Dual Diagnosis And Recovery By Rabia Zaidi
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Dual Diagnosis And Recovery By Rabia Zaidi

“Schizophrenia with the dual diagnosis of addiction”

Co-morbidity or dual diagnosis, is defined by United Nations Office on Drugs and Crime, if a person is diagnosed as having an alcohol or drug abuse problems in addition, usually psychiatric; e.g. mood disorder, schizophrenia; 2000. It refers to coexistence of two or more psychological disorders.

Williams explains different kinds of dual diagnosis in 2002:

• Primary mental illness: consequences of the illness leads to drugs misuse.

• Primary substance misconduct with psychiatric situations: lead to psychological symptoms, i.e; stress, depression

• Common conditions: bio/psycho/social factors. i.e; family dysfunction and conduct disorder with drug use

Krausz (1996) categorizes four dual diagnosis:

• The diagnosis of mental ailment, with a consequent dual diagnosis of substance misconduct that inauspicious effects on mental health.

• Diagnosis of drug dependency with psychiatric difficulties leading towards to mental issues.

• Co-occurrent identification of substance usage and psychiatric diseases.

• Dual diagnosis of substance utilization and mood disturbance, both resulting a traumatic experience, for example: PTSD.

In the occurance of dual diagnosis, when someone has a direct contact with a mental and substance abuse problems side by side. This classification can range from someone have mild depression because of drinking, to someone’s symptoms of bipolar disorder becoming more intense when that person uses heroin during periods of mania. A person have experienced a mental health condition may turn into drugs and alcohol in a form of self-medication to change the troubling mental health symptoms. Research shows that alcohol and other life threatening drugs only make the symptoms of mental health conditions worse, the effects of drugs on a person’s moods, thinking, brain mechanisms and behavior.

Morel (1999) compare non-specific psychiatric disorders found among addicts from complications specifically connected with drug use. Disorders among drug utilizers include:

• Anxiety disorders.

• Sleep disorders, result of depression, anxiety disorder or psychosis.

• Aggressive and violent behaviour, highlighted antisocial, psychopathic, schizophrenic or paranoid personality disorders.

• Pharmaco-psychoses evoked by hallucinogenic drugs or amphetamines;

• Chaos syndromes.

• Panic anxiety

• Obsessive compulsive disorders

• Substance abuse most dominates over any other disorder; (Buckley, Miller Lehrer, and Castle, 2009).

Researches on neuro-psychological and neuro-biological and advancement enable brain processes to visualized about the relationship between mental and physical trauma, development of brain, drug effects, stress and mental development, and addiction is directly connected to structural changes and adaptation of the brain at low and high levels (Nestler, 2001).

Theories link particular drugs to particular mental disorders, e.g. it has been suggested that heroin low stress, enhance pain and abolish alarming voices in schizophrenic and other borderline schizophrenic patients; however, patients with severe mental problems do not use heroin. Cocaine could lighten depressive states, behavioral disinhibition and permit narcissistic people to act out grandiosity. Cannabis relieve tension and ecstasy ease in social inhibitions (Verheul, 2001; Berthel, 2003).

People with schizophrenia; abuse substances, street drugs, over-the-counter drugs or alcohol). Studies shown about half of all people with schizophrenia have problems with drugs and alcohol, and up to 90% of population with schizophrenia are the common users of nicotine. The combination of mental illness and substance disorder is usually considered as “ongoing disorders” or “co-occurring disorders”, but in USA it is called as “dual diagnosis”.

Study comprised on 22 participants, all who were dually diagnosed with schizophrenia and abusers. After doing the intake paperwork, completing medical history and diagnosis, (age, current state) only few of the 22 cases schizophrenia was exposed before they experienced the onset of drug abuse.

New Zealand research on birth companion of 1073 people born in 1972 and 1973. At the age of 11 psychotic issues were judged from self reports. Same procedure at, 15 to 18 years, the participants were examined with reference to their cannabis usage. At the age of 26, psychiatric signs were measure by using an authentic consultation schedule to obtain diagnostic level. 759 study members have indicated that cannabis consumers by age 15 and 18 reveal more schizophrenic illness at the age of 26 than controls.

Theories link particular drugs to particular mental disorders, e.g. it has been suggested that heroin low stress, enhance pain and abolish alarming voices in schizophrenic and other borderline schizophrenic patients; however, patients with severe mental problems do not use heroin. Cocaine could lighten depressive states, behavioral disinhibition and permit narcissistic people to act out grandiosity. Cannabis relieve tension and ecstasy ease in social inhibitions (Verheul, 2001; Berthel, 2003).

