In 2015, SAMHSA, the Substance Abuse and Mental Health Services Administration, released their most recent findings on the prevalence concurrent mental health issues in people with substance abuse issues. The survey was comprehensive, covering substance abuse ranging from tobacco, alcohol and prescription drug abuse — more common, legal substances — to more illicit, often illegal substances: hallucinogens, inhalants and methamphetamine. Among the prescription drugs categorized were pain relievers, tranquilizers, stimulants and sedatives — all drugs that when dosages stray from doctor prescription guidelines can cause serious harm to human life.

As of 2015, SAMHSA found that 51.2% of Americans age 18 and over engaged in illicit drug use. They break down the percentages of the population by type of drug use as follows:

  • 46.9% used marijuana
  • 15.9% used cocaine – with 3.7% having used crack cocaine
  • 2.1% used heroine
  • 16.5% used hallucinogens – with 10.3% having used LSD, 2.6% having used PCP and 7.4% having used ecstasy
  • 9.7% used inhalants
  • 5.9% used methamphetamines.

Overall, illicit drug use other than marijuana reached 30.1% of the population.

Mental Illness and Substance Abuse

Drug use is widely known to have deleterious effects, both short- and long- term and on the individual and the community at large. From heart attacks, kidney and liver failure, hepatitis and AIDS, the health conditions that drug users risk are severe. Even if drug use does not result in physical ailment, it can lead to behavioral changes and impaired decision making that affects one’s own life course and the course of those around them: “Drug use can [affect] a person’s nutrition; sleep; decision-making and impulsivity; and risk for trauma, violence, injury, and communicable diseases. Drug use can also affect babies born to women who use drugs while pregnant. Broader negative outcomes may be seen in education level, employment, housing, relationships, and criminal justice involvement,” the National Institute on Drug Abuse explains.

With risks this dangerous, it begs the question: why are so many American adults using drugs?

The answer is not simple, of course. For decades scientists and researchers have studied the nature of addiction and the environmental landscapes that can put someone at risk for drug use. But only recently have studies taken into account the Biopsychosocial model, and started looking more inward at the individual risk that mental health issues carry for drug use.

Pre-existing and untreated mental health disorders can be a strong risk factor for drug use. According to the SAMHSA report, in 2015, 17.9% of the adult American population experienced a mental illness in the past year. NAMI, the National Alliance on Mental Health, reports from that over 7.9 million adult Americans experience both a mental disorder and substance abuse disorder simultaneously.

Integrated Treatment

The number of people suffering from undiagnosed mental illness is unknown. Given the historical stigma surrounding mental illness — with negative portrayals in media like television and film — in addition to the historical lack of funding, research and resources for the general public, it is no wonder that many people suffer in silence and unaware. It was only 77 years ago, in 1952, that the first Diagnostic and Statistical Manual of Mental Disorders, or DSM, was created.

Given these numbers, we can see why many people suffering from mental illness may self-medicate through illicit drug use. Symptoms of depression, anxiety, agitation, confusion and legitimate pain can lead many, unaware of other options, to turn to drugs for relief. Their drug use, unfortunately, leads to even worsening symptoms of mental health when the individual experiences withdrawal and, if the drug use continues, their lives become less directed and chosen and more controlled by their addiction.

The good news is that today, there are many resources for people with both a mental illness and drug addiction — known as dual-diagnosis. Detoxification programs, inpatient and outpatient rehabilitation, supportive housing, psychotherapy, medication management and self-help and support groups are widely researched, approved and culturally applicable forms of treatment to support and individual with a dual-diagnosis.

However accepted these treatments have become, many often still don’t receive the full treatment they deserve. According to DrugAbuse.com, an American Addiction Centers Resource, in 2016 only an estimated 6.9% of adults were treated for both their addiction and their mental illness — leaving many not entirely cared for and vulnerable to relapses.

