Co-occurring Disorders Co-occurring disorders or dual-diagnosis are terms used to describe clients with an SUD and mental illness. Much like the chicken and the egg, professionals continue to discuss and argue whether the substance use disorder (SUD) contributed to the mental illness, the mental illness led to the SUD, the mental illness and SUD co-exist, or whether the two are interconnected. While the verdict is still out, what is known is there are complications and challenges in using this diagnosis. There are also problems related to this subpopulation and treatment options used. One problem that exists is clinicians tend to compartmentalize body systems. For example, cardiologists treat the cardiovascular system, pulmonologists treat …show more content…
Unfortunately, the healthcare professional must wait weeks for the completion of the detoxification process to know for sure. “During that detoxification period, the provider also collects collateral data from family members and tests.” (Knopf, 2015). Additional complications are a poor clinical history, stigmas of SUD and mental illness placed on individuals by society, and the fact that withdrawal symptoms mimic all types of mental illnesses. And, to deteriorate conditions, co-occurring disorder clients have a much higher suicide rate, have an increased risk of homelessness, increased risk of abuse, an increased risk of incarceration, and have a much higher chance of contracting AIDS or hepatitis. “Drug users with psychiatric comorbidity (also called dual diagnosis) develop more medical (e.g., Human Immunodeficiency Virus (HIV) infection, Hepatitis) and psychosocial problems and have poorer prognosis than those without it.” (Chahua, …show more content…
Perhaps the stigma related to substance abuse is much more accepted than to mental illness. Regardless of reasons, individuals with mental illnesses tend to gravitate toward certain substances over others based on their illness. Individuals with Attention Deficit Hyperactivity Disorder (ADHD) are at risk for Central Nervous System (CNS) stimulant abuse with many using cocaine. Many people with schizophrenia have an SUD with drugs of choice to include hallucinogens, nicotine, and cocaine. Many of these individuals do not respond well to treatment, are noncompliant with their medications, suicidal, violent, homeless, or incarcerated. Anxiety disorder is another illness that is difficult to diagnose since it may predate the SUD or may have been caused by the SUD or the withdrawal of the SUD. Self-medicating drugs of choice include alcohol, opioids, or benzodiazepines. Dissociative identity disorder (DID), a condition where a person separates himself from reality as a form of escape from stress. Many have an SUD with alcohol or benzodiazepine abuse. A percentage of individuals with obsessive-compulsive disorder (OCD) may favor alcohol or benzodiazepine. Unfortunately, there is a high percentage of SUDs in persons with bipolar affective disorder which is further compounded by the withdrawal symptom of depression leading to a relapse. Depression, a disorder, is
Co-occurring mental health and substance abuse disorders are quite prevalent in today’s society. Treatment and prevention of co-occurring disorders are both critical topics. However, professionals across the board cannot seem to agree on what is the best way to approach these topics. Perhaps the most ‘at-risk’ demographic for substance use are adolescents, ages 12 – 17. (Substance Abuse and Mental Health Services Administration [SAMHSA], 2011) Thankfully, more and more research has been conducted in the areas of adolescents and co-occurring disorders over the past few decades. However, since treating and preventing co-occurring disorders in adolescents is so monumental for their proper development and for their future as adults, the research must continue.
Later in the article it goes on to say that in some circumstances, nurses, social workers, and pharmacists were too intimidated by the physicians to say anything about anything that they were questioning. I believe this plays a role in the systematical hierarchy that may be set forth in the health care professional environment. Another large factor in the ineffective communication between disciplines is that all of the disciplines have varying viewpoints of what the patients need first and last and because of this, other disciplines are unaware of what the group task may be instead of what their personal diagnoses of the problem are. Other factors that were listed in the article are limited opportunities for regular synchronous interaction throughout their busy daily schedules and unpredictable environment as well as differences in
The percentage of people with a mental illness and have an addiction is as follows: schizophrenia (47%), anxiety disorder (23.7%), phobia (22.9%), panic disorder (35.8%), OCD (32.8%), bipolar disorder (60.7%), and major depression (27.2%). Ocean Hill can diagnose the psychological problems and then target a person’s chemical abuse. “78% of cases show that a mental health condition goes along with substance abuse” (Ocean Hill). They try to give encouragement to the patient no matter which stage of recovery they are at. On the website it said, “...be giving... the perfect opportunity to identify the underlying causes of... addiction, learn how to establish positive and life-affirming relations…” these will additionally help with triggers (Ocean Hill). For clients who have had treatment and recovery should do the Fresh Start
Biological treatments consist of detoxification, antagonist drugs, and drug maintenance therapy. Detoxification is a withdrawal from a drug that is systematic and medically supervised. Outpatient detoxification programs exist, but hospitals and clinics also provide this service; individual and group therapy might also be available at the hospitals and clinics to provide a “full service” approach to treatment. There are two different approaches to detoxification. One way is to have clients gradually withdraw from a substance by taking smaller and smaller doses, until they are no longer on the drug. Another way, which is usually medically preferred, is to give clients other drugs that help with the withdrawal symptoms. For example, antianxiety drugs can be used to reduce alcohol withdrawal reactions that are severe, such as delirium tremens and seizures. Detoxification programs are successful in helping motivated people withdrawal from drugs, but relapse rates are usually high for individuals who don’t receive some type of follow-up
Generally speaking, the Diagnostic and Statistical Manual of Mental Disorders (DSM) references substance dependence (in this case, alcohol) as a cluster of cognitive, behavioral, and physiological symptoms that shows that the person is continuing use of the substance even with adverse effects on the individual’s life. Specifically, for a person to be diagnosed with substance dependence they must show at least three of the following symptoms; tolerance, withdrawal, substance being taken in larger amounts of over a longer period of time than intended, an unsuccessful desire or effort to control the use of the substance, there is a great deal of time devoted to the drug, important social, occupational, or recreational activities are given up or reduced due to the substance, and the individual continues use of the substance even with the knowledge that the substance is causing physical or psychological problems (APA, 2000).