People with schizophrenia; abuse substances, street drugs, over-the-counter drugs or alcohol). Studies shown about half of all people with schizophrenia have problems with drugs and alcohol, and up to 90% of population with schizophrenia are the common users of nicotine. The combination of mental illness and substance disorder is usually considered as “ongoing disorders” or “co-occurring disorders”, but in USA it is called as “dual diagnosis”.

Study comprised on 22 participants, all who were dually diagnosed with schizophrenia and abusers. After doing the intake paperwork, completing medical history and diagnosis, (age, current state) only few of the 22 cases schizophrenia was exposed before they experienced the onset of drug abuse.

New Zealand research on birth companion of 1073 people born in 1972 and 1973. At the age of 11 psychotic issues were judged from self reports. Same procedure at, 15 to 18 years, the participants were examined with reference to their cannabis usage. At the age of 26, psychiatric signs were measure by using an authentic consultation schedule to obtain diagnostic level. 759 study members have indicated that cannabis consumers by age 15 and 18 reveal more schizophrenic illness at the age of 26 than controls.

Treatment programs includes:

• Imperative outreach to enroll people who are often unwilling to come forward for help, courage and handling.

• Motivational criteria that move towards therapy, it lead to goals they define for themselves.

• An extent that go beyond reducing alarming signs of schizophrenia and substance abuse, including: social, work and housing support.

• An extended perspective based on improving people’s quality of life and a belief in the possibility of recovery.

A progress that combines both mental well being and addiction services in one program is the most beneficial

Treatment Programs:

Families have probably discovered, service systems have not been well structured with this people in mind. Technically a community has treatment benefits for people with mental disturbances in one agency and treatment for substance abuse in another. Clients are invoked back and forth between them in what some have called “ping-pong” therapy, resembling to table tennis. What is needed are “hybrid” service that address both the illnesses together. Creation of these programs locally requires considerable efforts.

Awareness is strength and gives you a better chance of developing effective coping strategies.

Compared to people who do not use substances, undergoing schizophrenia who take non-prescribed drugs and abuse alcohol generally:

• Usually ended in hospital or in jail.

• Exposure of relapses of their substance use and mental health disorder.

• Less likely to stick with and be successful in following self-planning.

• Greater issues with their physical health.

• Many problems with finances, household and personal relationships.

• Suicidal ideations, become aggressive, hostile.

Dual diagnosis practice in different states, nationally financed mental health takes responsibility for giving treatments and services for clients with severe mental illness, those clients have mainly been added to community functions within the system. Interventions during the 1980s examined the application of conventional substance abuse treatments, such as 12-step groups. These studies had disappointing results for at least two reasons. The clinical programs did not take into consideration, the complex needs of the public, and researchers had not yet resolved basic problems. For example: initial programs usually neglect to incorporate outreach and motivational interventions, and checking criteria were not upto the mark level because of lack of reliable and valid assessment of substance abuse. A series of demonstration projects using more detailed programs that incorporated assertive outreach of rehabilitation began to show effective results. It creates motivational interventions to clients who did not acknowledge their difficulties.

Around 50% of patients suffering with schizophrenia have co-occurring substance abuse disorder, most frequently alcohol and cannabis. Symptoms of drug misconduct or drug withdrawal resemble the symptoms of schizophrenia. Withdrawal symptoms from alcohol, cocaine, or heroin can cause episodes of distorted thinking and visual or auditory hallucinations in excessive users. During the detoxification, addicts may think that they persecuted by others or pursued by legal authorities, there is no authentic justification for these beliefs.

Patients will have 24-hour care, they are tapered off drugs and other medications. Patient’s first procedure is detoxification, it may take weeks, and when a patient has a severe disorder, doctors will also balance medications and symptoms to make sure the patient’s safety. Once detoxification is complete, it leads to therapy, to manage their mental issues and learn to avoid triggers and to take medications properly. Cognitive behavior therapy (CBT) is commonly used with psychotic disorders. Antipsychotic medications frequently used to help patients maintain their level, maintain brain function and return to normal life. Depending on their intensity of an episode, to look after patients all the time, day and night and to have medications adjusted regularly.

Nearly half of all diagnosed schizophrenics in United States abuse drugs or alcohol. Marijuana usage may also play a factor in schizophrenia in few individuals. Study published in 2011, Journal of Neuroscience. Another study published in 2012 in the named: Journal Current Pharmaceutical Design. The effective components in marijuana, called tetrahydrocannabinol (THC), it has an an extreme effect on two different structures in the brain, one is prefrontal cortex and the other is hippocampus; that play a vital role in human ability to make judgments and form memories. These brain structure signs of distortion are the symptoms of schizophrenics.


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