Dual Diagnosis Treatment Spans the Full Gamut of Addiction, Psychological and Societal Methodologies

Dual diagnosis treatment spans the full gamut of addiction, psychological and societal methodologies. The term dual diagnosis can be misleading since someone may have more then one addiction or mental health problem. About 70 percent of people with drug and alcohol addictions may suffer from dual diagnosis. Statistics in the United States, such as 22.2 million persons (9.1 percent of the population) in 2005 who have substance dependence or abuse show the magnitude and commonality of the problem. Equivalent populations include ten percent of the United States population that are foreign born, ten percent of the worlds’ population that lives in coastal areas that may sink as the oceans rise. Ninety countries have more than 10 percent of their population in areas of high mortality risk from two or more hazards (drought, floods, cyclones, earthquakes, volcanoes and landslides), and more than 10 percent of children that do not survive their first year of life in Ethiopia. While immigration, climate change, natural disasters and third world starvation, disease and civil war are daily headlines, dual diagnosis is not found in the lexicon of our day-to-day colloquy. This is quite interesting considering that the cost of substance abuse exceeds 500 billion dollars in the United States and Americans’ cultural taboos generally stop them from discussing the very common link between substance abuse and mental illness. Maybe we should rethink our standards of decorum and social embarrassment so that we may become informed as a people, to remove the stigmas of substance abuse and mental illness. Then those with these very common problems may address their plight as casually as we do with immigration, climate change, natural disasters, third world starvation, disease and civil war.

Dual diagnosis treatment is initially looked at by asking the question, which came first, the chicken or the egg or which came first, the substance abuse or the mental illness. This intellectual dalliance should be left to the professionals since there may be multiple addictions and multiple mental illnesses to address and treat.

The question becomes moot since social alcohol or drug use (even small amounts for some people) may lead to psychiatric symptoms, or pre-existing mental health problems may lead to increased drug and alcohol use. To complicate matters withdrawal or detoxification may lead to psychological or psychiatric symptoms. Sometimes intoxication may result in short-term behavioral or psychological problems that disappear with the intoxication affects.

Since so many substances are abused and there are many mental illnesses, the professional uses an array of tools in the process of recovery, such as, psycho-education lectures, groups, and individual sessions to educate the dual diagnosis patient about the medical and psychological aspects of his/her dual diagnosis. There should be expert pharmacotherapy if medications are prescribed so that only the most effective medications offering the greatest benefit and the least side effects should be used.12-Step programs are provided according to their specific needs. Relapse prevention programs are specifically designed for ongoing recovery of the dual diagnosis patient. Dual diagnosis patients are encouraged to invite their family members to participate in a family program. These programs should be the staple of the dual diagnosis treatment plan.

To enhance and reach more specific areas, adjunct groups that focus therapeutic work on specific areas of concern to the dual diagnosis treatment of the patient, such as , cocaine/heroin addiction, eating disorders, stop smoking, grief and trauma, healthy sexuality, compulsive gambling and women's, and men's groups should be included. Integrative therapies may include acupuncture, and massage. Other lesser known therapies include eye movement desensitization and reprocessing (EMDR) which uses eight distinct steps the client focuses on a visual image related to the negative memory and the therapist assists by directing eye movements for 20 to 30 seconds. Therapists will often use auditory tones, tapping, and other types of tactile stimulation. Also somatic psychotherapy, which assists in the learning and understanding of the relationships between sensation, emotion, illness and thought and how this impacts on our sense of wellness and well being.