.
What are some of the mental illnesses that occur in co-occurring disorders?
Substance abuse disorders can occur with any mental illness; however, they are more likely to occur with a severe mental illness such as bipolar disorder or schizophrenia. Some of the other mental health illness with which substance abuse occurs is as follows: antisocial personality disorder, manic episode, schizophrenia, panic disorder, obsessive compulsive disorder, and with phobias. In one study conducted, forty-seven percent of people with schizophrenia also had a substance abuse disorder and sixty one percent of individuals with bipolar disorder also had a substance abuse disorder. These individuals are four and five times as likely, respectively, to have a co-occurring disorder than the general population.
Individuals with severe mental illness are more likely to go in for treatment, most likely because the symptoms of their particular disorder have made living a normal existence difficult or because a loved one recognizes this individual needs help. It is usually at this juncture that substance abuse treatment is also incorporated.
What Type of Treatment is Available for Co-occurring Disorders?
Perhaps one of the best forms of treatment for co-occurring disorders is what is known as integrated treatment. As the name implies, the patient receives treatment for both mental illness and substance abuse from the same clinician or from a team of clinicians. Basically, the team works together to make sure that the different interventions are brought together. This way the client will see no division between mental health and substance abuse treatment. This eliminates the confusion that can often occur when obtaining treatment in two different centers. The beauty of integrated treatment is that each client has his or her specific program plan. This way, the individual can move at his or her own pace, thereby resulting in a more effective treatment situation which will hopefully lead to long lasting recovery.
Do The Individuals Have a Good Chance at Recovery?
Yes. Individuals with Co-occurring disorders can recover. Since treatment for such a disorder is two-fold, those involved in treatment, must remember that treatment in a dual diagnosis program will take time. Recovery should be regarded as a long term goal, one that is attainable if proper and effective treatment is obtained. Perhaps the most difficult problem with such a disorder is identifying that it exists. Once some is identified as having this problem, treatment can begin. The next big step is finding an effective program, and then the healing can begin.
Dual Diagnosis and Integrated Treatment of Mental Illness and Substance Abuse Disorder. Http://www.nami.orgTemplate.cfm?Section=By_Illness&template=/ContentManagementContentDisplay.cfm&ontentID=10333 Accessed 21 July 2007
Green-Hennessey S: Factors associated with receipt of behavioral health services among persons with substance dependence. (2002). Psychiatric Services 53:1592–1598.
Harris, K.M. & Edlund, M.J. (2005). Use of Mental Health Care and Substance Abuse Treatment Among Adults With Co-occurring Disorders. Psychiatric Services 56:954-959.
Kessler RC, Nelson CB, McGonagle KA, et al: The epidemiology of co-occurring addictive and mental disorders: implications for prevention and service utilization. (1996). American Journal of Orthopsychiatry 66:17–31.
Watkins KE, Burnam A, Kung FY, et al: A national survey of care for persons with co-occurring mental and substance use disorders (2001). Psychiatric Services 52:1062–1068.
Wu LT, Ringwalt CL, Williams CE: Use of substance abuse treatment services by persons with mental health and substance use problems. (2003). Psychiatric Services 54:363–369.