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…
the respiratory system, etc. The human body is one complete complex system composed of many parts. Paul tells us that all parts of the body depend on one another and are equally important as God had arranged the members of the body in I Corinthians 12:12-27. Instead of treating only the mental illness or the SUD, a comprehensive approach should be taken in treating the whole person. A difficult challenge in treating a co-occurring disorder is in utilizing the necessary skills to determine whether signs and symptoms presented are from the substance used, withdrawal symptoms from the substance, symptoms of the mental illness, or an exacerbation of the mental illness caused by the SUD.
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…
2015). Substance abusers tend to self-medicate for emotional stress, emotional pain, or to cope with traumatic memories.
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
complicated tremendously by SUD. The SUD counteracts the positive effects of the medications used to treat depression exacerbating the disorder. Conversely, treatment for SUD may contribute to the depression. People with eating disorders, compulsive gambling, and anti-social personality disorder (ASPD) tend to self-medicate with alcohol. The problems with clients having co-occurring disorders seems insurmountable. First, most are forced into treatment by their families or by the courts. Secondly, there are not enough treatment facilities that can appropriately treat their special needs, not to mention the intolerance of those who are supposed to reach out to others without showing partiality (James 2). Thirdly, the clients of this population use denial as their defense mechanism by using one illness to defend the other and vice versa. Regrettably, there are professionals that want to focus solely on the substance abuse or the mental illness. As mentioned earlier, the focus should be on the whole person. As a healthcare professional, would you give attention to substance treatment and ignore treatment for diabetes or hypertension? Another problem with co-occurring disorders is medication compliance. Clients may refuse to take their medication, continue to use alcohol or drugs even after admission to treatment, only taking the medications they want to, or stop medication. Some individuals may save their meds and take many at one time. Of the various models of treatment, the most successful for people with co-occurring disorders is an integrated treatment program. There the individual’s SUD and mental illness are treated concurrently. The first stage of treatment involves establishing a therapeutic relationship with the client utilizing patience and understanding. The second stage consists of teaching the client the effects of the SUD and his mental illness. Motivation and encouragement are used as issues are presented that may impede rehabilitation. The third stage is the actual treatment/rehabilitation process teaching the client how to manage their illness, coping skills, relapse prevention, group therapy, and build a support system. This is a long, slow process that takes much patience, but abstinence is possible.
Fortinash, K. M., & Holoday Worret, P. A. (Eds.). (2012). Substance-related disorders and addictive behaviors. Psychiatric mental health nursing (5th ed., pp. 319-362). St. Louis, MO: Elsevier Mosby.
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
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
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
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).
Treatment There are both drug and alcohol therapy and rehabilitation. Inpatient and Outpatient treatment is available depending on the needs of individuals who suffer from SUD’s. These therapies are most commonly applied by a counselor through appropriate set-up of counseling sessions. For this purpose, there are many treatment centers that offer different rehabilitation programs for persons in need (Doweiko, 2012). These programs mainly include weekly individual counseling sessions, group sessions, and activities, utilize existing support services (12 step groups) and treatment planning goals designed in such a way, to program the patient and help him/her gain self-confidence to stand on their own without the reliance of drugs and alcohol.
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
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...
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...
Furthermore, mental illness and drug addiction are conditions that often occur together. This is a person who has two brain disorders that influence one another, and which both need treatment. Some say that certain drugs may actually cause mental illness in individuals with a weak genetic profile (Genetic Science Learning Center, 2011).With that being said, symptoms may get worse, but drugs do not necessarily cause mental illness. Some people may begin using drugs of abuse as a form of self-medication. For instance, drugs of abuse may temporarily relieve some of the symptoms associated with stress, anxiety, or depression, but the problems will still exist. Therefore, the form of self-medicating when using drugs can lead to harmful effects in a person’s mental health. People who have been undiagnosed may also suffer from serious mental disorders. So they may take drugs to relieve their symptom which is known as self-me...
Through research and information provided in this course, I understand why such a disorder is difficult to treat and overcome. With SUDs, scientist have discovered when a foreign substance like drugs, alcohol, or opioids are introduced to the body and is used on a regular basis, the brain alters its chemistry to crave this substance. During this chemical change, the brain releases an excessive amount of dopamine, causing the person to become dependent. The body goes through a phase where they develop a tolerance to the amount of substance used and more is needed to get the same effect as if they were ingesting a smaller amount. The body also craves the substance in order to function normally. This change can occur rapidly or there can be a small subtle change over time. Regardless of how faint the changes are, your brain develops an uncontrollable, compulsive response to the constant drug use due to the dopamine receptors adapting to the substance. Scientist have also proven that addiction does not necessarily have to be to a substance but can be related to an impaired control, or some sort of persistent behavioral action. With behavioral dependence, there is no craving, but just like a chemical dependence, the brain circuit and chemicals are
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.
seems not always best for the patients. It is expected of doctors to be a