It is never easy to deal with a serious mental disorder or an addiction. Imagine the plight of a person struggling with both, most likely unaware of at least one of these problems. It is, therefore, always challenging to treat patients suffering from dual diagnosis – the condition which involves concurrent symptoms of a mental illness and a substance use disorder. In many instances, there has been displeasure shown about the kind of treatment provided. An outdated approach to dual diagnosis treatment poses serious threat to the sufferer as recovery is most unlikely. Treatment is critical, but very few get it – pushing them toward self-medication and thus, worsening the United States’ opioid epidemic.
Even though the shortage of dual diagnosis treatment has been a matter of concern for almost all the states, it’s particularly bad in Arizona. According to Dr. Michael Franczak, director, population health at Partners in Recovery Medical Services, the number of beds available in Arizona is much less than the number of people requiring treatment. As a result, emergency rooms and residential treatment are overused with no long-term outcome.
He said the type of services needed for the patients of dual diagnosis, or cooccurring disorders, were “not readily available” as recommended by the American Society of Addiction Medicine.
In the words of Dr. Bobbie Erke, director (integrated substance recovery services) at Partners in Recovery, “What’s available is not a place that anyone would send our loved ones to.” According to an estimation by Dr. Erke, almost 50 percent of people suffering from a mental illness were also afflicted with an addiction at the same time.
This meant that they had a tendency to get dependent on alcohol or cocaine, or in more serious cases, on opioids. This causes concern because dependence on opioids induces a painful withdrawal. When doctors, in the course of treatment, cut off the opioids from prescription, the patients turn to unregulated street drugs, which only aggravates their psychotic state.
Getting help for dual diagnosis
The families of dual diagnosis patients often have to struggle in finding proper treatment for symptoms ranging from depression to severe hallucinations and paranoia. What causes the problem now is the fact that the treatment system for mental illnesses and substance use disorders are quite different. Many a times, this could be the cause that both treatment systems attempt to avoid taking on the responsibility of patients in case of complicated cases of dual diagnosis.
Adding to this, even those patients who are able to get admission to a treatment center may find it difficult to get a proper care for their symptoms as it poses a major challenge for medical professionals to find the perfect treatment for the dually diagnosed patients. This could be because they have a different set of techniques for both, which is made complicated mainly by the overlapping of symptoms. For instance, professionals treating mental health problems often believe that substance abuse is mainly the response to mental illness and hence, minimize the treatment for concurrent substance abuse.
Since dual diagnosis is an illness that affects the mental state of a person, recovery is slow as it is difficult to convince the patients to be regular with their medications. In many instances, centers are forced to turn away the patients who don’t seem to be showing any inclination to get clean. It is not easy for the family members to deal with all these hurdles and find the best treatment when the options are limited and the demand is on the rise.
Dual diagnosis and homelessness
Co-occurring disorders are more common among homeless people. This section of the patients have limited access to integrated care, which is critical for recovery. One way for the people who have been on the streets to get access to integrated care is to implement integrated screening and assessment throughout the homeless system of care.
Stigma is another major hurdle to treatment. David Satcher, surgeon general of former President George W. Bush, wrote in Mental Health: A Report of the Surgeon General: “Stigma deters the public from wanting to pay for care and, thus, reduces consumers’ access to resources and opportunities for treatment and social services. A consequent inability or failure to obtain treatment reinforces destructive patterns of low self-esteem, isolation, and hopelessness. Stigma tragically deprives people of their dignity and interferes with their full participation in society. It must be overcome.”
Relapse and recovery
Dick Dunseath, whose son has been a dual diagnosis patient (schizoaffective disorder and addiction), advocated expanded services for those suffering from dual diagnosis during a recent public meeting. He said he was tired of hearing the word “recovery” and that majority of the providers he came across tried to cut corners by taking on the easy cases because they work out better for them financially; while more challenging cases, like his son, cost money.
Arizona, New York or California, there are fewer dual diagnosis treatment centers in the states across the U.S. However, Sovereign Health is a renowned name as far as treatment for dual diagnosis in California is concerned. Our dual diagnosis treatment centers in California adopt an integrated approach to both the co-occurring disorders, resulting in effective treatment with minimal chances of a relapse.
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