Dual diagnosis is when substance abuse addiction and mental illness happen at the same time. A substance abuse patient may not find out that drug and alcohol addiction often co-occur with other disorders, until seeking drug or alcohol addiction treatment. About 70 percent of people with drug and alcohol addictions may suffer from dual diagnosis. They often have undiagnosed and untreated secondary diagnoses.
Individuals with mental illnesses may engage in alcohol addiction or substance abuse without their families’ knowledge. It is reported that both mental health professionals and families of mentally ill relatives underestimate the amount of substance abuse and alcohol addiction among people in their care. This could be due to the difficulty in separating the dual diagnosis behaviors of mental illness from those of drug and alcohol addiction and abuse. There may be denial of the problem, because there has been so little information and help offered to people with dual diagnosis illnesses.
Individuals with co-occurring disorders or dual diagnosis may begin to use drugs or alcohol for recreational use. They could be trying to treat symptoms of the illness or the side effects of their medications as well. They could also be trying to reduce anxiety or depression. Some professionals say that there may be some underlying vulnerability of the person that brings about the dual diagnosis in the individual with both mental illness and substance abuse. They believe that these certain individuals may be at risk of dual diagnosis with even mild drug use.
Social factors, such as where the individual lives, may also play a part in continued substance abuse. People with mental illnesses may find themselves living in marginal neighborhoods where alcohol addiction and drug use prevails, and it is hard to avoid substance abuse, it is all they know. Because they have difficulty developing social relationships, dual diagnosis sufferers find themselves more easily accepted by groups whose social activity is based on drug abuse. Some may believe that an identity based on drug or alcohol addiction is more acceptable than one based on mental illness.
The more an individual understands the disorder, the better able they are to manage the impact of disease has on them, their family, and on their social community. It is why a good dual diagnosis treatment program should include educational components.
Some of the components of a good dual diagnosis treatment program include the following:
- Psycho-education – Lectures, groups, and individual sessions educate the dual diagnosis patient about the medical and psychological aspects of his/her dual diagnosis.
- Expert pharmacotherapy – If medications are prescribed, only the most effective medications offering the greatest benefit and the least side effects are used.
- 12-Step programs – Patients are provided a range of quality in-house 12-Step meetings according to their specific needs.
- Relapse prevention program specifically designed for ongoing recovery of the dual diagnosis patient.
- Adjunct groups that focus therapeutic work on specific areas of concern to the dual diagnosis treatment of the patient, such as , cocaine/heroin addiction, eating disorders, stop smoking, grief and trauma, healthy sexuality, compulsive gambling and women’s, and men’s groups.
- Dual diagnosis patients are encouraged to invite their family members to participate in the Family Program.
- Integrative therapies may include acupuncture, massage, Eye Movement Desensitization and Reprocessing (EMDR), and Somatic.