A process in which simultaneous conditions are identified and diagnosed which can include eating disorders and alcoholism, schizophrenia and illicit drugs is referred to as a ‘dual diagnosis’ or also known as ‘dual disorder’. It is a diagnosis that refers to someone who has both a mental illness as well as a substance abuse problem. It suggests that two disorders are occurring at the same time, however there can be more than two disorders relating to either the substance abuse or mental illness. When diagnosed, the medical practitioner views one of more symptoms of one disorder that are established which is independent on the other disorder, but not just a number of symptoms that come from the same disorder. However multiple disorders re-occurring at the same time can also be classified as a dual diagnosis. In comparison to the individuals who have a mental health disorder and a substance abuse problem, the rates are considerably higher than the general public. Dual diagnosis patients experience more severe and chronic medical, social and emotional problems. It often leads to worsening of the psychiatric disorder which in return leads to the addiction relapse (American Psychiatric Association, Diagnostic and Statistical Manual of Mental Disorders, Fourth Edition).
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A high consumption of alcohol or drugs leading to leading to dependency is commonly referred to as alcoholism or substance abuse. These are chronic disorders with highly mental and physical consequences to the individual suffering from the known disorder. Substance abuse is characterized by a physical dependence upon the illicit drug, such as cocaine to prevent symptoms of withdrawal due to increased tolerance to the drug. Known as a co-occurring disorder, it usually develops alongside other illnesses/disorders such as an eating disorder. Eating disorders and cocaine addiction frequently occur in most cases. A major problem that exists between eating disorders and cocaine use is that the addiction for the drug is a stronger force than the complications that the individual may face due to the mental illness, however severe it may be. In the case of eating disorders, individuals cannot properly comprehend the fact that the drugs is in fact making the symptoms of their eating disorder much worse, which is why the need for alcohol has increased and will continue to increase and the tolerance level will not go down leading to worsened condition of their mental illness as well as their substance abuse problem.
Addiction to an illicit substance is a disease that affects brain function and behaviour. In a research conducted in Australia, nearly 50% of individuals with an eating disorder also have a substance abuse or alcohol problem which is a rate nearly 5 times greater than what is seen in the general population (Substance use and Eating disorders, National Eating disorders, Amy Baker Dennis & Bethany Helfman).
Substance abuse and eating disorders such as anorexia nervosa or bulimia nervosa are interconnected, one affecting the other with death rates higher from both the medical complications that the individual may face in the time as well as high risks of suicide. This particular dual disorder can cause cardiovascular disease, cancer, stroke, hepatitis B and C, as well as lung disease and cognitive changes and irregularities within the body and brain shown to be quite evident. In the past 20 years, the number of individuals with eating disorders combined with cocaine addiction has almost doubled, but only 10% of those have received any kind of treatment. Out of those who are treated, only 35% are at a special eating disorder facility and almost 80% of the individuals who get treatment aren’t in therapy long enough to achieve a full recovery. It has been highlighted that teenagers in the age of 13 start or try illicit substances (Integrated Treatment of Substance Abuse & Mental Illness)
Substance abuse are mostly influenced by genetics, biological, environmental and psychological factors
As a health practitioner who is treating individuals who are have present symptoms of a mental illness and a substance abuse problem, it is the duty of the health/medical practitioner to find an integrated program that supports the medical as well as physical and psychosocial treatments that will be the most effective in the recovery of both a substance addiction and the eating disorder Substance use and Eating disorders, National Eating disorders, Amy Baker Dennis & Bethany Helfman).
In addition also being aware of the connections between eating disorders and cocaine addiction can be quite advantageous in the treatment plans. In the event of educating the public, small seminar or sessions can be held for the public in order to gain some information about the disorders
Drugs, whether it’s overusing and becoming dependent on prescription medication or illicit drugs, both almost always worsens the underlying mental illness. Abuse of drugs results in a worse prognosis for a person with a mental illness who are actively using are less likely to follow with their treatment plans and often miss appointments with their medical health practitioner leading to adverse outcomes. The treatment of these co-occurring disorders are complicated and depending upon the individual and type of treatment given and received. Many people who are undergoing treatment go through the process of stopping their drug and alcohol abuse. This can include inpatient detoxification which can involve being admitted in hospital or a detoxification facility, with the addition of medications to minimize serious complications of substance withdrawal.
Research has indicated that individuals undergoing psychiatric treatment is more effective if they are not actively using substances such as drugs and patients who have safely been removed the use of drugs from their lives. It is very hard to treat these co-occurring disorders, however not impossible. The interventions that are used to treat a dual diagnosis disorders are more effective when the individual is sober and more able to actively participate in treatment. Some interventions can include inpatient rehabilitation centers or supportive housing. Some patients choose to return home to their family and friends for support and encouragement to continue their efforts as well as further encouragement. Some individuals find therapy to be a very helpful part to stay sober and away from drugs such as cognitive behavioural therapy as well as self help groups such as Alcoholic Anonymous, Narcotics Anonymous or Smart Recovery (Substance use and Eating disorders, National Eating disorders, Amy Baker Dennis & Bethany Helfman).
Dual diagnosis services involve developing the capability of hospital and community based alcohol and drug, mental health treatment and support services to improve health outcomes of individuals with a dual diagnoses.
In addition to providing hospital and community based services, it also provides primary, secondary as well as tertiary consultations with health practitioners who give you the best support and treatment available, both young and adult. Furthermore, providing education and training on dual diagnosis which is critical with patients who have a mental illness and a substance abuse problem (Eastern Health- Dual Diagnosis, 2014).
In conclusion, to be able to make the general public understand that even if their loved one is going through a similar situation, these conditions or disorders are treatable but seeking professional help is crucial. Understanding the connection between these two disorders can aid in the individuals need to seek professional help and treatment. By being aware of the resources and medical facilities and specialists that around you can further help you into making your decision. In order to recover and lead a normal and healthy life, one always has to make a step forward out of their comfort zone and take on the world, one step at a time.
REFERENCES
http://www.betterhealth.vic.gov.au/bhcv2/bhcarticles.nsf/pages/Dual_diagnosis
http://www.dualdiagnosis.org/eating-disorders/
http://www.psychologytoday.com/conditions/co-occurring-disorders
http://www.fairwindstreatment.com/dual-diagnosis-treatment-a-unique-approach-proven-results/
http://www.nationaleatingdisorders.org/substance-abuse-and-eating-disorders
http://www.easternhealth.org.au/services/mentalhealth/adult/dualdiagnosis.aspx
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