Dual Diagnosis

For some people drug addiction comes with a second problem that may have led to the addiction or been a result of it. Dual diagnosis, or “co-occurring disorder,” is the term used to describe a double whammy for the patient who has both a psychiatric diagnosis, such as depression, anxiety, a personal disorder, or schizophrenia, and a substance abuse problem on top of it.

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Treatment for a dual diagnosis must address both problems, as they are generally so intertwined that it can be difficult to determine which came first. Did the person take drugs for anxiety, or did the anxiety occur as the result of long-term drug abuse? Until the patient is free of drugs, it might be difficult to tell. The first step in treatment, therefore, is generally drug detoxification to rid the patient’s body of the toxins built up by drug abuse and to erase all residual traces of the alcohol or drugs. This helps to eliminate the possibility of drug residue within the body triggering physical cravings, sometimes years later.

A dual diagnosis can be difficult to treat, because the underlying causes of either disorder can be so complex. The drug use may mask the mental disorder, or the emotional problems may be driving the person to self-medicate to avoid dealing with them. Family or personal relationships may be contributing to the overall stress, making it harder to get to the root cause of either problem.

Help for dual diagnosis is complex, and can be frustrating for both patient and doctor. Drug abuse, or even the symptoms incurred by withdrawal, can resemble some types of mental illness. Alcohol or drug abuse can mask psychiatric symptoms. Failure to treat the drug abuse can led to reoccurrence of mental problems, while failing to correctly treat the psychiatric illness can lead to a deeper abuse problem. A dual recovery program addresses both problems.

Dual diagnosis is not at all uncommon. According to the American Medical Association, 37% of alcohol abusers and 53% of drug abusers also have some sort of mental or emotional problem, while 29% of people diagnosed with a mental problem also abuse alcohol or drugs. People with one or the other disorder are at much greater risk for developing the second as well, to end up with a dual diagnosis and the subsequent need for treatment.

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Before any sort of accurate diagnosis or real help for dual diagnosis can take place, the person must first be freed from the grip of the drug or the alcohol. This will separate the two conditions, removing the masking effect of the drugs or alcohol, and allow the medical practitioner to assess the person’s sober mental state. Without this crucial first step of detoxification, treatment for dual diagnosis is unlikely to result in true forward progress for the patient toward understanding and relieving the secondary disorder. A treatment facility that understands dual diagnosis and how to treat both disorders should be the first choice of anyone attempting to cope with the dual burden of substance abuse and emotional or mental problems.