Treating Dual Diagnosis Disorders Effectively
Over the years, several models for substance abuse disorder treatment have gained traction in rehabilitation programs. These models include the following:
- Moral model. The moral model of substance abuse disorder treatment states that addiction is a moral weakness.
- Psychodynamic model. This asserts that childhood traumas dictate how we cope or do not cope as adults.
- Disease model. This argues that the origin of addiction naturally lies within the individual suffering from substance abuse disorder.
While each of these models of treatment has experienced certain levels of success, there’s one common dynamic they each fail to address – the existence of symptoms of mental health disorders within a majority of individuals who abuse drugs or alcohol.
Where these models fail to address this issue, the dual-diagnosis or co-occurring model of treatment places its focus. What is a co-occurring disorder, and how are they treated in individuals with substance abuse disorder?
What Is a Co-occurring Disorder?
A co-occurring disorder is a mental health disorder occurring simultaneously with a substance abuse disorder. This can include a number of different mental health disorders and isn’t limited to one specific substance.
Individuals with the existence of a co-occurring disorder may display several signs associated with this diagnosis. The following section outlines potential signs of a co-occurring disorder.
What are the Possible Signs of a Dual Diagnosis?
Dual diagnoses can be difficult to identify, considering the complexities of both disorders. Mental health disorders may display symptoms of substance abuse disorder and vice-versa. A proper diagnosis begins with identifying signs that are present in the individual in question.
- Drastic changes in behavior or personality
- Ignoring the dangers of using substances
- Engaging in risky behaviors
- Withdrawal from family and friends
- Requirement of substances to function
- Mood changes and confused thinking
- Thoughts of suicide
Many individuals who suffer from substance abuse disorder exhibit the previously mentioned signs. This leads to the question: how common is a dual diagnosis in substance abuse cases?
How Common Is Dual-Diagnosis?
The Substance Abuse and Mental Health Services Administration (SAMHSA) publishes multiple types of research and studies relevant to mental health and substance abuse. The following list contains certain portions of data relevant to those studies on dual diagnosis.
- 45% of Americans suffer from a dual diagnosis. Individuals diagnosed with a mental health disorder have a much higher risk of developing challenges associated with substance abuse.
- 17 million young adults over the age of 18 suffer from some form of mental health disorder. About 23% of these young adults also struggled with substance abuse disorder.
- The number of patients in treatment for opioid abuse disorder with a co-occurring disorder rose from 12 to 16% in six years.
- Patients with dual diagnoses are often able to operate and function. It’s estimated that 10.6% of full-time workers have a substance abuse issue, while 10.2% have severe psychiatric challenges.
- More than half of the patients suffering from mental health challenges did not receive one treatment regimen to improve recovery rates.
- Out of three million Americans that have been diagnosed with co-occurring disorders, only one million received treatment for either one or the other. Only about 150,000 received treatment for both.
Two things stand out among these statistics. The first is the prevalence of dual diagnosis among individuals with substance abuse disorder. Secondly, there is a significant lack of treatment options for these individuals.
The Mental Disorder and Addiction Connection
The problem with dual diagnosis is that most mental health clinics are separate from clinics that make substance abuse treatment available. This leads to patients receiving treatment for these separately and not allowing them to be addressed simultaneously.
Because of the mental disorder and addiction connection, individuals must understand the intersection of these disorders. The most important part is realizing how the challenges of one feed into the other and receiving proper treatment to address these challenges.
Individuals who suffer from dual diagnoses begin their substance abuse as a form of self-medication for their mental disorder. While this provided temporary relief, there are significant risks involved with this type of self-medication.
High-Risk Profiles In Addiction Treatment
High-risk profiles in addiction treatment include individuals that exhibit certain symptoms and situations that make them at high risk for relapse. Studies conducted produced data that highlights the importance of dual-diagnosis treatment.
The research led to the following conclusions:
- Unpleasant emotions associated with mental health disorders led to the highest rates of relapse.
- Personal control and pleasure emotions (the feelings associated with intoxication) had the lowest influence on relapse.
- Interpersonal factors (peers and trigger situations) presented the second-highest amount of risk.
Doctors leading this research concluded that clinical and psychological approaches should be taken on simultaneously to prevent relapse.
The Risk of Self-Medication for Dual-Diagnosis
Mental health disorders often lead to individuals seeking a way to self-medicate. This often happens at the expense of the individual developing a substance abuse disorder along the way.
Regardless of the substance in question, there are significant risks associated with self-medicating, which are highlighted below. It’s important to note that these self-medication risks are not limited to one particular substance.
- Self-medicating with marijuana leads to the risk of schizoaffective disorders in some cases.
- Individuals self-medicating with methamphetamines and stimulants run the risk of developing meth-induced psychosis.
- Medicating with opioids leads to physical dependence and the requirement of detox if the individual abstains from use.
- Individuals run the risk of overdosing when self-medicating.
- Self-medicating normally always turns to some form of substance abuse disorder and physical or mental dependence.
- Self-medication may also lead to a higher risk of suicidal thoughts or attempts.
- What began as a type of relief can further complicate the underlying mental condition.
