When a mental illness and an addiction are present within an individual, these two types of disorders are said to be co-occurring. Co-occurring mental health and substance abuse disorders are more common than one might think. In fact, about half of all Americans who have a substance abuse disorder also have a mental illness of some type. The opposite is also true. Half of all Americans whose primary diagnosis is a mental illness also struggle with addiction.
Kentucky is a state in the Southern United States and is home to about 4.4 million people. The Bluegrass State boasts rolling, grassy hills and peaceful landscapes. The state is affected by mental health and substance abuse issues nonetheless. Substance abuse, particularly the prescription drugs along with heroin, has been identified as one of the most pressing crises within the state of Kentucky.
In Kentucky, about 206,000 individuals 12 years of age or older in 2014-2015 had an alcohol use disorder. This number makes up about 5.6% of Kentucky's population of individuals 12 and older. Approximately 23,000 people in Kentucky were enrolled in substance use treatment in one day in 2015, this was a sharp increase from 2011.
From 2011 to 2015, Kentucky's annual use mental health service within the past year among adults aged 18 or older with any mental illness was 42.9%. This means that 53.1% of mental ill Kentuckians did not receive treatment of any kind. This is a high percentage of untreated mental illness within the state. In 2015, 56,515 children and teens under the age of 17 were served in Kentucky's public mental health system.This number is lower than the nation as a whole.
All in all, there is room for improvement in Kentucky in terms of the provision of care for the mentally ill and addicted persons.
There is a genetic risk factor for both substance use and certain mental health disorders, however all instances of the co-existence of these disorders are not attributed to genetic makeup. There are other factors which can lead to a co-occurrence of mental illness and substance abuse. These factors include family history, environmental stressors, life stressors, and traumatic life events. Still, these other outside factors affect a person's genes. Stress can cause permanent changes to genes that can even be passed to the next generation. Reversal and improvement is possible in these cases, treatment is required.
Drugs affect different people differently. Individuals with mental illness may be more biologically susceptible to the effects of mood altering substances. For these folks, using a substance can be exponentially more harmful to the brain than if a person without a mental illness were to use the same drug. Additionally, they may use drugs or drink alcohol to cope with mental health symptoms or to help their social anxiety in comfortable situations.
People who have a mental health disorder are at much higher risk of also having a substance use disorder and, conversely, people who have a substance use disorder are at much greater risk of developing a mental health disorder. These two types of disorders are undoubtedly interrelated to a large degree.
Believing that you or a loved one is facing co-occurring disorders can be a scary situation. In order to help yourself or your loved one it is crucial to know the signs and symptoms to look for in a dual diagnosis since these cases tend to be more complicated. Although it will take a trained professional to diagnose the specific disorders, there are obvious signs and symptoms that can point one in the right direction.
Inability to tolerate being sober/cannot engage in normal activities without using first
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Treatment and recovery is possible for people with co-occurring mental health and substance disorders. These types of cases have proven difficult to manage in the past, but through research and development, many improvements have been made to the provision of care and outcomes were dramatically improved. The main improvement stemmed from research done in the 1990s. The researchers found that instead of treating the disorders separately and sequentially, it was much more effective to treat them simultaneously. This is now known as an integrated approach to care.
Using this integrated approach, an unified team of medical professionals work together under the same roof to provide treatment for patients with co-occurring disorders. The team will create an unique plan for each individual requiring treatment. These plans are individualized, but most follow a similar trajectory of detoxification, inpatient or outpatient rehabilitation, transitional housing and continuing care. These are the tried and true methods clinicians have been using for years to help patients on their way to recovery.
Often the first step in treatment is to take the patient off of a drug or drink safely. To safely bring someone off harmful substances can be tricky. The body may require tapering doses to be administered in order to preserve the sensitive organs and tissues within the body. Patients in detox centers are able to receive these tapering doses as well as any pain management medication they might need to remain comfortable through the detox process. Detoxification clinic staff are trained to hold safety as their highest priority and will always ensure that the patient is physically as well as mentally and emotionally safe. Detoxing from a drug of choice can be a difficult thing to overcome and caring staff is there to support patients every step of the way.
Whether or not a patient needed to spend time in a detox center, the actual treatment for addiction and mental illness begins in a rehabilitation program. For many people, the best choice is the most immersive choice, inpatient rehabilitation. For those who enter into inpatient facilities, every facet of their life is temporarily interrupted creating the ideal mental space to incorporate healthy changes. If a patient remains within a familiar environment, such as at home, it is easy to remain stuck in old habits. Checking in to a residential treatment facility may be the absolute best option for most people needing to make a huge change in their lives. Treatment programs are individualized based on each patient's needs. However, many plans include psychotherapy, medication, and some alternative therapies such as acupuncture or massage.
The most effective form of psychotherapy used to treat addiction and mental illness is cognitive behavioral therapy (CBT). CBT therapists use techniques that enable a patient to observe the harmful patterns of thought and behavior that are contributing to their illnesses. Once the thoughts and behaviors are observed and recognized, there is a change for these patterns to be interrupted and eventually eliminated. Therapists not only strive to help a patient to eliminate the toxic patterns, they also guide patients to replace them with new, healthy patterns that allow a patient to cope with life's stressors in an effective and productive way.
After a patient has graduated from their rehabilitation program, many are encouraged to move into transitional housing for a time. When a person is newly sober and first in recovery, they are at their most vulnerable. The goal is for the new healthy coping mechanisms and mental wellness tools to remain in effect within the person and for that person to learn to use them in the real world. Life in transitional housing is conducive to achieving these goals. Patients have a greater degree of liberty than they had in treatment, but still enjoy a level of support and structure within the walls of a transitional community. Transitional housing communities offer financial education, occupational therapy, case management, and transportation to medical appointments. These communities tend to be affordable so they are extremely inclusive in terms of cost of living. This is an advantage for those who are freshly coming out of rehab and attempting to get back on their feet.
It is important that patients continue to work on their recovery when treatment is completed. Doing so helps to ensure a positive outcome in their case. In order to continuing care, patients must continue to attend their therapy sessions and take their prescribed medications. Continuing care also includes peer support groups and self-help groups. Patients are able to become connected to these types of groups during their stay in transitional housing and there are also a wide variety available outside of these channels.
References
https://www.samhsa.gov/data/sites/default/files/Kentucky_BHBarometer_Volume_4.pdf
https://odcp.ky.gov/Documents/2015%20KY%20ODCP%20Overdose%20Fatality%20Report%20Final.pdf
https://www.drugabuse.gov/publications/research-reports/common-comorbidities-substance-use-disorders/why-there-comorbidity-between-substance-use-disorders-mental-illnesses
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