Identifying and treating underlying psychiatric disorders in people suffering from substance abuse can be extremely tricky, and is a relatively new approach originating in the 1990s. Symptoms of a disorder can, at times, closely mimic the symptoms of substance abuse (and vis versa)—particularly if the case is severe. The similarities between the two problems can be so easily confused that a proper, accurate diagnosis and subsequent recovery can take years. Sometimes, the only way a physician can be sure they’ve identified the correct diagnosis is after the patient cleanses his or herself of drugs/alcohol and has completely detoxified.

Profound Treatment’s Los Angeles Dual Diagnosis Treatment Program:

Since we at Profound Treatment understand this need for a more complex, holistic treatment plan, we offer dual diagnosis treatment programs. Dual diagnosis programs are constructed to specifically help individuals with a need for two, simultaneous treatments: one for drugs/alcohol and one for an underlying disorder. To treat each issue separately is to put the patient at a much higher risk of relapse, since one issue could very well be fueling the other.

Typically, the most common psychiatric disorders amongst substance abusers include:

  • Depressive disorders
  • Anxiety disorders
  • Personality disorders

At our treatment facility in Los Angeles, we treat a variety of the above disorders and more, such as:

  • Anxiety disorder
  • Depression
  • Bipolar disorder
  • Personality disorders
  • Panic disorder
  • ADHD

Why is dual diagnosis treatment important?

Roughly a third of alcohol abusers and half of drug abusers have at least one serious mental disorder, and a little under a third of those who are mentally ill are prone to abuse drugs/alcohol. This correlation stems from an epidemic of self-medicating: to feel happier, calmer, etc., people turn to alcohol or drugs, which, in turn, can fuel dependency and subsequent addiction. Because of this, successful treatment plans must analyze and address the psychiatric, emotional, and physical/chemical needs of each person for patients to see real results.

How is dual diagnosis treatment different?

Dual diagnosis combines the most effective components of mental health and substance abuse care by handling both as a continuum, rather than treating them separately. Indeed, the US Department of Health and Human Services reported in 2002 that only 12% of those suffering from a psychiatric disorder and substance abuse problem received the care they needed through a dual diagnosis treatment plan, making this an extremely underserved, and vulnerable, group of people.

All the individuals on our team of medical professionals specializing in dual diagnosis treatment have studied co-occurring mental health disorders in depth, and have received extensive training in this field. Because of this, we can offer personalized treatment plans that cater to each patient’s specific needs, all at once. Through our dedicated treatment program, our patients get the help they need, minimizing their risk of falling prey to the cycle of psychiatric disorders and substance abuse.

How do I get a dual diagnosis?

All our patients that suffer from both psychiatric disorders and addiction receive the care they need through our dual diagnosis program. When you join our west Los Angeles treatment facility, our team of mental health and addiction specialists will evaluate you. From there, you can enroll in our multi-disciplinary treatment program, putting you on the path to a more sustainable, long-term recovery.

What are the signs/symptoms that I might need dual diagnosis?

Candidates for dual diagnosis exhibit classic signs of addiction, such as:

  • Neglecting friends and family
  • Changing sleep patterns
  • Consistent relapses
  • Experiencing withdrawal
  • Failing or struggling to fulfill responsibilities (such as schoolwork)
  • And expressing guilt about their compulsive behavior.

along with the symptoms of a psychiatric disorder, which vary widely, but may include:

  • Deliberately withdrawing from loved ones
  • Having trouble fulfilling responsibilities (like holding down a job) due to mood swings
  • And dramatic mood swings and changes in energy levels.

Dual Diagnosis Treatment

Dual diagnosis (also called co-occurring disorders, COD, or dual pathology) is the condition of suffering from a mental illness and a comorbid substance abuse problem. There is considerable debate surrounding the appropriateness of using a single category for a heterogeneous group of individuals with complex needs and a varied range of problems. The concept can be used broadly, for example depression and alcoholism, or it can be restricted to specify severe mental illness (e.g. psychosis, schizophrenia) and substance misuse disorder (e.g. cannabis abuse), or a person who has a milder mental illness and a drug dependency, such as panic disorder or generalized anxiety disorder and is dependent on opioids. 

Diagnosing a primary psychiatric illness in substance abusers is challenging as drug abuse itself often induces psychiatric symptoms, thus making it necessary to differentiate between substance induced and pre-existing mental illness when going into dual diagnosis treatment .

Those with co-occurring disorders needing dual diagnosis treatment face complex challenges. They have increased rates of relapse, hospitalization, homelessness, and HIV and hepatitis C infection compared to those with either mental or substance use disorders alone.

The identification of substance-induced versus independent psychiatric symptoms or disorders has important treatment implications and often constitutes a challenge in daily clinical practice in dual diagnosis treatment. Similar patterns of comorbidity and risk factors in individuals with substance induced disorder and those with independent non-substance induced psychiatric symptoms suggest that the two conditions may share underlying etiologic factors in dual diagnosis treatment.

Dual Diagnosis Treatment

Drug abuse, including alcohol and prescription drugs, can induce symptomatology which resembles mental illness, which can make it difficult to differentiate between substance induced psychiatric syndromes and pre-existing mental health problems in dual diagnosis treatment. More often than not psychiatric disorders among drug or alcohol abusers disappear with prolonged abstinence. Substance induced psychiatric symptoms can occur both in the intoxicated state and also during the withdrawal state. In some cases these substance induced psychiatric disorders can persist long after detoxification, such as prolonged psychosis or depression after amphetamine or cocaine abuse. Abuse of hallucinogens can trigger delusional and other psychotic phenomena long after cessation in dual diagnosis treatment of use and cannabis may trigger panic attacks during intoxication and with use it may cause a state similar to dysthymia. 

Severe anxiety and depression are commonly induced by sustained alcohol abuse which in most cases abates with prolonged abstinence. Even moderate sustained use of alcohol may increase anxiety and depression levels in some individuals that need dual diagnosis treatment. In most cases these drug induced psychiatric disorders fade away with prolonged abstinence. A protracted withdrawal syndrome can also occur with psychiatric and other symptoms persisting for months after cessation of use. Among the currently prevalent medications, benzodiazepines are the most notable drug for inducing prolonged withdrawal effects with symptoms sometimes persisting for years after cessation of use inside dual diagnosis treatment.

Prospective epidemiological studies about dual diagnosis treatment do not support the hypotheses that comorbidity of substance use disorders with other psychiatric illnesses is primarily a consequence of substance abuse or dependence or that increasing comorbidity is largely attributable to increasing use of substances.

Yet emphasis is often on the effects of substances on the brain creating the impression that dual disorders are a natural consequence of these substances. However addictive drugs or exposure to gambling will not lead to addictive behaviors or drug dependence in most individuals but only in vulnerable ones, although, according to some researchers, neuroadaptation or regulation of neuronal plasticity, and molecular changes, may alter gene expression in some cases and subsequently lead to substance use disorders that necessitate dual diagnosis treatment.

Research instruments are also often insufficiently sensitive to discriminate between independent, true dual pathology, and substance-induced symptoms. Structured instruments, as Global Appraisal of Individual Needs – Short Screener-GAIN-SS and Psychiatric Research Interview for Substance and Mental Disorders for DSM-IV-PRISM, have been developed to increase the diagnostic validity. While structured instruments can help organize diagnostic information, clinicians must still make judgments on the origin of symptoms.