What is the relationship between alcohol or drug abuse and mental illness? Does drug abuse lead to mental health problems? Is mental illness a cause of drug and alcohol abuse? The answer to these questions may not be found in trying to determine which came first: mental illness or drug abuse; but rather in understanding that both can and often times do co-exist with one another at the same time.
According to the Alcohol, Drug Abuse and Mental Health Administration, fifty percent of Americans with severe mental illness also abuse drugs or alcohol. The term most often used to describe this condition is dual-diagnosis. In additional to dual diagnosis, other terms used are co-morbid disorders, co-occurring disorders, concurrent disorders, or dually diagnosed disorders. The US Surgeon General's 1999 Report stated that 7 to 10 million Americans have co-occurring disorders.
Of those, 41-65% who abuse substances have at least one mental health disorder and 51% of those with a lifetime mental illness have at least one substance abuse disorder. The occurrence of dual-diagnosis among criminal justice populations is even higher with 72% of jail booking detainees that have a severe mental disorder also have substance abuse dependence based on a 2005 study.Current research suggests that only 19% of those with dual-diagnosis receive the appropriate form of treatment for this condition. Instead, many are treated in programs or centers that specialize in substance abuse or mental health but not both at the same time. Research also shows that those who are dually diagnosed are three times more likely to receive treatment for mental health than for substance abuse.
Those suffering from dual-diagnosis need a specialized form of treatment that combines mental health with substance abuse treatment. This form of treatment is often referred to as Integrated Substance Abuse and Mental Health Treatment. It has been shown that integrated treatment for those with this condition when delivered over a sufficient length of time results in significant reductions of substance use and improvement of severe mental health conditions, such as depression, schizophrenia, and bipolarity.
Dual diagnosis treatment tends to take longer than standard drug and alcohol addiction treatment. The presence of a mental health illness is a complicating factor that needs extended and specialized care. Treatment staff must be trained and experienced in both the medical and clinical treatment of mental health issues and substance abuse because there are often both physical and psychological symptoms that must be diagnosed and treated. Physical symptoms associated with substance use and abuse can mask or exacerbate underlying mental health conditions. The treatment of dual diagnosis in addiction treatment is crucial because, if the mental health component is ignored, the mental health condition may hinder a long term recovery from chemical dependency.