But it is becoming increasingly evident that there is a dire need for these types of programs to serve the people who suffer from dual-diagnosis. The numbers prove it: according to the Foundations Recovery Network, a research-based non-profit, the percentage of patients in drug rehabilitation programs who were then diagnosed with mental illnesses increased from 12 to 16% in a span of 6 years. As patient-care programs become more aware of their patient’s needs, mental illness treatment as a component in care is becoming more and more recognized.

Dual Diagnosis Treatment

It is important that, when looking into substance abuse treatment options, mental health is considered as a component. Seeing the signs of addiction and/or mental illness can be difficult — not everyone functions at low levels while they are suffering. The Foundations Network notes the SAMHSA findings that 13.2% of men employed full-time suffer from drug addiction or abuse in the past year; 14.2% of women employed full-time have dealt with mental illness in the past year. Functioning levels can vary, but suffering from untreated addiction or mental illness should never be the standard for quality of life when there are options available. Psychotherapy, cognitive-behavioral therapy and medication management — some of the most effective forms of treatment for common mental illnesses like bipolar disorder and depression  — are available at select treatment centers for people will mental illness.

Mental health disorders are not uncommon. In the United States, an estimated 43.8 million people suffer from a mental health illness in any given year – that’s 1 in 5 Americans.

Many people seeking treatment for substance abuse disorders also suffer from mental health disorders, a condition called dual diagnosis. According to the most recent Substance Abuse and Mental Health Services Association (SAMHSA) survey gathered in 2014, 7.9 million people in the U.S experience both a mental disorder and substance abuse disorder simultaneously.

However, a majority of rehabilitation treatment centers in the U.S. only treat either addiction disorders or mental health disorders, not both concurrently. In a 2014 research study published in Administration and Policy in Mental Health and Mental Health Services Research that reviewed 256 programs across the U.S., only 18% of addiction treatment programs and 9% of mental health treatment programs addressed both issues with the individual and could be classified as “Dual Diagnosis Capable.”

This suggests that patients and families seeking care in these programs have a 1 in 10 to 2 in 10 chance of having both disorders addressed adequately. Despite the national and perhaps international call to action for integrated services (i.e. “no wrong door”), these data suggest that the opportunity for systemic improvement persists,” the study says.

When given a dual diagnosis, addressing clients’ goals in treating both disorders is a key factor in the outcome of their recovery. A Dual Diagnosis treatment center is considered highly effective in combating the client’s symptoms and suffering. NAMI, the National Alliance on Mental Illness, says, “In fact, joint approaches offer the best chance for recovery.”

A study by NAMI from 1999, one of the most comprehensive in recent history, looked at 981 male dual diagnosis patients and followed-up with them 1 year later. The results were extraordinary. Dual diagnosis patients who were treated for both disorders:

  • Had a higher abstinence rate 1 year later than at intake (39% versus 2%)
  • Had improved freedom from psychiatric symptoms from intake (60% to 68%)
  • Had higher levels of employment from intake (20% to 29%)

Overall, a dual diagnosis treatment center can vastly improve outcomes. NAMI suggests that the best approach provides a combination of methods for treating the client, including psychotherapy, cognitive-behavioral therapy (CBT), medication and behavioral treatments. “The combinations of different technologies increase therapeutic effect by exerting a synergistic impact on symptoms,” the study concludes.  Ultimately, the outcomes for individuals suffering dual diagnosis who get treatment for both disorders is optimistic.

As we continue our look into dual diagnosis, we already have identified the many challenges involved, symptoms, and some at-risk populations. Today we discuss dual diagnosis treatment.

Once again, the National Alliance on Mental Illness (NAMI) says that dual diagnosis is “a term for when someone experiences a mental illness and a substance use disorder simultaneously.” The two diagnoses share a close relationship across a number of areas. NAMI states: “Either disorder—substance use or mental illness—can develop first. People experiencing a mental health condition may turn to alcohol or other drugs as a form of self-medication to improve the mental health symptoms they experience. However, research shows that alcohol and other drugs worsen the symptoms of mental illnesses.”

