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Dual Diagnosis: Drug Addiction, Alcoholism and Associated Psychiatric Disorders

A person who suffers from alcohol abuse / alcoholism, drug abuse / drug addiction and an emotional/psychiatric problem is said to have a dual diagnosis. To recover fully, the person will require addiction treatment and psychiatric treatment for both problems.

How Common Is Dual Diagnosis?

Dual diagnosis is a common diagnosis. According to a report published by the Journal of the American Medical Association: Thirty-seven percent of people with alcohol abuse and fifty-three percent of people with drug abuse also have at least one serious mental illness. Of all people diagnosed as mentally ill, 29 percent suffer from alcohol abuse or drug abuse.

What Type of Mental Health Problems are Seen in People with Dual Diagnosis?

The following psychiatric problems occur in Dual Diagnosis - i.e., in tandem with alcoholism or drug addiction. Disorders, such as depression and bipolar disorder; anxiety disorders, panic disorder, obsessive-compulsive disorder, and phobias. Other psychiatric disorders, such as schizophrenia and personality disorders are also common in a dual diagnosis.

The following table based on a National Institute of Mental Health study, lists seven major psychiatric disorders and shows how much each one increases an individuals risk for drug addiction. Psychiatric Disorder Increased Risk For Substance Abuse; Antisocial personality disorder 15.5% Manic episode 14.5 Schizophrenia 10.1 Panic disorder 4.3 Major depressive episode 4.1 Obsessive-compulsive disorder 3.4 Phobias 2.4

Thus, someone suffering from schizophrenia is at a 10.1 percent higher-than-average risk of alcohol addiction or drug addiction. Someone who is having an episode of major depression is at a 4.1 percent higher-than-average risk of developing alcoholism or drug addiction.

Drug Addiction, Alcohol Addiction or the Emotional Problem….Which Came First?

Often the psychiatric problem develops first. In an attempt to feel calmer or more cheerful, a person with emotional symptoms may drink or use drugs; doctors call this "self-medication." Frequent self-medication may eventually lead to physical or psychological dependency on alcohol or drugs, alcohol addiction or drug addiction. If it does, the person then suffers from more than one problem. In adolescents, however, drug abuse or alcohol abuse may merge and continue into adulthood, which may contribute to the development of emotional difficulties or psychiatric disorders. Dual diagnosis is a complex disorder to diagnose.

If a Person Suffers From Drug Addiction, Alcoholism and a Mental Health Disorder, Which Should Be Treated First?

In a perfect world, both problems should be treated simultaneously. For any substance abuse problem, however, the first step in treatment must be detox - a period of time during which the body is allowed to cleanse itself of alcohol or drugs. Ideally, drug detox or alcohol detox should take place under medical supervision. It can take a few days to a week or more, depending on what substances the person abused and for how long.

Until recently, alcoholics and drug addicts dreaded detox because it meant a painful and sometimes life-threatening "cold turkey" withdrawal. Now, doctors are able to provide those people with a drug addiction or alcohol addiction carefully chosen medications while in detox, which can substantially ease withdrawal symptoms. Detox done under medical supervision, is safer for the dually diagnosed.