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Dual Diagnosis

Addictions professionals refer to a dual diagnosis when a patient suffering an addiction also presents with an additional condition, most often psychiatric in nature. A single diagnosis of depression, bi polar disorder, anxiety or borderline personality disorder significantly increases the likelihood of an experienced addiction, and substance use and dependency amongst psychiatric patients is uniquely devastating, and also more complex to treat.

Patients suffering from an existing psychological disorder often use illicit drugs or alcohol as a way of self medicating psychiatric symptoms; and while during intoxication there can be some negative symptoms relief, the use of non prescribed substances invariably exacerbates the intensity of psychiatric symptoms. Self medication too often creates a downward spiral of ever increasing abuse in response to ever worsening psychiatric symptoms.

Additionally, psychiatric patients abusing drugs or alcohol are far less likely to remain complaint on prescribed mental health medications, and even if they remain compliant, the interaction of illicit substance or alcohol often renders these prescribed medications less effective.

Clinical professionals recommend that drug treatment for dual diagnosis patients occur within a residential drug rehab center, unless the severity of psychiatric symptoms discludes safe participation. The rehab treatment can occur as normal, but dual diagnosis patients will need special monitoring, pharmacological interventions, and the treatment for dual diagnosis patients almost always takes longer and requires more intensive therapies than for single diagnosis patients.

The pre assessment intervention needs to be as thorough as possible to get an accurate picture of the severity of abuse and psychiatric symptoms, and to that effect all current case workers and medical personnel should be invited to contribute to the diagnosis and to the development of a care and recovery plan.

All recovering addicts benefit from aftercare treatment, but because of the special challenges facing dual diagnosis patients, aftercare needs to be intensive and long lasting, and should ideally include the participation of a case worker responsible for the progress of the patient; and ready to intervene should circumstances of abuse warrant it. Some dual diagnosis patients also benefit from transitional housing in a sober living environment after rehab.