Tag: dual disorders

Double Trouble: A Dual Diagnosis

What is the relationship between drug abuse and mental illness?

Many chronic drug abusers–the individuals we commonly regard as addicts–often simultaneously suffer from a serious mental disorder. Drug treatment and medical professionals call this condition a co-occurring disorder or a dual diagnosis.

What is chronic drug abuse?

Chronic drug abuse is the habitual abuse of licit or illicit drugs to the extent that the abuse substantially injures a person’s health or substantially interferes with his or her social or economic functioning. Furthermore, any person who has lost the power of self-control over the use of drugs is considered a chronic drug abuser.

What are some serious mental disorders associated with chronic drug abuse?

Chronic drug abuse may occur in conjunction with any mental illness identified in the American Psychiatric Association (DSM-IV). Some common serious mental disorders associated with chronic drug abuse include schizophrenia, bipolar disorder, manic depression, attention deficit hyperactivity disorder (ADHD), generalized anxiety disorder, obsessive-compulsive disorder, post-traumatic stress disorder, panic disorder, and antisocial personality disorder. Many of these disorders carry with them an increased risk of drug abuse.

Disorders With Increased Risk of Drug Abuse

  • Antisocial personality disorder 15.5%
  • Manic episode 14.5%
  • Schizophrenia 10.1%
  • Panic disorder 04. 3%
  • Major depressive episode 04.1%
  • Obsessive-compulsive disorder 03.4%
  • Phobias 02.1%

 Source: National Institute of Mental Health.

How prevalent are co-occurring disorders?

Co-occurring disorders are very common. In 2002 an estimated 4.0 million adults met the criteria for both serious mental illness and substance dependence or abuse in the past year.

Which occurs first–chronic drug abuse or serious mental illness?

It depends. In some cases, people suffering from serious mental disorders (often undiagnosed ones) take drugs to alleviate their symptoms–a practice known as self-medicating. According to the American Psychiatric Association, individuals with schizophrenia sometimes use substances such as marijuana to mitigate the disorder’s negative symptoms (depression, apathy, and social withdrawal), to combat auditory hallucinations and paranoid delusions, or to lessen the adverse effects of their medication, which can include depression and restlessness.

In other cases mental disorders are caused by drug abuse. For example, MDMA or Ecstasy, produces long-term deficits in serotonin function in the brain, leading to mental disorders such as depression and anxiety. Chronic drug abuse by adolescents during formative years is a particular concern because it can interfere with normal socialization and cognitive development and thus frequently contributes to the development of mental disorders.

Finally, chronic substance abuse and serious mental disorders may exist completely independently of one another.

Can people with co-occurring disorders be treated effectively?

Yes, chronic drug abusers who also suffer from mental illness can be treated. Researchers currently are investigating the most effective way to treat drug abusers with mental illness, and especially whether or not treating both conditions simultaneously leads to better recovery. Currently, the two conditions often are treated separately or without regard to each other. As a result, many individuals with co-occurring disorders are sent back and forth between substance abuse and mental health treatment settings.

Source: http://www.justice.gov/ndic/pubs7/7343/index.htm

For more info on the Dual Diagnosis see: http://bipolar.about.com/cs/dualdiag/a/0008_dual_diag.htm

Getting Both Barrels

Dual Diagnosis of Mental Illness and Substance Abuse

Drugs & booze are deadly

Dual diagnosis services are treatments for people who suffer from co-occurring disorders — mental illness and substance abuse. Research has strongly indicated that to recover fully, a consumer with co-occurring disorder needs treatment for both problems — focusing on one does not ensure the other will go away. Dual diagnosis services integrate assistance for each condition, helping people recover from both in one setting, at the same time.

Dual diagnosis services include different types of assistance that go beyond standard therapy or medication: assertive outreach, job and housing assistance, family counseling, even money and relationship management. The personalized treatment is viewed as long-term and can be begun at whatever stage of recovery the consumer is in. Positivity, hope and optimism are at the foundation of integrated treatment.

How often do people with severe mental illnesses also experience a co-occurring substance abuse problem?

There is a lack of information on the numbers of people with co-occurring disorders, but research has shown the disorders are very common. According to reports published in the Journal of the American Medical Association (JAMA):

  • Roughly 50 percent of individuals with severe mental disorders are affected by substance abuse.
  • Thirty-seven percent of alcohol abusers and 53 percent of drug abusers also have at least one serious mental illness.
  • Of all people diagnosed as mentally ill, 29 percent abuse either alcohol or drugs.

The best data available on the prevalence of co-occurring disorders are derived from two major surveys: the Epidemiologic Catchment Area (ECA) Survey (administered 1980-1984), and the National Comorbidity Survey (NCS), administered between 1990 and 1992.

Results of the NCS and the ECA Survey indicate high prevalence rates for co-occurring substance abuse disorders and mental disorders, as well as the increased risk for people with either a substance abuse disorder or mental disorder for developing a co-occurring disorder. For example, the NCS found that:

  • 42.7 percent of individuals with a 12-month addictive disorder had at least one 12-month mental disorder.
  • 14.7 percent of individuals with a 12-month mental disorder had at least one 12-month addictive disorder.

The ECA Survey found that individuals with severe mental disorders were at significant risk for developing a substance use disorder during their lifetime. Specifically:

  • 47 percent of individuals with schizophrenia also had a substance abuse disorder (more than four times as likely as the general population).
  • 61 percent of individuals with bipolar disorder also had a substance abuse disorder (more than five times as likely as the general population).

For the rest of this article, go to NAMI:  http://www.nami.org/Template.cfm?Section=By_Illness&Template=/TaggedPage/TaggedPageDisplay.cfm&TPLID=54&ContentID=23049

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