Mental illness and addiction need to be treated together

dual diagnosis

So many times, I’d take Charles somewhere for treatment and they’d draw a line in the sand between mental illness and drug abuse/addiction. Everything seemed to be treated separately although they most always seem to happen together.

Substance use disorder is listed in the Diagnostic and Statistical Manual of Mental Disorders (DSM-III) as a mental illness. Mental and emotional symptoms of alcoholism exist long before the grave physical complications of the disease appear.

In a study of 133 of those with substance use disorder, 93% met the criteria for one or more psychiatric disorders other than substance abuse. Depressions and personality disorders, often in combination, were most prominent.

So often if you take someone to a psychiatric facility, they refuse to treat that individual because of addiction. At least that’s what happened to Charles.

That’s like being a cardiologist and treating the heart but refusing to treat the artery next to that heart. Oftentimes in medicine when two things are involved in a major condition, those medical professionals work together.

When you have diabetes, you might have ophthalmologist and a endocrinologist who work together to treat the patient since eyesight is at risk with diabetes. Two different things for sure, but for the wellness of that patient, they come together to achieve the best outcome.

Few do that when it comes to addiction and depression for example.

First, even our doctors and medical professionals need to accept mental illness as a disease and not as a weakness. There is still quite a bit of stigma in mental health profession and healthcare profession.

Much of the time, those with depression reach for a substance to self medicate and if they are predisposed to addiction, they develop that, too. Ideally, we’d utilize mental health screening tools to treat mental illness early in order to avoid addiction or at least the early onset of addiction that often results in a higher risk of early death.

The younger the child, the more damage to the developing brain and higher risk that individual will become addicted. The chances of a child under 25 becoming addicted to an opiate is 15-18%, while it’s 10% for adults.

If we are going to be successful in helping people find mental wellness, we need to treat mental diseases that happen simultaneously and not ignore one because it’s inconvenient for us and we’d rather not address it as a dual diagnosis.

We don’t do that in any other aspect of medicine. Why would we do it here?

Stigma writes me a letter

3 thoughts on “Mental illness and addiction need to be treated together”

  1. That makes no sense! You are right….they are many times self medicating when they get into it…when that happens, you can’t solve the addiction without talking about what they are medicating!? Is that so hard to understand? Our mental health system is so broken.

  2. As a mental health nurse, at a state mental hospital, off and on for 40 + years I can say you are absolutely correct. Anyone with alcohol/drug problems could only be admitted to the Chemical Dependency Unit. Only on rare occasions did they receive a psychiatric consult. Generally they were admitted for 28 days, detoxed and attended AA meetings. Two of my sons, including my son who took his life in Dec. 2015, both had psychiatric diagnosis which were never addressed during their hospital stays. We did send them to out-patient treatment with local psychiatrists.

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