Dual-Diagnosis in Addiction Treatment

There has been a great deal written and discussed regarding dual-diagnosis in addiction treatment. Dual-diagnosis is when a client is diagnosed with an alcohol/drug use disorder and mental health problems, such as depression or anxiety. In some cases schizophrenia or bi-polar depression can exist along with alcoholism. One disorder can mask the other, so the professional therapist has to sort all this out.

The professional has to determine if the mental health disorders require medication. The professional has to determine if the alcohol and drugs are the main cause of the mental health problems, or if the client abuses alcohol and drugs to deal with the mental health problems. If a client uses alcohol and drugs to deal with mental health disorders, then the professional has to wonder why a person would use alcohol/drugs to deal with mental health problems when the alcohol/drugs don’t alleviate mental health problems and often make them much worse. In fact, with people who experience mental health problems, alcohol and other drugs, like cocaine, can push the person over the edge.

In most instances of long term mental health problems, the person has seen mental health professionals and has been prescribed appropriate medications for the mental health problems, so why is the person using alcohol/drugs instead of the prescribed medication? The answer could be the person is using alcohol/drugs because they have an independent problem with alcohol/drugs. If this condition is misdiagnosed, and the client gets the impression that when they have dealt with the mental health problems they can successfully drink or do other drugs, then the client might experience more problems down the road when the addiction progresses.

A general rule of thumb for some professionals is when there are coexisting problems, first work on removing the alcohol/drug use until the professional knows what they are dealing with. If the person refuses to stop the alcohol/drug use, or can’t, then the therapist gains some very valuable information.