Mental Health & Substance Abuse

DUAL DIAGNOSIS TREATMENT

Dual diagnosis treatment is an integrated, coordinated approach to substance abuse and mental health interventions for individuals with co-occurring disorders. This means that multidisciplinary teams of clinicians are working together under one roof to provide client-centered, seamless services ranging from holistic therapy to social skills training with a consistent approach. By the end of the treatment program, individuals will be able to effectively manage both illnesses in order to pursue meaningful goals and dreams.

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Dual Diagnosis Treatment

According to a study funded by the National Institute on Alcohol Abuse and Alcoholism (NIAAA), about 23 million Americans suffer from some form of a co-occurring disorder associated with a substance use disorder (National Institutes of Health, 2015). These comorbid disorders are considered dual diagnosis disorders, and the survey also reveals that the majority of these disorders are left untreated.

Why Do Dual Diagnosis Disorders Go Untreated?

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)

What is Dual Diagnosis?

The term “dual” refers to the treatment of both substance use disorders and co-occurring disorders simultaneously. This treatment model takes into account the relationship between addiction and psychosis and patients are viewed as having two primary chronic illnesses requiring specific treatment for each. (1)

The Diagnostic Statistical Manual of Mental Disorders, Fifth Edition (DSM-5) divides substance use disorders into three classifications: mild, moderate and severe. Addiction psychiatrists use criteria such as the patient’s desire to quit medication (but to no avail); repetitive and progressive decline in performance concerning work, personal and academic obligations; and continued usage of drugs despite severe adverse consequences. Of the 11 total criteria, a condition that meets 2-3 is considered mild; 4-5, moderate, and 6 or more, severe. Common disorders include alcoholism and addiction to marijuana, opioids, and cocaine.

Dual diagnosis disorders, also known as co-occurring disorders, are comorbid disorders that occur concurrently with substance use disorders. The significance of identifying dual diagnosis disorders lies in the presence of mental illness. Patients who have some form of mental health disorder such as depression, Bipolar disorder, schizophrenia, or chronic anxiety are more likely to develop an addiction to substance abuse than those who do not have a mental illness (SAMHSA, 2016).

(1) Center for Substance Abuse Treatment. Medication-Assisted Treatment for Opioid Addiction in Opioid Treatment Programs. Rockville (MD): Substance Abuse and Mental Health Services Administration (US); 2005. (Treatment Improvement Protocol (TIP) Series, No. 43.) Chapter 12. Treatment of Co-Occurring Disorders. Available from: https://www.ncbi.nlm.nih.gov/books/NBK64163/
(2) Minkoff, Kenneth (2006). An Integrated Treatment Model for Dual Diagnosis of Psychosis and Addiction. Psychiatric Services https://doi.org/10.1176/ps.40.10.1031

Common Comorbid Disorders Treated at Dual Diagnosis Treatment Centers

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.

Benefits of Dual Diagnosis Treatment

Dual diagnosis treatment has a myriad of benefits. When both comorbid disorders are taken into account, this treatment model reduces the likelihood of homelessness, suicide, premature death and incarceration (SAMHSA, 2016). Not only does it reduce negative consequences of under-treated disorders, it also lowers the cost of treatment and optimizes outcomes. A team of interdisciplinary licensed professionals often work together to assist clients in recovery. Addiction therapists work with social workers who are often on the front lines working with persons suffering from substance use disorders. Through a collaborative network, social workers refer clients to the best dual diagnosis treatment centers for further treatment. (3)

(3)Kelly, TM & Daley DC (2013) Integrated Treatment of Substance Use and Psychiatric Disorders. Soc Work Public Health. 2013; 28(0): 388–406. doi: 10.1080/19371918.2013.774673

Why New Method Wellness Is One of the Nation’s Best Dual Diagnosis Treatment Centers

Handpicked by Dr. Phil, New Method Wellness is a premier dual diagnosis treatment center dually accredited by The Joint Commission and CARF International. It has been singled out as one of the best drug and alcohol rehab centers in America, offering a unique 2:1 staff-to-client ratio that pairs every client with two therapists instead of one. At New Method Wellness, we add another dimension to dual diagnosis treatment, and that is the integration of holistic therapy, such as massage/acupuncture therapy, equine therapy, and art therapy. As addiction therapists and substance abuse counselors work with clients to treat the substance use disorder and the co-occurring illness associated with it, holistic therapy adds meaning to life after treatment and sustains long-term recovery. Our 2:1 staff-to-client ratio ensures client success after treatment, as evidenced by our Extended Aftercare program.

For more information about New Method Wellness’s treatment programs, call 866.951.1824

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