And, as we’ve note, NAMI further states: “According to a 2014 National Survey on Drug Use and Health, 7.9 million people in the U.S. experience both a mental disorder and substance use disorder simultaneously. More than half of those people—4.1 million to be exact—are men.”

Dual Diagnosis Treatment

How can dual diagnosis be treated?

As we noted previously, the Substance Abuse and Mental Health Services Administration (SAMHSA), “supports an integrated treatment approach to treating co-occurring mental and substance use disorders. Integrated treatment requires collaboration across disciplines. Integrated treatment planning addresses both mental health and substance abuse, each in the context of the other disorder. Treatment planning should be client-centered, addressing clients’ goals and using treatment strategies that are acceptable to them.”

NAMI notes that “the best treatment for dual diagnosis is integrated intervention, when a person receives care for both their diagnosed mental illness and substance abuse.” Importantly, “the idea that ‘I cannot treat your depression because you are also drinking’ is outdated—current thinking requires both issues be addressed.”

Common methods can include:

  • Inpatient Rehabilitation. “A person experiencing a mental illness and dangerous/dependent patterns of substance use may benefit from an inpatient rehabilitation center where they can receive medical and mental health care 24/7. These treatment centers provide therapy, support, medication and health services to treat the substance use disorder and its underlying causes.”
  • “Supportive Housing, like group homes or sober houses, are residential treatment centers that may help people who are newly sober or trying to avoid relapse. These centers provide some support and independence. Sober homes have been criticized for offering varying levels of quality care because licensed professionals do not typically run them. Do your research when selecting a treatment setting.”
  • “Psychotherapy is usually a large part of an effective dual diagnosis treatment plan. In particular, cognitive behavioral therapy (CBT) helps people with dual diagnosis learn how to cope and change ineffective patterns of thinking, which may increase the risk of substance use.”

 

In our last post, we started to identify the many challenges associated with “dual diagnosis.” Today we go deeper into symptoms and identify different communities that may be susceptible.

We reported that the National Alliance on Mental Illness (NAMI) says that dual diagnosis is “a term for when someone experiences a mental illness and a substance use disorder simultaneously.” The two diagnoses share a close relationship across a number of areas. NAMI states: “Either disorder—substance use or mental illness—can develop first. People experiencing a mental health condition may turn to alcohol or other drugs as a form of self-medication to improve the mental health symptoms they experience. However, research shows that alcohol and other drugs worsen the symptoms of mental illnesses.”

NAMI further states: “According to a 2014 National Survey on Drug Use and Health, 7.9 million people in the U.S. experience both a mental disorder and substance use disorder simultaneously. More than half of those people—4.1 million to be exact—are men.”

So what are the symptoms and what populations might be at risk?

NAMI notes that the symptoms can vary widely. This is because “many combinations of dual diagnosis can occur,” As a result, “mental health clinics are starting to use alcohol and drug screening tools to help identify people at risk for drug and alcohol abuse.”

According to NAMI, substance use disorder symptoms may include:

  • Withdrawal from friends and family
  • Sudden changes in behavior
  • Using substances under dangerous conditions
  • Engaging in risky behaviors
  • Loss of control over use of substances
  • Developing a high tolerance and withdrawal symptoms
  • Feeling like you need a drug to be able to function

Symptoms of a mental health condition can also vary greatly. Warnings signs, such as extreme mood changes, confused thinking or problems concentrating, avoiding friends and social activities and thoughts of suicide, may be reason to seek help.

One population where dual disorders can occur is with military veterans. The Substance Abuse and Mental Health Services Administration (SAMHSA), part of the U.S. Department of Health and Human Services, notes that “co-occurring disorders, such as post-traumatic stress disorder (PTSD) and substance use, is prevalent among veterans and the military community. According to the Veterans Affairs Department (VA), approximately one-third of veterans seeking treatment for substance use disorders also met the criteria for PTSD.”

It continues: “Veterans and service members benefit from integrated care for mental and substance use disorders. However, some veterans may not seek medical treatment for one of many reasons, including a fear of being treated differently.”

