Latest Advances in Dual Diagnosis Treatment
Over 8 million adults suffered from a substance abuse disorder and mental illness simultaneously in 2015, according to the National Survey on Drug Use and Health.
Dual diagnosis is the term we use when the two disorders are seen in one person at the same time. It’s a relatively new concept that came about in the 1990s.
Before the 90s, many providers refused to treat a client’s mental illness until the substance abuse problem was addressed. Now, we understand the importance of treating both simultaneously.
Identifying Dual Diagnosis
Symptoms of addiction and many mental illnesses can overlap, which makes a dual diagnosis difficult.
There is also a correlation between addiction and suicide, which makes prompt diagnosis and treatment even more crucial. Whenever there are symptoms of addiction and warning signs of mental illness, we should consider the possibility that both are present.
Some common symptoms of substance abuse:
- Withdrawal from social interactions
- Sudden behavioral changes
- Engaging in risky behavior
- Loss of control with substances
- High tolerance and withdrawal symptoms
- Feeling that drugs or alcohol are necessary
A few warning signs of mental illness:
- Extreme mood changes
- Problems concentrating
- Thoughts of suicide
Treatment for a Dual Diagnosis
Mental illness covers a broad range of disorders that each have their own treatment plan.
Providers must consider this when creating their approach. Because each approach must be tailored to the individual, there are many variations in treatment for a dual diagnosis.
If you think you’re suffering from a mental illness along with substance abuse, look for a treatment provider who has experience with both. He or she should understand the ways each disorder affects the other.
The treatment plan for a dual diagnosis may include the following.
Detox is the first hurdle to overcome. Inpatient detoxification is recommended for people with a dual diagnosis because of the complexity of the condition.
Expect to be monitored 24/7 for up to a week to ensure your personal safety. You may receive medication to help with withdrawal symptoms.
Once your body has detoxed from addictive substances, if a mental illness is present, expect to participate in an inpatient rehabilitation program where you can receive medical and mental health support around the clock.
In-patient rehabs are the best place to handle a dual diagnosis because they provide support, therapy, health services and medication. This should help attack the causes from all areas.
After rehab, supportive housing helps introduce the newly sober back into society. These residential treatment centers provide some support while helping you gain some independence.
Supportive housing centers typically do not offer medical services, but they provide group and peer support. These treatment centers are available to anyone, but they are especially beneficial at helping homeless people with a dual diagnosis.
Cognitive Behavioral Therapy (CBT) and Motivational Interviewing (MI)
CBT helps people who are suffering from mental illness and a substance abuse disorder learn how to change ineffective thinking patterns, which may lead them to relapse.
Motivational Interviewing (MI) attempts to help a person find the motivation to make confident decisions towards established goals.
A 2014 review of 12 studies comprising 1,721 patients found that CBT and MI were useful for treating clinical and subclinical alcohol use disorder and major depression. MI relies on a collaborative, non-confrontational effort between the patient and therapist to spark motivation.
Certain medications can help during the withdrawal phases of recovery and others can help treat symptoms of mental illness.
A review of 43 research trials sheds some light on which medications work best in specific cases of mental illness and substance abuse. For example, the review concluded that:
- Antidepressants were ineffective or had dangerous side effects for people suffering from anxiety and substance abuse disorders.
- Antipsychotics were found to be useful for treating schizophrenia and comorbid substance abuse with clozapine, olanzapine, and risperidone being the most effective.
- Clozapine appears to be most effective for reducing alcohol, cocaine and cannabis abuse among people with schizophrenia.
It can feel isolating to deal with a dual diagnosis, and support groups offer the perfect outlet for people to connect with others who have had similar experiences.
The Bottom Line...
We have come a long way since the early days of diagnosing co-existing mental illness and substance abuse disorders, and we’re still learning about the best ways to treat people with a dual diagnosis. The research is sparse, but new studies are being done to help us find new dual diagnosis treatments.
If you think you may be dealing with a substance abuse disorder and mental illness simultaneously, the most important thing is that you get help right away.
Look for a treatment center that specializes in treating people with a dual diagnosis to get the best cutting-edge care. Having a dual diagnosis does add another layer to recovery, but in the right hands, you’ll be on your way to recovery in no time.