The doctor-patient relationship is one of many debates and change over the years. The reason it is so debatable, is that many people have different views on what this actual relationship should be, and how certain situations may cause questions in this relationship. Such questions could be, do I really want my doctor to make decisions for me, or I know my body the best, why should I not be able to make these decisions on my own, maybe a mixture of both. Either way this subject can be debatable on how the doctors and patients should go about these relationships. There are two models, in particular, out of four that have been deemed the models that doctors and patients should go by. These two, main models are, the interpretive model and the deliberative model.
Moreover, substance use can be another way individuals with schizophrenia interact with criminal justice system because persons with schizophrenia are most likely to self-medicate to relieve or reduce themselves of psychotic symptoms. Schug & Fradella (2015).
Detox is generally the first phase of the drug rehabilitation process. It occurs when patients begin taking less of the drug than their usual dosage, which causes various withdrawal symptoms. Detox may consist of completely ceasing drug use or gradually reducing the dosage over time, depending on the specific program and severity of the addiction (Doweiko, 2012).This phase of rehabilitation typically occurs in an inpatient setting where professionals can monitor the patient and their vital signs. Detox is not an effective treatment by itself, and patients will soon begin using drugs again if they don't receive further rehab and rec...
More than half of those people are men, (4.1 million to be precise). Specific things to look for include, but certainly are not limited to the following: withdrawal from friends and family, sudden changes in behavior, using substances under dangerous conditions, engaging in risky behaviors, loss of control over substance use, developing symptoms of withdrawal and a high tolerance for the substance, and the person in question relying on the drug for everyday function. Dual diagnosis can be treated with the following methods such as detoxification, inpatient rehabilitation, supportive housing, psychotherapy, self-help and support groups, and medication. However, symptoms of any mental health condition may also vary greatly. Warning signs such as drastic mood changes, confused thinking or problems concentrating, avoiding friends and social activities, and thoughts of suicide are reasons to seek
Substance abuse complicates almost every aspect of care for the person with a mental disorder. When drugs enter the brain, they can interrupt the work and actually change how the brain performs its jobs; these changes are what lead to compulsive drug use. Drug abuse plays a major role when concerning mental health. It is very difficult for these individuals to engage in treatment. Diagnosis for a treatment is difficult because it takes time to disengage the interacting effects of substance abuse and the mental illness. It may also be difficult for substance abusers to be accommodated at home and it may not be tolerated in the community of residents of rehabilitation programs. The author states, that they end up losing their support systems and suffer frequent relapses and hospitalizations (Agnes B. Hatfield, 1993).
Substance abuse often occurs with mental health issues. Studies show that nearly fifty percent of individuals with this co-occurring disorder will relapse soon after recovery. Residents seemed to be able to function while in a rehabilitation facility, but have difficulty managing time and prioritizing activities after discharge. This can lead to missed appointments, court dates, work and more. Difficulty p...
During this course I have learned a significant amount regarding substance abuse. All my years within the medical field, I never looked at substance abuse patients as unique, delicate, and should be treated with care. I have increased my level of understanding and now have the tools to have substance abuse conversations with my patients, family members, or friends. What gave me a different outlook on substance abuse treatment is understanding that some patients have a co-occurring diagnosis that may change their treatment plan. I always thought that one treatment needed to be completed prior to the next treatment, and during this class, I’ve learned that co-occurring disorders are the most difficult to treat based on the acuity of the patient.
Counseling is the most common form of drug abuse treatment but no single treatment is appropriate to everyone. Many drug-addicted individuals also have other mental disorders. Medically assisted detoxification is only the first stage of addiction treatment and that alone does little to change long term drug abuse. Also, studies show that treatment does not need to be voluntary to be effective. Lastly, treatment programs should assess patients for HIV/AIDS, hepatitis B and C, tuberculosis, and other diseases as well as provide risk-reduction counseling.
However, drug addiction is a serious and difficult illness which many people do not become aware of until it is too late. People who do drugs have many things they share in common though the reasons might defer. A very common characteristic is unreliability; which can be seen when diagnosing someone with a drug addiction problem, and depression. Drug users suffer a state that degrades a person's state of life and causes a loss of interest in...
seems not always best for the patients. It is expected of doctors to be a