Another area to watch: Primary Care. SAMHSA notes: “People who receive primary care often may have multiple health issues, including co-occurring disorders. Integrating behavioral and primary care is especially important to meeting their needs.”

“People with co-occurring disorders may seek primary care services first before seeking behavioral health services. As a result, primary care practitioners have unique opportunities to identify people with co-occurring disorders through screening. Screening for co-occurring disorders in primary care settings can assist practitioners in recognizing and addressing conditions early. Screening also can serve as a baseline to measure clinical progress.”

How is dual diagnosis treated? That’s our next post.

Among the many challenges associated with substance abuse is the propensity for “dual diagnosis.”

As the National Alliance on Mental Illness (NAMI) notes, dual diagnosis is “a term for when someone experiences a mental illness and a substance use disorder simultaneously.” The two diagnoses share a close relationship across a number of areas. NAMI states: “Either disorder—substance use or mental illness—can develop first. People experiencing a mental health condition may turn to alcohol or other drugs as a form of self-medication to improve the mental health symptoms they experience. However, research shows that alcohol and other drugs worsen the symptoms of mental illnesses.”

In fact, the interactions may be even more tightly intertwined. How common Is dual diagnosis?

The Substance Abuse and Mental Health Services Administration (SAMHSA), part of the U.S. Department of Health and Human Services, notes that “People with a mental disorder are more likely to experience a substance use disorder and people with a substance use disorder are more likely to have a mental disorder when compared with the general population. According to the National Survey of Substance Abuse Treatment Services (N-SSATS), about 45% of Americans seeking substance use disorder treatment have been diagnosed as having a co-occurring mental and substance use disorder.”

Or, as NAMI states: “According to a 2014 National Survey on Drug Use and Health, 7.9 million people in the U.S. experience both a mental disorder and substance use disorder simultaneously. More than half of those people—4.1 million to be exact—are men.”

Dual Diagnosis Integrated Treatments

As highlighted here, some co-occurring or dual diagnoses include:

In fact, SAMHSA “supports an integrated treatment approach to treating co-occurring mental and substance use disorders. Integrated treatment requires collaboration across disciplines. Integrated treatment planning addresses both mental health and substance abuse, each in the context of the other disorder. Treatment planning should be client-centered, addressing clients’ goals and using treatment strategies that are acceptable to them.”

The site continues: “Integrated treatment or treatment that addresses mental and substance use conditions at the same time is associated with lower costs and better outcomes such as:”

  • Reduced substance use
  • Improved psychiatric symptoms and functioning
  • Decreased hospitalization
  • Increased housing stability
  • Fewer arrests
  • Improved quality of life

In our next post, we’ll go deeper into symptoms and certain populations at risk.

suicidewarningtoolSuicide Warning Tool: Is path warm?

People sometimes contemplate suicide because of overwhelming things in their life, depression, loss, or for many other reasons. But being aware of some signs and symptoms can help to prevent suicide. Often, preventing a loved one from suicide can depend on the ability of individuals in their life to recognize distress and risky behaviors. Recently, the American Association of Suicidology developed a simple tool that is available for everyone to use to remember the warning signs of suicide. This helpful tool is called “IS PATH WARM” and outlines the key points to remember:

I  – Ideation (suicidal thoughts)

S – Substance Abuse

P – Purposelessness

A – Anxiety

T – Trapped

H – Hopelessness/Helplessness

W – Withdrawal

A – Anger

R – Recklessness

M – Mood changes

The American Association of Suicidology also indicated that other signs and behaviors to be aware of including:

  • Direct and indirect verbal expressions: “I don’t want to live anymore”, “there is nothing to live for anymore”, “people will be better off without me”
  • Dramatic changes in mood
  • Loss of interest in previously enjoyed activities
  • Agitation
  • Increase in drug and alcohol use
  • Risk taking behavior
  • Aggressive, impulsive and/or violent acts
  • Expressions of hopelessness and purposelessness
  • Lack of self care or outright neglect of self
  • Sleeping too much or too little
  • Feeling tired most of the time
  • Gaining or losing a significant amount of weight
  • Changes in eating and sleeping pattern
  • Withdrawal from family, friends, and interests
  • Giving away prize possessions and/or making a will; tidying up personal affairs; writing notes; making notes on belongings
  • Reconnecting with old friends and extended family as if to say goodbye
  • Previous unresolved or recent suicide attempt(s)
  • Unusual happiness and peace after an intense period of turmoil and displaying the above characteristics

