Addiction and Co-Occurring Mental Disorders:
It’s Not a Simple Battle
by Ned Wicker
When many people examine the problem of addiction, or are asked to offer a solution, they will usually focus solely on the will power of the addicted individual and determine that if a person really wanted to quit, they could. If only it were a matter of will power—that would make the problem so much easier to attack.
But rarely is it just one thing that drives the addiction, so to have successful treatment, addiction professionals must not only focus on the addiction itself, but on ALL of the contributing factors. In most cases, there are other co-occurring mental disorders that aggravate any successful treatment program.
Depression and Addiction OFTEN Co-occur
Co-Occurring Disorders (COD) means that a person with an addiction also has another serious mental disorder occurring at the same time. Depression, Bi-Polar or PTSD are common mental health disorders that “co-occur” with substance abuse and addiction. Addiction often is caused by or causes other mental health problems and any treatment of the addiction must consider these issues.
Dr. David Mays, MD, PhD summarizes the issues
Recently, Dr. David Mays, MD, PhD summarized his conclusions about recent treatment research in this area. The remainder of this article discusses some of what he has found to be useful in treating addiction when it co-occurs with other mental health disorders.
Integrated treatment is the best option
Clinicians often try to treat the whole person, not just one condition, because the two or more conditions can effect the success of treatment. If you miss one, the characteristics of treatment become significantly less useful.
Addiction is often overlooked because it is very hard to treat and often has been present for a long time in the patient. Alcohol or Marijuana addiction often co-occur with depression but are ignored by the doctor because the time required to deal with both issues is not available.
Issues to be considered with treatment
When mental health problems like depression and addiction often co-occur and here are some treatment issues that need to be considered:
- There are worst treatment outcomes for both disorders,
- There is usually higher health care utilization and higher medical costs,
- There is increased risk of violence, trauma, suicide, child abuse, child neglect and criminal justice involvement.
More things to understand about addiction with other mental health issues
- Other characteristics to consider with co-occurrence are:
- There is likely a faster progression to addiction,
- Patient less likely to comply with treatment,
- Patient is more likely to be hospitalized,
- Patient is more likely to commit suicide and relapse faster.
Principles of COD treatment
Here are some more issues to consider when treat someone whose addiction is accompanied by other mental health problems.
Treatment is more likely to succeed if both disorders are being treated, not just one or the other.
Patience and flexibility is required, as it takes four years for 50% of patients to achieve abstinence. They go from wet, to damp to dry. It’s a process.
Clients probably benefit from mental health treatment, even when they are actively abusing a substance.
Some more ideas that can help!
Some general treatment modifications for COD patients would include:
- shorter meetings
- simplified educational components
- increased repetition
- education about proper use of medications
- education on useful vs. harmful drugs
- low confrontation and high support
What Do Clients Say helps Them the Most?
Clients report that stable housing, POSITIVE social support, relying on a higher power, participating in meaningful activity, changing how they think about their lives, attention to eating well, sleeping well and looking good are major factors in their treatment and recovery.
What Gets in the Way?
Addicts with persistent mental illness are often excluded from substance abuse programs. It is often difficult for them to negotiate their way through separate systems, multiple clinicians and different funding streams.
There is considerable research that supports the idea of combining substance abuse and mental health services.
Co-occurrence is very common with addiction
It's important to realize that MANY addicts have an underlying co-occurring mental issue that needs to be address at the same time for addiction treatment to work.
If you or your loved is trying to recover from addiction please consider the issues of co-occurrence and work with your doctor and treatment program to try to fully deal with both issues.
** We're also launching four new
classes which will help you learn how to use motivation, affirmation
and encouragement to end addiction in yourself or a loved one. Each
class will focus on an evidence-based concept, explaining how to illicit positive
in yourself or in someone you love.
We will teach you practical techniques that
research has shown to be effective for achieving change and successfully ending addiction.
We'll begin offering these classes this September through Learn-It-Live (Learn-It-Live is easy to use teaching tool and you don't need to download anything to use it). Click Register Now! below to join one of our classes. The registration process includes setting up an account, but you determine your screen name to protect your confidentiality.
Four new addiction classes:
- Addiction 101, a FREE 60 minute course introducing key substance addiction recovery concepts. This seminar examines many aspects of drug addiction, including symptoms and treatment. It also introduces the Stages-of-Change as a building for recovery. It will be held on Monday November, 6 at 6:00pm central-time.
- Intervention, introduces you to Change-Talk as an alternative to "tough-love". Change-Talk is a method, which you can learn, to get an addict (including yourself) to move away from addiction and toward recovery. This is a 2-hour class that meets Thursday November 9, at 10:00 am central-time at a cost of
- Change-Talk, is a building-block for addiction recovery. This course
teaches you to recognize, listen to, and encourage Change-Talk in yourself and others. Research has shown it helps lead to positive change. This is a 2-hour class on Thursday, October 13 at 10:00 am central-time, for a cost of $10.
- Effective Conversations, explains how to use conversation to connect for recovery. Reflective listening and change-focused conversations often facilitate positive change and addiction recovery. This is a 2-hour class that will meet on Thursday, October 19 at 10:00 am central-time, at a cost of $10.