Integrated Treatment of Dual Diagnosis

By Kirk Brown

  • Overview

    Integrated Treatment of Dual Diagnosis
    Integrated treatment approaches have proven to be effective for people who have both a mental disorder and an alcohol or drug dependency--a combination known as a dual diagnosis. The value of integrated treatment is that it encourages and enables clinicians to focus simultaneously on a patient's psychological and substance abuse problems. But for this or any treatment to succeed, dual diagnosis patients must consciously choose to get better. The life-changing pathway to recovery and health also will require ample courage and plenty of hope.
  • Treatment Steps

    An inpatient detoxification period is often the first step in caring for dual diagnosis patients who are strongly addicted to alcohol or drugs. Next, the integrated treatment of the individual's mental illness and substance abuse problem begins. Psychotropic medications may be prescribed for patients, who also typically receive counseling and behavior-modification instruction. Many dual diagnosis patients take part in support groups as part of their integrated treatment. Integrated treatment of dual diagnosis also include help that goes beyond standard medicines and therapies. Patients may receive services such as housing and job assistance, family counseling and financial and relationship management advice.
  • Dual Diagnosis Prevalence

    Substance abuse problems and mental illnesses like depression, schizophrenia and bipolar disorder are often inextricably linked. According to figures in the Journal of the American Medical Association, 37 percent of alcohol abusers and 53 percent of drug abusers have at least one serious mental illness. Conversely, roughly half of people with severe mental disorders also are affected by substance abuse. Women dual diagnosis patients are prone to depression, post-traumatic stress and other anxiety disorders while antisocial personality disorder is more prevalent in male dual diagnosis patients.


  • Causes

    Research has shown developmental, environmental and genetic factors may all contribute to a dual diagnosis patient's mental illness and substance abuse. Substance abuse problems are the cause of the emotional and mental difficulties that some individuals experience. For others, psychological problems result in a dependence on drugs and alcohol stemming from misguided attempts at self-medication.
  • Treatment Obstacles

    Despite its proven effectiveness, integrated treatment is not widely available to dual diagnosis patients. Mental health services usually aren't well prepared for patients who are dependent on alcohol or drugs. At the same time, a sizable number of substance abuse centers frown on dispensing any drugs, even those needed by patients with serious psychological conditions. Many patients are improperly diagnosed or simply fall through the cracks of fragmented health care systems.
  • Roles of Relatives and Friends

    Supportive and well-informed family members and friends can lend a hand to dual diagnosis patients as part of an integrated treatment approach. Those who are closest to a dual diagnosis patient must learn to avoid enabling undesirable behaviors. For instance, they need to say no if the patient asks to borrow money to procure illegal drugs or alcohol. Loved ones and friends should strive to stay calm, understanding and upbeat. They can emphasize the importance of complying with treatment requirements and also impose limits to prevent disruptive outbursts.
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