If a loved one is showing these symptoms, it is important to get help from a trustworthy source and to let other loved ones know as soon as possible. Doing so could prevent suicide and help the loved one find peace and solace and heal from suicidal thoughts and behaviors.

 

Source: yourlifecounts.org

talkingaboutdepressionTalking About Depression

Unfortunately, depression seems to be lurking everywhere. It’s become more common among teens and the elderly and remains a problem for many adults. Talking to those you love about their depression can be difficult. Individuals may become defensive, angry, or even more depressed. The website helpguide.org gives guidelines concerning the discussion about depression. Most individuals want to help those they love to overcome or lessen their depression and the following ideas and suggestions can be very helpful. However, it is key to remember that giving advice won’t go as far as simply being a compassionate listener. Usually, individuals with depression need someone to listen to their concerns and feelings without judgment. As a good friend or loved one, the simple act of listening, maybe over and over, can really help those who are struggling with depression.

The following is taken directly from helpguide.org and can significantly benefit the process of opening up a conversation with someone dealing with depression:

Ways to start the conversation:

  • “I have been feeling concerned about you lately.”
  • “Recently, I have noticed some differences in you and wondered how you are doing.”
  • “I wanted to check in with you because you have seemed pretty down lately.”
  • Questions you can ask:
  • “When did you begin feeling like this?”
  • “Did something happen that made you start feeling this way?”
  • “How can I best support you right now?”
  • “Have you thought about getting help?”
  • “You are not alone in this. I am here for you.”
  • “You may not believe it now, but the way you’re feeling will change.”
  • “You are important to me.”

Being supportive of a loved one with depression will go a long way. This can take patience and extra compassion, but allowing that person to feel loved is key to them overcoming depression.

Source: helpguide.org

 

Two years ago, when he made the decision to tell the world about his diagnosis of bipolar disorder, KSTP-TV meteorologist Ken Barlow could only guess what kind of reaction he would get.

“I could have lost my job,” he said. “I could have lost my friends. I had no idea what was going to happen, but I felt like I just couldn’t hold it in anymore.”

In 2007, after a lifetime of manic bursts followed by debilitating depressions, Barlow was diagnosed with bipolar I disorder. For five years, fearing that the truth about his mental illness could have a negative impact on nearly every aspect his life, Barlow told only a select few people about his diagnosis. And even those people were sworn to secrecy.

Read the full article here.

Source: Minnepost.com
Artcile by: By Andy Steiner

Mental health in word tag cloudDual Diagnosis Treatment

Dual Diagnosis Treatment is much more common that it once was. Years ago, addiction and mental health disorders were treated separately. In fact, many believed that one had to overcome addiction first in order to work on mental health disorders. Research shows that working on both addictive disorders (alcoholism, drug addiction, gambling addiction, sex addiction or another behavioral addiction) and mental health disorders (depression, bipolar disorder, anxiety disorders, schizophrenia, a personality disorder, etc.) can result in successful outcomes.

So, instead of drawing a hard line between psychiatric health and addiction, the two areas of addiction and mental health are treated as part of a continuum. Therapists and clinicians who work in addiction recovery treatment can now receive training and credentials in the treatment of co-occurring mental health disorders. Also, many rehab facilities now offer recovery services that are personalized for clients with a Dual Diagnosis.

However, research shows that finding the right rehabilitation program can still be challenging, especially if individuals are struggling with depression or anxiety as well as substance abuse. Interestingly, The Office of Applied Studies, a division of the U.S. Department of Health and Human Services, reports that in 2002, just 12 percent of the 4 million American adults who suffered from a Dual Diagnosis received adequate treatment for both conditions.

