Unless you are well acquainted with the world of addiction treatment, you may not have heard of the phenomenon of dual diagnosis treatment. Dual diagnosis treatment is relatively modern- up until the 1990’s, individuals who experienced symptoms of various mental health disorders were treated in isolation from those with alcohol or substance use disorders. However, this failed to account for the large population of people dealing with both mental health issues as well as addiction. Those who were diagnosed with a mental disorder and substance use disorder never received the care they needed during this time.
However, more integrative approaches at treating mental illness as well as substance abuse have begun to evolve in the new century. Addiction treatment professionals often now pursue education in the field of treatment of co-occurring mental health disorders. Rehab facilities that treat those with substance use disorders have begun to open to clients with dual diagnoses. This growth represents a burgeoning population of dually diagnosed individuals- it is estimated that of the 17.5 million Americans with a mental disorder, 4 million also struggled with an alcohol or substance use disorder. However, current dual diagnosis treatment services cannot provide for the amount of individuals who need them- reports from The Office of Applied Studies reports that only 12 percent of the 4 million adults with dual diagnoses receive treatment for both conditions.
Addictive disorders may include alcoholism, drug addiction, gambling addiction, sex addiction or another behavioral addiction, whereas a mental health disorder might be typified by anxiety disorders, schizophrenia, personality disorders, depression, mood disorders or bipolar disorder. Current, effective dual diagnosis treatment includes a variety of dynamics:
Inclusive treatment that utilizes family counseling in terms of individual counseling, group meetings, or education
A non-confrontational form of therapy that instead uses CBT and other therapies to increase self-esteem and self-confidence
Parallel, ongoing treatment of any mental health disorders as well as substance use disorders
Proper acknowledgment of medications for both psychotherapeutic purposes as well as medications used to assist addiction treatment
However, treatment approaches used for individuals with dual diagnoses were not always so effective or researched. Before the 1990’s the widely used treatment for dual diagnosis was “Sequential Treatment.” Practitioners of Sequential treatment believed that mental health treatment and dual diagnosis treatment should be separate. Subsequently, individuals with a dual diagnosis were not allowed to enter one area of treatment until they had completed the other. This usually manifested in alcoholics and addicts not being able to receive treatment for mental health disorders until after detoxing and going through addiction treatment. However, more current research has proven Sequential Treatment not only an ineffective approach, but also one with a high relapse potential. Since mental health disorders are often among the complex determinants of addiction, failure to treat mental illness often leads to relapse as a form of self-medication.
The need for dual diagnosis treatment only continues to grow, as does the population of Americans living with both mental illness and addiction. In the last six years, the population of dual diagnosis patients in drug rehabs increased from 12 to 16 percent. Dual diagnosis patients come from a variety of backgrounds and demographics. Women are receiving increasing rates of dual diagnoses- from 1995 to 2001, the amount of women admitted into dual diagnosis treatment programs rose to 44 percent, from 28. Dual diagnosis patients are not hiding in the shadows either they are often very functional in the workforce, while masking great emotional pain. In fact, for those employed full-time, about 10.6 percent dealt with a substance abuse disorder, another 10.2 percent were diagnosed with a  psychological issue, and 2.4 percent were diagnosed with both.
For an individual to receive a dual diagnosis, they must meet the criteria for a mental health disorder as defined by the current version of The Diagnostic and Statistical Manual of Mental Disorders, published by the American Psychiatric Association. They must also meet the criterion for an Alcohol or Substance Use Disorder. Some symptoms that often lend to a dual diagnosis, include:
An inability to maintain daily rituals or reliance upon substances to cope with stress
Feelings of regret and guilt
Repeated relapse
Seeking out larger doses or more high-risk behavior in order to satiate a high
An inability to maintain personal relationships or sense of self
Legal issues
Financial problems
Extreme mood swings as well as lack of coping mechanisms to control emotions
Withdrawal symptoms as well as other physical deterioration
If someone you love is experiencing some of the above symptoms, treatment is critical. However, in order to be the most effective, an individual’s recovery plan must address their specific mental disorder as well as their history of addiction. There are a variety of treatment facilities clients who have severe issues with substance abuse or who have had severe expressions of mental illness, often benefit from a residential treatment program. However, for more stable clients, an intensive outpatient treatment program, is often referred. It is important that any treatment center or treatment program embrace the benefits of pharmacotherapy such as medications used to reduce agitation, stabilize moods, prevent traumatic flashbacks and more. Furthermore, any dual diagnosis treatment programs should educate spouses, partners, and children about the nature of dual diagnosis symptoms and recovery. 12-step meetings, peer support groups and family counseling have all also been found to be helpful parts of dual diagnosis treatment and recovery.
When looking for dual diagnosis programs, Maryland Addiction Recovery Center represents the forefront of integrated addiction treatment and mental health services

Published by David Milsont