Understanding Dual Diagnosis in Addiction Treatment

Drug and alcohol addiction carries with it certain stigmas, the most troubling of which is that addiction is a choice, and that as a choice, the addict or alcoholic is able to “turn off” his addiction at the drop of a hat.

Such appraisals are both insulting and ill-informed.

Addiction is much more than the decision to imbibe without end or to engage in the unadulterated abuse of prescription pills and/or other narcotics. Addiction may actually be a symptom of something much larger and much more insidious.

Evolving methodologies in drug and alcohol addiction treatment have ushered in a prevailing approach to recovery: the idea of dual diagnosis. Dual diagnosis operates under the belief that, often, addiction does not present itself alone and that it doesn’t appear as if from nowhere. Dual diagnosis espouses that, in conjunction with substance abuse, there may be psychological issues present that exacerbate addiction and that may become exacerbated by said addiction.

The Treatment of Dual Diagnoses

Someone suffering from the condition of dual diagnosis – also referred to as comorbidity or co-occurring disorders (COD) – has presented with substance abuse problems and psychological issues, and addiction may prove insurmountable unless both are treated. The question as to whether they should be treated concurrently has been wildly debated, but in our opinion, treatment is most effective when all of a client’s needs are being addressed in tandem by use of a precisely individualized treatment plan.

Treatment will ideally work to address any of a bevy of issues ranging from depression to schizophrenia, and these illnesses may be brought on by anything from physical or psychological trauma, problems with family or in relationships, financial stressors, or hormonal imbalances. Truly, because of the complexity of the human experience, the treatment of a dual diagnosis can be long and arduous.

Disorders may be pre-existing or substance-induced. Because of this, prior to the evaluation and treatment of co-occurring disorders, a client must sufficiently detox< so as to rid the body of any drugs or alcohol present. This is supremely important in that the influence of drugs and alcohol may present certain symptoms – such as psychosis and depression – that may be misdiagnosed as psychiatric episodes, thus stalling potentially effective addiction treatment. Once detox is completed, healing can begin.

Dual Recovery

As we and others in our field always say, “Recovery is a lifelong process.” With the advent of industry-wide understanding of dual diagnoses, recovery has expanded to include not only recovery from addiction, but recovery from psychological and emotional troubles as well. Comprehension of dual diagnosis becomes all the more important once a psychiatric evaluation gives way to a determination of a mental affliction. It is important that, as the transition from addiction to sobriety takes place, a client realizes that addressing his or her personal issues is equally – if not more – important. The complexity of substance abuse is such that the disease of addiction may prove a symptom of something greater, and it is only through the admission and acceptance of one’s flaws – be they mental or physical – that true recovery can be achieved.