| What is Dual Diagnosis? | | | | occupational or expressive therapy, can help individuals |
| A person who has both an alcohol or drug problem | | | | better understand and communicate their feelings or |
| and an emotional/psychiatric problem is said to have a | | | | develop better problem-solving or decision-making skills. |
| dual diagnosis. To recover fully, the person needs | | | | Must a Dual Diagnosis Patient Be Treated in a |
| treatment for both problems. | | | | Hospital? |
| How Common Is Dual Diagnosis? | | | | Not necessarily. The nature and severity of the illness, |
| Dual diagnosis is more common than you might | | | | the associated risks or complications, and the person's |
| imagine. According to a report published by the Journal | | | | treatment history are some of the facts considered in |
| of the American Medical Association: | | | | determining the appropriate level of care. There are |
| - Thirty-seven percent of alcohol abusers and | | | | several different levels or intensities of care including |
| fifty-three percent of drug abusers also have at least | | | | full hospitalization or inpatient treatment, partial |
| one serious mental illness. | | | | hospitalization, and outpatient treatment. |
| - Of all people diagnosed as mentally ill, 29 percent | | | | What is the Role of the Patient's Family in Treatment? |
| abuse either alcohol or drugs. | | | | With both rehabilitation for substance abuse and |
| What Kind of Mental or Emotional Problems are Seen | | | | treatment for a psychiatric problem, education, |
| in People with Dual Diagnosis? | | | | counseling sessions, and support groups for the |
| The following psychiatric problems are common to | | | | patient's family are important aspects of overall care. |
| occur in dual diagnosis - i.e., in tandem with alcohol or | | | | The greater the family's understanding of the problems, |
| drug dependency. | | | | the higher the chances the patient will have a lasting |
| -Depressive disorders, such as depression | | | | recovery. |
| and bipolar disorder. | | | | How Can Family and Friends Help with Recovery |
| - Anxiety disorders, including generalized anxiety | | | | from the Substance Abuse? |
| disorder, panic disorder, obsessive-compulsive disorder, | | | | They need to learn to stop enabling. Enabling is acting |
| and phobias. | | | | in ways that essentially help or encourage the person |
| - Other psychiatric disorders, such as schizophrenia | | | | to maintain their habit of drinking or getting high. For |
| and personality disorders. | | | | instance, a woman whose husband routinely drinks too |
| The following table based on a National Institute of | | | | much, might call in sick for him when he is too drunk to |
| Mental Health study, lists seven major psychiatric | | | | go to work. That's enabling. Likewise, family members |
| disorders and shows how much each one increases | | | | or friends might give an addict money which is used to |
| an individual's risk for substance abuse. | | | | buy drugs, because they're either sorry for him or |
| Psychiatric Disorder Increased Risk For Substance | | | | afraid of him. That's enabling also. |
| Abuse | | | | When family and friends participate in the recovery |
| Antisocial personality disorder 15.5% | | | | program, they learn how to stop enabling. If they act |
| Manic episode 14.5 | | | | on what they've learned, the recovering substance |
| Schizophrenia 10.1 | | | | abuser is much less likely to relapse into drinking or |
| Panic disorder 4.3 | | | | taking drugs. |
| Major depressive episode 4.1 | | | | How Can Family and Friends Help with Recovery |
| Obsessive-compulsive disorder 3.4 | | | | from a Psychiatric Condition? |
| Phobias 2.4 | | | | They should be calm and understanding, rather than |
| Thus, someone suffering from schizophrenia is at a 10.1 | | | | frightened or critical. They should be warm and open, |
| percent higher-than-average risk of being an alcoholic | | | | rather than cool or cautious. Although it is fine to ask |
| or drug abuser. Someone who is having an episode of | | | | the person matter-of-factly about the psychiatric |
| major depression is at a 4.1 percent | | | | treatment, that shouldn't be the only focus of |
| higher-than-average risk of being an alcohol or drug | | | | conversation. |
| abuser...and so on. | | | | If Someone I Know Appears To Have A Substance |
| Which Develops First - Substance Abuse or the | | | | Abuse Problem And The Symptoms Of A Psychiatric |
| Emotional Problem? | | | | Disorder, How Can I Help? |
| It depends. Often the psychiatric problem develops | | | | Encourage the person to acknowledge the problems |
| first. In an attempt to feel calmer, more peppy, or more | | | | and seek help for themselves. Suggest a professional |
| cheerful, a person with emotional symptoms may drink | | | | evaluation with a licensed physician, preferably at a |
| or use drugs; doctors call this "self-medication." | | | | medical center that's equipped to treat addiction |
| Frequent self-medication may eventually lead to | | | | problems and psychiatric conditions. If the person is |
| physical or psychological dependency on alcohol or | | | | reluctant, do the legwork yourself - find the facility, |
