Almost one out of every five American adults aged 18 and older in 2014 suffers from some form of a mental health disorder each year. These mental health issues may disrupt a person’s ability to interact with the world, making changes to moods, behaviors, and thinking, the National Alliance on Mental Illness (NAMI) reports. Mental illness may vary in severity. According to NAMI, 10 million adults in the United States in any given year battle a mental illness severe enough to disrupt daily life functioning and abilities.
Almost 22 million Americans aged 12 or older had issues with substance abuse or dependence in 2013, the National Survey on Drug Use and Health (NSDUH) publishes. When an individual uses drugs or alcohol regularly for a period of time, a chemical and psychological dependency may occur, and substance use may no longer be controllable creating social, emotional, physical, and behavioral concerns.
Substance abuse and mental illness may be complexly intertwined and often occur together. The Substance Abuse and Mental Health Services Administration (SAMHSA) reports that close to 8 million American adults battled both a substance use disorder and a mental health disorder in 2014. The presence of both an alcohol or drug use disorder and a mental health disorder in the same person at the same time is known as co-occurring disorders, per Psychology Today. Mental illness can increase the side effects of drug or alcohol abuse just as abusing substances can exacerbate mental illness symptoms.
When an individual suffers from co-occurring disorders and is chemically dependent to drugs or alcohol, medical detox is needed. With medical detox, highly trained professionals monitor vital signs and mental health 24/7 until the toxins from the substances of abuse are completely detoxed from the body. A complete drug screen and evaluation is an important tool to ensure that all medications that may be used to manage withdrawal symptoms will not have negative interactions or consequences related to the substances abused.
Motivational Interviewing (MI) is a style of counseling that is often helpful in assessing and treating co-occurring disorders, as it is nonconfrontational and goal-oriented. MI can serve to help individuals find inner motivation to want to change for the better while accepting where they are in their recovery. Behavioral therapies, such as Cognitive Behavioral Therapy (CBT) and Dialectal Behavior Therapy (DBT), may be beneficial methods that use both group and individual therapy sessions to facilitate improved self-image and healthier coping mechanisms.
Co-occurring disorders are complex, and no two people will experience them in exactly the same way, meaning that treatment plans should be individually tailored to suit the specialized needs of each person. SAMHSA recommends integrated treatment models for co-occurring disorders as the optimal choice for simultaneous and comprehensive care for both a mental illness and problematic substance abuse.
Behavioral therapies seek to uncover the root causes of substance abuse and/or mental illness in an effort to help individuals learn how to manage potential triggers and process stress, trauma, and intense emotions. Medications are often part of the treatment plan for mental illness in order to balance brain chemistry that may be unstable. When a substance abuse disorder is also present, healthcare providers may need to use caution when prescribing certain pharmaceuticals.
Someone with a history of substance abuse or addiction, for example, may be best served to use alternatives to benzodiazepine medications, which are anxiety-reducing drugs with a potential for abuse. The National Institute of Mental Health (NIMH) recommends using benzodiazepines for short periods of time, if at all, in those with potential substance abuse concerns.
Medications are typically used as part of an overarching treatment plan that will also include therapeutic methods. All treatment providers should work together to design and carry out a care and recovery plan for co-occurring disorders, in order to ensure that all disorders are treated simultaneously and effectively. Reevaluations should be done periodically to ensure progress is being made.
Support groups are often part of recovery and aftercare services for both the continued improvement of mental health and abstinence from substance abuse. Many 12-Step programs may have traditionally taken a hard line against participants using any type of drugs, even for therapeutic purposes to treat mental illness symptoms. These programs may expect complete abstinence from any type of psychoactive substance. Medications may be an important part of recovery for co-occurring disorders, however, and peer and support groups are available that are more accepting and understanding of these needs.
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