DUAL DIAGNOSIS TREATMENT COVERED BY YOUR PPO INSURANCE

The National Survey on Drug Use and Health has found that 45% of people in the United States have a dual diagnosis for co-occurring addiction and mental illness. People who have mental illnesses are twice as likely as the rest of the population to engage in substance abuse. At the same time, people who struggle with substance abuse are also more likely to develop a mental illness or behavioral disorder. It’s an accepted fact that mental illness can lead to substance abuse, and that addiction can cause other mental illnesses.

Dual diagnosis is far more common now than it used to be. At one point, mental illness and addiction would be treated as separate conditions. A person with depression or bipolar disorder would be referred to a mental health facility. Someone addicted to alcohol or drugs would be referred to an addiction rehab center. The problem with this approach is both conditions often did not receive adequate treatment.

For example, a patient in addiction rehab might be discharged as not responding to treatment due to their mental disorder. Meanwhile, a person in a mental health facility might be prescribed medication to treat their disorder, but their addiction to drugs or alcohol ends up interfering.

It’s easy to see why both conditions are now treated at the same time as co-occurring disorders at most addiction treatment centers.

Co-occurring disorders of addiction and mental health issues often have overlapping symptoms. Only a dual diagnosis professional can make a true determination on the nature of the mental health issue occurring alongside addiction. However, there are some questions you can ask yourself or a loved one if you suspect the presence of co-occurring disorders.

• Can you remember the last time you felt happy or satisfied with life without using drugs or alcohol? Think back before you started using drugs or alcohol. Were you happy or unhappy? If you can’t remember being happy before substance abuse, then you may have an underlying mental illness.

• Did you start using drugs or alcohol to overcome negative feelings? If you started using drugs or alcohol to cope with stress, anxiety or depression, this may indicate the presence of an underlying mental health issue.

• Have you experienced trauma in the past? Trauma, especially in your early years, increases your risk for mental illness and addiction. Trauma alters brain chemistry and causes people to experience undue stress on a daily basis.

• Do you have a history of mental illness in your family? If you have family members who have been diagnosed with mental illness, you’re more at risk. All mental illnesses have a genetic aspect along with other factors.

Untreated dual diagnosis disorders usually make each other worse and make treatment more difficult.

Clients are often treated for one disorder while the other one goes undetected. Several major factors contribute to the treatment of one without the other:

• Separate treatments for addiction and mental health are received at two different facilities (lack of integrated treatment)
• Some facilities restrict the type of patients they admit, forcing patients to choose which type of disorder to treat1
• Insufficient provider training and/or screening (SAMHSA, 2016)

A common question for dual diagnosis treatment is: Which one of the co-occurring disorders should be treated first? Addiction is a mental illness, but often the underlying causes of it are due to another mental health issue. Many people with undiagnosed mental health issues turn to substance abuse as a form of self-medication. The substance abuse eventually leads to addiction.

For example, someone with anger issues or high anxiety might decide to use opiates as they have a calming and sedative effect. Someone with depression might choose stimulant drugs like cocaine or amphetamines in order to feel more energetic and alive. These people might feel like they’re helping themselves by countering their symptoms. Unfortunately, addiction to drugs or alcohol eventually makes these symptoms worse.

Mental health and addiction are ultimately two sides of the same coin. Integrative therapy after a dual diagnosis means that mental health is addressed during and after physical treatments for substance abuse, such as detox. Even when a person’s body is freed of the addictive substance, the underlying reasons for the addiction still remain. If the underlying reasons include undiagnosed mental illness, then that is the next step of treatment.

Sometimes people become addicted to drugs or alcohol without prior mental illness, but they may still need therapy to address the trauma or stress that led them to substance abuse.

At dual diagnosis treatment centers like New Method Wellness, individuals with substance use disorders receive client-centered integrated treatment in the context of their co-occurring mental health disorder. Listed below are some common treatment approaches used for various comorbidities:

• Depression – Major depression is the most common co-occurring disorder associated with drug and alcohol addiction. Clinicians must differentiate between depressive episodes induced by substance use versus depressive episodes that were not caused by another medical condition, psychiatric illness, or chemical dependency. The high prevalence of major depression and substance use disorder is such that dual diagnosis treatment of these disorders is imperative; the integrated treatment model used in dual diagnosis treatment centers is critically important for individuals with this comorbidity.
• Bipolar disorder – Also known as manic depression, bipolar disorder is characterized by extreme swings between manic episodes (highs) and depressive episodes (lows) and is generally categorized into Bipolar Disorder 1, Bipolar Disorder 2, Cyclothymic Disorder, Rapid-cycling and “Mixed features.” In dual diagnosis treatment centers, integrated group therapy is a common treatment approach for individuals who have substance use disorder and bipolar disorder.
• Attention Deficit Hyperactivity Disorder (ADHD) – Substance-induced ADHD and primary ADHD share symptoms that are strikingly similar, such as impulsivity, impaired concentration, and hyperactivity. Due to the symptomatic overlap, clinicians within dual diagnosis treatment centers are very conservative about their pharmacological approach to addiction treatment. To assess whether ADHD is the primary disorder in a client, practitioners generally treat for the substance use disorder first before making a clinical diagnosis after a period of abstinence.
• Anxiety – Various anxiety disorders such as post-traumatic stress disorder (PTSD), generalized anxiety disorder (GAD), and panic disorder have been associated with substance use disorder. In dual diagnosis treatment centers, clinicians use psychosocial interventions in integrated treatment models to target maladaptive learned behaviors such as avoidance, which is very common among individuals with some form of anxiety disorder and substance use disorder.