| drugs. If it does, the person then suffers from not just | | | | make the appointment, offer to go with the person. A |
| one problem, but two. In adolescents, however, drug or | | | | little encouragement may be all it takes. If you talk to |
| alcohol abuse may merge and continue into adulthood, | | | | the physician first, be honest and candid about the |
| which may contribute to the development of emotional | | | | troubling behavior. Your input may give the doctor |
| difficulties or psychiatric disorders. | | | | valuable diagnostic clues. |
| In other cases, alcohol or drug dependency is the | | | | There Is Hope |
| primary condition. A person whose substance abuse | | | | As a relative or friend, you can play an important role |
| problem has become severe may develop symptoms | | | | in encouraging a person to seek professional diagnosis |
| of a psychiatric disorder: perhaps episodes of | | | | and treatment. By learning about dual diagnosis, you |
| depression, fits of rage, hallucinations, or suicide | | | | can help this person find and stick with an effective |
| attempts. | | | | recovery program. |
| How Can a Physician Tell Whether the Person's | | | | The more you know about dual diagnosis, the more |
| Primary Problem is Substance Abuse or an Emotional | | | | you will see how substance abuse can go |
| Disorder? | | | | hand-in-hand with another psychiatric condition. As with |
| At the initial examination, it may be difficult to tell. Since | | | | any illness, a person with dual diagnosis can improve |
| many symptoms of severe substance abuse mimic | | | | once proper care is given. By seeking out information, |
| other psychiatric conditions, the person must go | | | | you can learn to recognize the signs and symptoms of |
| through a withdrawal from alcohol and/or drugs before | | | | dual diagnosis - and help someone live a healthier or |
| the physician can accurately assess whether there's | | | | more fulfilling life. |
| an underlying psychiatric problem also. | | | | For More Information: |
| If a Person Does Have Both an Alcohol/Drug Problem | | | | Contact your local Mental Health Association, |
| and an Emotional Problem, Which Should Be Treated | | | | community mental health center, or: |
| First? | | | | National Mental Health Association |
| Ideally, both problems should be treated simultaneously. | | | | 2001 N. Beauregard Street, 12th Floor |
| For any substance abuser, however, the first step in | | | | Alexandria, VA 22311 |
| treatment must be detoxification - a period of time | | | | Phone 703/684-7722 |
| during which the body is allowed to cleanse itself of | | | | Fax 703/684-5968 |
| alcohol or drugs. Ideally, detoxification should take place | | | | Mental Health Resource Center 800/969-NMHA |
| under medical supervision. It can take a few days to a | | | | TTY Line 800/433-5959 |
| week or more, depending on what substances the | | | | National Clearinghouse on Alcohol and Drug Information |
| person abused and for how long. | | | | Phone: 800-729-6686 |
| Until recently, alcoholics and drug addicts dreaded | | | | Dual Recovery Anonymous World Services Central |
| detoxification because it meant a painful and | | | | Office |
| sometimes life-threatening "cold turkey" withdrawal. | | | | P.O. Box 8107 |
| Now, doctors are able to give hospitalized substance | | | | Prairie Village, KS 66208 |
| abusers carefully chosen medications which can | | | | Phone: 877-883-2332 |
| substantially ease withdrawal symptoms. Thus, when | | | | Alcoholics Anonymous |
| detoxification is done under medical supervision, it's | | | | 475 Riverside Drive |
| safer and less traumatic. | | | | 11th Floor |
| What Is Next After Detoxification? | | | | New York, NY 10115 |
| Once detoxification is completed, it's time for dual | | | | Phone: 212-870-3400 |
| treatment; rehabilitation for the alcohol or drug problem | | | | Narcotics Anonymous World Service Office in Los |
| and treatment for the psychiatric problem. | | | | Angeles |
| Rehabilitation for a substance abuse problem usually | | | | P.O. Box 9999 |
| involves individual and group psychotherapy, education | | | | Van Nuys, CA 91409 |
| about alcohol and drugs, exercise, proper nutrition, and | | | | Phone: 818-773-9999 |
| participation in a 12-step recovery program such as | | | | Alanon and Alateen Family Group Headquarters Inc. |
| Alcoholics Anonymous. The idea is not just to stay off | | | | 1600 Corporate Landing Parkway |
| booze and drugs, but to learn to enjoy life without | | | | Virginia Beach, VA 23454-5617 |
| these "crutches." | | | | Phone: 888-425-2666 |
| Treatment for a psychiatric problem depends upon the | | | | Listen to Arthur Buchanan on the Mike Litman Show! |
| diagnosis. For most disorders, individual and group | | | | THIS LINK WORKS, LISTEN TODAY! |
| therapy as well as medications are recommended. | | | | With Much Love, |
| Expressive therapies and education about the | | | | Arthur Buchanan |
| particular psychiatric condition are often useful | | | | President/CEO |
| adjuncts. A support group of other people who are | | | | Out of Darkness & Into the Light |
| recovering from the same condition may also prove | | | | 43 Oakwood Ave. |
| highly beneficial. Adjunct treatment, such as | | | | |