If an individual meets the diagnostic criteria for a mental health disorder and an addictive disorder, they can be classified as a Dual Diagnosis client when entering treatment. The best treatment for a Dual Diagnosis should involve considering both the addiction and the mental illness when going through the recovery process.

Dualdiagnosis.org indicates that to increase the chances of recovering fully, one’s care should include:

“Parallel treatment of your mental health and substance use disorders by the members of a highly trained treatment team

Acknowledgement of the importance of psychotherapeutic medications, such as antidepressants or anti-anxiety meds, in the treatment of co-occurring disorders

A supportive approach to therapy that reinforces self-esteem and builds self-confidence instead of confronting the client with negative, aggressive statements

An inclusive treatment strategy that brings partners, spouses, children and other household members into therapy for individual counseling, group meetings or education

‘Sequential treatment’ was the norm before the 1990s, when clinicians believed that there should be a division between mental health treatment and addiction rehabilitation, note the authors of the text Integrated Treatment for Dual Disorders: A Guide to Effective Practice. In the sequential approach, clients with a Dual Diagnosis were excluded from one area of treatment until they were considered stable in the other. For instance, a depressed person with active alcoholism might not be able to receive therapy for depression until she had been through detox and rehab. Sequential treatment became less popular as research showed that it led to a higher rate of relapse.”

If an individual is struggling with both addiction and mental health issues, it would benefit them greatly to explore the possibilities of Dual Diagnosis Treatment.

Source: dualdiagnosis.org

 

 

whitismentalhealthAdult ADHD and addiction

Recently, psychcentral.com posted an article written by Natalie Jeanne Champagne regarding Adult ADHD and Addiction.  In this very informative article, Champagne discusses the important fact that ADHD is often difficult to diagnose in adults.  This is most likely why more children are diagnosed with ADHD than adults.  In fact, Champagne suggests that 1-5% of adults who have ADHD do not realize they are struggling with it.

In regards to addiction, many studies have shown that there is a high correlation between ADHD and the development and exhibition of addictions.  Champagne points out that those suffering from ADHD who have not been diagnosed or are not treating their ADHD exhibit a much more frequent incidence of addictive behavior than those who do not suffer from ADHD or those who are being treated for ADHD.

One may wonder why this correlation is so prevalent.  Again Champagne cites research conducted that enlarges understanding this correlation: “Addiction and ADHD Adults,” Carl Sherman quotes a study by Timothy Milens, MD: “In our study…only 30 percent [of participants] said they used substances to get high… Seventy percent are doing it to improve their mood, to sleep better, or for other reasons” (2007). Sherman goes on to elaborate that abuse of substances, when connected to adult ADHD, often is based on a need to self-medicate the symptoms: “…This kind of ‘self-medication’ seems especially common among individuals whose ADHD remains undiagnosed or who have been diagnosed but have never gotten treatment” (2007).

Most of the research conducted focuses primarily on how nicotine and alcohol addiction correlate with ADHD sufferers.  In fact Champagne cites Carl Sherman who indicates that, “A recent survey found that more than 15 percent of adults with the disorder had abused or were dependent upon alcohol or drugs during the previous year. That’s nearly triple the rate for adults without ADHD” (2007).

However, it has been found that other drugs are often abused as well when an individual suffers from ADHD.  This includes cocaine, which can provide temporary relief from the frustrating symptoms of ADHD. The medication used to treat ADHD has stimulant properties and affects the same area of the brain as stimulant drugs (cocaine), though to a lesser (safer) degree. Primarily because of this, the potential for abuse among those being treated with adult ADHD, especially those who have a history of substance abuse, is difficult and requires a comprehensive approach.

Further, it is interesting to note that adults suffering from undiagnosed ADHD may engage in addictive behavior can prevent addictive cycles if they receive a proper diagnosis and proper treatment.  With these tools, they will be less likely to turn to drugs or alcohol, and less likely to succumb to addiction.

© 2019 Turning Point Centers | All Rights Reserved
Font Resize