At one time, treatment for drug or alcohol addiction was considered to be separate from treatment for mental health disorders, and care was delivered at different facilities using radically different therapeutic approaches. As a result, many people who suffered from depression, schizophrenia, obsessive-compulsive disorder, bipolar disorder or other serious psychiatric conditions never received treatment for their substance abuse. By the same token, many drug rehab graduates with co-occurring disorders often never received adequate care for their underlying mental health concerns.
Today, addiction specialists and mental health clinicians view co-occurring disorders treatment as a unique field in its own right. The U.S. Department of Health and Human Services estimates that severe psychiatric disorders like schizophrenia, bipolar disorder and schizoaffective disorder affect up to 5 percent of Americans, and that as many as one in five Americans struggles with mental illness at some level.
Within that group, approximately 7 million also suffer from drug or alcohol addiction. Integrated treatment for co-occurring disorders is the key to protecting this group from the poverty, illness, isolation, incarceration and homelessness that often affect Dual Diagnosis individuals.
The Importance of Integrated Care
In recent years, studies of rehabilitation programs for people with co-occurring disorders have shown that integrated treatment is the most effective approach.
Treating addictive disorders and co-occurring mental health disorders at the same time is important for several reasons:
- Integrated recovery plans are designed to overcome the negative side effects of mental health disorders, such as a reduced attention span, a low level of motivation, and a fear of socializing with others.
- Medication therapy is more effective when your pharmacological plan addresses your mental health disorder as well as your substance abuse disorder.
- In co-occurring disorders treatment, the traditional hesitations about prescribing psychotherapeutic medications are no longer an issue.
- Group therapy for people with co-occurring disorders offers a stronger support network for individuals who are struggling with mental illness as well as addiction.
- Treating addiction and a mental health disorder at the same time helps rehab clients address their unique relapse triggers, such as depression, mood swings or panic attacks.
In facilities that emphasize treatment for co-occurring disorders, staff members have specialized training and qualifications in Dual Diagnosis treatment. These addiction specialists understand that clients with co-occurring disorders face certain challenges because of their mental illness.
Approaches to Treatment
Since the 1990s, the field of co-occurring disorders treatment has continued to grow.
In 2001, Dr. Kenneth Minkoff, a pioneer in the field of Dual Diagnosis treatment, published an article in Psychiatric Services outlining the best standards of care for co-occurring disorders. According to Minkoff, principles of effective care include:
- Welcoming clients with co-occurring disorders into substance abuse treatment instead of excluding them because of a psychiatric condition
- Giving the addictive disorder and the co-occurring psychiatric disorder the same level of attention and care during the rehabilitation process
- Addressing both the mental illness and the substance use disorder as chronic, relapsing conditions that require long-term support
- Ensuring that care is provided by a treatment team that’s trained in addressing co-occurring disorders
- Assessing each client for mental health disorders as early in the rehabilitation process as possible so treatment can begin promptly
- Treating all clients with dignity and respect, even if they are in the midst of a mental health crisis or acutely intoxicated.
When treatment for co-occurring disorders is combined with treatment for addiction, therapy sessions and group meetings can be structured to reflect the needs of those who are mentally ill. Symptoms like social anxiety, feelings of hopelessness or compulsive behavior don’t have to become an obstacle to care if these programs are tailored to the needs of clients with co-occurring disorders.
When you enter a drug or alcohol rehab program that specializes in treating co-occurring disorders, you should have a full range of options to choose from. The thought of trying to recover from a mental health disorder like depression or bipolar disorder can be overwhelming if you’re also faced with the work of recovering from addiction. That’s why a comprehensive treatment plan and a supportive team are essential to your success.
Consider these treatment strategies when you’re planning your recovery:
- Residential treatment programs. Intensive residential treatment programs provide structured, supervised support as you go through rehab. Removed from the stresses and triggers of your daily environment, you may find that it’s easier to focus on your recovery.
- Outpatient treatment options. Many rehabilitation facilities offer outpatient alternatives for clients who don’t need 24-hour supervision. For younger teenagers, parents or people with work commitments, outpatient care may be the best way to get the proper treatment without interrupting important life routines.
- Individual therapy. Individual therapy for co-occurring disorders centers on tasks like building motivation, identifying self-defeating thoughts and learning positive new behaviors. Today, the leading rehab facilities have abandoned the old, confrontational style of therapy in favor of a non-confrontational, collaborative approach to treatment that focuses on reinforcing the client’s sense of self-worth and preventing relapses in the future.
- Medication therapy. Psychotherapeutic medications, such as antidepressants, anti-psychotic medications and anti-anxiety drugs, are often prescribed as part of a co-occurring disorders treatment program. Anti-addiction medications may also be prescribed to minimize cravings and withdrawal symptoms.
- Peer support groups. Social withdrawal is often the result of living with a serious mental health disorder; when you add drugs and alcohol to the mix, isolation can get even worse. Peer support groups and 12-step programs like Dual Recovery Anonymous (DRA) let you know that you’re far from alone in your efforts to lead a healthy, stable life. Group counseling and 12-step programs are an integral part of many rehab programs.
- Education and counseling for families. Supporting a loved one with a mental illness and a substance abuse problem can be frustrating and heartbreaking. Whether you’re the patient or someone who’s close to the patient, education and support can make all the difference in the world when it comes to surviving co-occurring disorders.
- Holistic therapies. Increasingly, mental health clinicians have come to appreciate the role of alternative therapies in drug and alcohol rehab. Acupuncture, hypnotherapy, massage, equine-assisted therapy and yoga are now offered by many rehabilitation programs as part of a treatment plan for co-occurring disorders.
- Ongoing support after rehab. After you’ve completed a rehabilitation program, your recovery journey is really just beginning. Finding a program that offers comprehensive aftercare services is as important as choosing a facility that provides integrated care. You should have access to counselors, support groups and other recovery resources after you’re discharged from treatment, so you can continue to evolve in recovery. Many facilities offer transitional housing for graduates who need a partially structured, secure environment to minimize their chance of a relapse.
Having a disorder like bipolar disorder, depression or schizophrenia is no longer considered to be a reason for excluding clients from substance abuse treatment. At the same time, clients who abuse drugs or alcohol should not be excluded from psychiatric treatment because of a substance use disorder. But the fact remains that many drug rehab facilities don’t have the resources or the personnel to handle clients with psychiatric disorders.
If you’re seeking help for a co-occurring disorder, we offer the specialized care you’re looking for. Our centers rely on the latest therapeutic strategies for Dual Diagnosis rehab, such as the Foundations Model, to give our clients the very best chance of success. Contact one of our addiction specialists to find out how you can begin the process of recovery today.
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David W. Newton is a board certified pharmacist and also has been a board member for boards of examiners for the National Association of Boards of Pharmacy since 1983. His areas of expertise are primarily pharmaceuticals as well as cannabinoids. You can read an article about his expertise in CBD on the National Library of Medicine.