Dual Diagnosis (also called co-existing disorders, COD) is when one suffers from mental illness and substance abuse. One of the problems diagnosing patients is the fact that many of the symptoms of drug abuse mirror those of mental illness. The clinician has to differentiate between substance abuse psychiatric symptoms and mental illness. Very often, psychiatric symptoms such as depression and post-acute withdrawal last far longer than the detox itself. It’s a very real and growing problem, to the point that the USA National Survey on Drug Use and Health found that in 2011, 17 ½% of all adults with a mental illness also had substance abuse problem. It’s a very changeling condition and one that requires an often higher level of care than standard drug rehab facilities can offer. The good news though, is that those with a valid Dual Diagnosis disorder have far more options these days than they had a mere ten years ago.
Aside from inquiring if a facility treats Dual Diagnosis disorders, one of the main things to find out is if the program you’re looking into is comprehensive in terms of having several avenues of treatment. A facility that handles patients with eating disorders and/or body dismorphia may not be equipped to handle Bi-polar disorder. By the same token, is the post-acute depression someone is suffering from due to post-acute withdrawal, or a life-long condition? A diagnosis by a physician and/or psychiatrist is the place to start, and from there you can really begin – and narrow down – your search for the best treatment facility to meet your needs. Ask as many questions as you can!
There are several different treatment models involving Dual Diagnosis treatment. Some of the more common and effective are 1) Treating the primary disorder first, followed by secondary. This is called Sequential Treatment. 2) Is Parallel Treatment, where both the mental disorder and the substance abuse issue are treated simultaneously, although not always by the same staff or clinician. 3) Integrated Treatment is generally more comprehensive, blending seamless interventions into a treatment package that has a consistent philosophy, and each disorder is considered primary. The results are increased accessibility, stronger treatment compliance, and highly-individualized service and engagement, often with stronger long-term success. Again, ask as many questions as you need to from a prospective facility.
One of the most important issues in Dual Diagnosis is medication. Many patients initially reject medication as being adverse to addiction treatment, with good reason. However, depending on the disorder one is battling, supervised medication may be critical in the early stages counteracting anxiety, paranoia and craving. Have some trust in qualified medical professionals; remember, you don’t have all of the answers…if you did, you probably wouldn’t be here.
Lastly, another important thing to consider is the length of the program. Treating dual Diagnosis disorder takes time, usually more time than a standard drug/alcohol program; find out the standard length of the program you are considering, and also inquire about extensions. It’s important to look at recovery as a marathon, rather than a sprint.