How Inpatient Drug Treatment Centers Treat Dual Diagnosis

Dual diagnosis, according to the NIDA, can also be referred to as comorbidity and a person exhibiting the symptoms for it may be called MICA, or a mentally ill chemical abuser. The definition of dual diagnosis is “the occurrence of two disorders or illnesses in the same person, either at the same time (co-occurring comorbid conditions) or with a time between the initial occurrence of one and the initial occurrence of the other (sequentially comorbid conditions).”

In addition to the drug addiction an individual attends treatment for, dual diagnosis also refers to an issue like depression, bipolar disorder, anxiety disorders, or mental illnesses that the individual is also struggling with at the same time. In most cases, an inpatient drug treatment center would be the best place for an individual with dual diagnosis. But how do these facilities treat this condition?

Diagnosing Comorbidity

A patient suffering from drug addiction might also suffer from depression.

It is extremely common for individuals who abuse drugs, especially illegal ones like methamphetamine, cocaine, heroin, etc., in the long term to suffer from another mental disorder as well. According to the NIDA, “Compared with the general population, people addicted to drugs are roughly twice as likely to suffer from mood and anxiety disorders, with the reverse also true.” But merely being addicted to drugs does not automatically prove a dual diagnosis.

Patients must be analyzed and meet certain criteria for a mental disorder as defined by The Diagnostic Statistical Manual of Mental Disorders. If they have been abusing drugs for some time, it is important that it is discovered whether or not they show signs of mental or behavioral disorders that may have either contributed to or stemmed from the addiction. Some of the common disorders of these types are:

• Depression
  • Major depression
  • Persistent depressive disorder (PDD)
  • Depression with psychotic features
• Bipolar disorder
  • Cyclothymic disorder
• Anxiety disorders
  • Panic disorder
  • Generalized anxiety disorder (GAD)
  • Specific phobias
  • Obsessive compulsive disorder (OCD)
  • Post-traumatic stress disorder (PTSD)
  • Social phobia
• Schizophrenia
• Attention deficit hyperactivity disorder (ADHD)
• Borderline personality disorder
• Eating disorders
• Pathological gambling
• Compulsive buying disorder

Thinking that you may suffer from one of these conditions is not enough; a doctor must diagnose you with it. That is done when you are measured against the criteria put forth for each disorder. Still, it is important to keep an open mind to the possibility of these issues as patients who suffer from them need to be treated for both conditions in order to have a stronger, more well-rounded recovery.

Treating Dual Diagnosis in Inpatient Centers

Patients are encouraged to attend treatment in inpatient centers when they have a dual diagnosis because more time, effort, and energy can be placed on treating both conditions. Also these facilities often have more funding and a better ability to treat both disorders. After patients are diagnosed with their conditions, a treatment plan is set out that contains both a course of action for their addiction treatment and for their co-occurring disorder. Usually, though, these issues are treated together as one, a concept that is fairly new but getting incredible results.

These conditions are usually treated together as “patients who have both a drug use disorder and another mental illness often exhibit symptoms that are more persistent, severe, and resistant to treatment compared with patients who have either disorder alone” (NIDA). However, this can be difficult, but it is the best way so far that comorbidity can be treated with the same care as addiction itself.

Medication

In an inpatient treatment center, it is understood that the same medication which would be beneficial in treating addiction alone may be ineffective or even dangerous when treating someone with depression or another co-occurring disorder. However, certain medications have been found to be helpful for both issues. For example, bupropion has been approved to treat both depression and nicotine dependence, but it has been recently found to “help reduce craving and use of the drug methamphetamine.”

Medication is prescribed and given carefully and will not be used if it is detrimental to one mental condition or the other. The only way for the individual to recover is for both illnesses to be treated in a way that is effective and beneficial, so any medications that do not do so for one condition cannot be used for the other.

Therapy

Therapies are used to treat both mental disorders and addiction, but certain types of behavioral treatments can be especially beneficial to in the treatment of both disorders together. These include

• Therapeutic communities
  • A type of inpatient treatment center model
  • Treatment usually lasts for 12 months.
  • Resocialization is used to allow patients access to a full community of individuals who are all influencing them positively toward recovery.
  • Many of these facilities are specifically catered to a certain gender, age, or group of individuals.
    • This is especially beneficial, for example, for women who suffer from PTSD and abuse and who need to be somewhere they feel safe in order to be open to treatment.
• Exposure therapy
  • Allows patients to face their triggers/fears slowly, exposing them to these issues until the patient’s defenses eventually minimize
  • Has been found to be effective for those with PTSD, phobias, and other anxiety disorders
  • Helps patients find a new way to cope with their disorder that does not involve drug abuse
• Dialectical behavior therapy
  • Beneficial in the treatment of individuals suffering from suicidal thoughts, self-harm, and borderline personality disorder
  • Teaches patients ways in which they can fight the urge to harm themselves as well as the urge to abuse drugs
• Cognitive-behavioral therapy
  • Especially beneficial to adolescents
  • Teaches patients a new way of looking at their behavior and how to adapt to more positive actions
  • Teaches ways to fight triggers for both a mental disorder and drug cravings

A study from the NCBI states, “Patients with high psychiatric severity” are expected to do well in inpatient treatment. This is because facilities such as these treat both addiction and mental disorders with medication (whenever possible), therapies that address both issues, and a caring staff who understand the special needs of those with dual diagnosis. These facilities will also help patients into aftercare programs that are beneficial to their needs if necessary.