Individuals suffering from co-occurring disorders stand to gain the most from choosing the appropriate facility for treatment. How should individuals approach this decision, and what should they look for in the proper facility?
Choosing a Facility for Dual-Diagnosis Treatment
Choosing the proper facility is critical when looking for a dual-diagnosis treatment center. Because of the availability of facilities specializing in this treatment, you must be selective.
Any facility in question should provide multiple types of behavioral treatment. They should highlight their ability to diagnose and treat the following mental health conditions in conjunction with substance abuse:
- Anxiety in relation to substance abuse
- PTSD and alcoholism
- Depression and drug abuse
- Thought disorders and addiction
- Psychosis and stimulant abuse
There may be other highlights and options, but mental health disorders with intersecting substance abuse challenges must be clearly stated as treatment options. You should also be aware of the treatment process of dual diagnosis.
A Treatment Plan as Unique as the Client
Everyone suffering from dual diagnosis has unique situations and characteristics present in their disorders. However, listed below are some of the primary options and frameworks for dual diagnosis treatment.
- Individuals first must be diagnosed by psychological and addiction treatment professionals. They are assessed and monitored for the most prevalent symptoms associated with dual diagnosis during one-on-one sessions and other forms of testing.
- Medically-assisted detox is typically the first step in treatment. It’s difficult for individuals to heal from dual-diagnosis challenges if they’re managing a substance abuse disorder and dealing with the side effects of withdrawal. Clients receive therapy and medication during medically-assisted detox to prevent some of the most severe symptoms of withdrawal.
- Partial hospitalization and inpatient programs are required in normally every occasion of dual-diagnosis treatment. Subsequent treatment of mental health and substance abuse disorders may begin upon intake.
- Unique activities and programs that provide various forms of therapy are also provided to help overcome the challenges associated with substance abuse. This includes Art Therapy, Gestalt Therapy, Psychodynamic Therapy, and Psychoeducational Groups.
- Finally, relapse prevention planning and aftercare services must be prescribed for individuals exiting a treatment program.
- Monitoring should also be provided for individuals displaying suicidal ideation during treatment.
Because of the complexities involved with dual-diagnosis treatment, many individuals question whether insurance covers dual diagnosis. In most cases, insurance companies will cover most, if not all, costs associated with this form of treatment.
However, they may require proof of the administration of treatment for both disorders. This is usually satisfied by a simple email or fax from the facility that outlines your treatment plan. Basically, they’re looking for evidence of some form of integrated treatment for dual diagnosis.
Integrated Treatment for Dual-Diagnosis
Integrated Dual Disorder Treatment (IDDT) is an evidence-based practice that improves the quality of life for individuals suffering from substance abuse disorder and mental health disorders. The treatment normally includes elements of pharmacological (medication) treatment, and psychological, educational, and social interventions.
Many facilities also include family involvement during the treatment process. Several benefits of IDDT include:
- Decreased hospitalization
- Lower rates of relapse
- Reduction of service costs
- Duplication of certain services
- Increased continuity of care (aftercare services)
- It helps individuals obtain stable housing and independent living
Continuity of care is another critical element during dual-diagnosis treatment. This is what takes place once individuals complete their specific treatment regimen.
Aftercare Planning for Dual Diagnosis
Completing a treatment program for dual diagnosis doesn’t imply that there isn’t room for improvement. Individuals who suffer from co-occurring disorders are at high risk for falling into relapse.
A therapy team must assist each client in preparing for aftercare services as graduation approaches. There are multiple types of aftercare services that are all critical in preventing relapse.
Family members benefit from an individual’s treatment program just as much as the individual that participates in services. Aftercare initiatives offer guidance for individuals with substance abuse disorder and their families during the days, weeks, and months after treatment.
This includes group and individual counseling sessions for all parties involved. Further educational campaigns may also assist in this process.
Group Recovery Programs
Group recovery programs, including 12-step and similar peer-based groups, are one of the most important elements of aftercare. Individuals who participate in these groups receive continued education regarding substance abuse.
Additionally, engaging with peers in the same situation creates an atmosphere of accountability. Over the years, group recovery programs have been considered an overwhelming success in the treatment of substance abuse disorder. Many of these programs place emphasis on mental wellness alongside substance abuse.
Achieving Recovery from Co-occurring Disorders is Possible
Achieving long-term recovery from co-occurring disorders is possible through the right avenues of care. Individuals can expect a full and healthy recovery with the right combination of medically-assisted detox, treatment programs, mental health counseling, and aftercare services.
At Icarus Behavioral Health, we specialize in taking a holistic approach to all of the previously mentioned elements. We provide an atmosphere that’s conducive to recovery, including medically-assisted detox, as well as multiple combinations of treatment programs.
We also place emphasis on preparing clients for a return to their personal and professional lives. Each client graduating from treatment will be able to craft an aftercare plan with the assistance of mental health and substance abuse professionals. These plans include resources and tips for navigating life after treatment.
Navigating recovery is possible without falling into relapse with the right team behind you. Contact Icarus Behavioral Health to find out about our team and how they can help you achieve recovery today.