Program Development for the Dual-Diagnosed

Topics: Mental disorder, Psychiatry, Drug addiction Pages: 5 (1624 words) Published: August 19, 2013
I live in Maylene, Alabama which is within Alabaster which is one of the fastest growing cities in Alabama. Alabaster has grown more than 63% in the last ten years. The fast growth has made Alabaster a profitable place to do business and the demand for retail and restaurants is high. Alabaster’s crime rate is one of the lowest in Shelby County which makes it an attractive place to live. With its fast growing economy, Alabaster has much opportunity for employment (City of Alabaster). Though industry is high, opportunities for mental health care are low. Shelby County has a mental health clinic, though it is not located in Alabaster. Alabaster has some psychiatry services, though none are non-profit or work on a sliding scale pay rate. There are opportunities for individuals who have health insurance to obtain services, though the resources for low income individuals or the unemployed are slim. Shelby County Mental Health Clinic would be the nearest resource that would be available to Alabaster citizens, though treatment may be challenging if transportation is an issue.

Alabaster has a population of 30,991 with 79% being white, 13.5% black, and 9% Hispanic or Latino. Individuals between 25 and 34 make up the highest percentage of this population (US Census Bureau). Alabaster’s limited resources and its high percentage of young adults would make it an ideal place to introduce a substance abuse clinic specializing in dual-diagnosis. Inaba and Cohen (2007) point out that in recent years more attention has been placed on treating people with a dual-diagnosis. The rates of individuals with an SMI and SUD (substance use disorder) vary depending upon the type of mental illness. Individuals suffering from “bipolar disorder have an incidence of co-occurring disorders approaching 75%” (Inaba & Cohen, 2007, p. 32). Inaba and Cohen also note that 47% of individuals with a thought disorder, such as schizophrenia also suffer with an SUD and 81% of incarcerated individuals with an SUD have some type of mental illness (2007, p. 520). It is difficult for those who are not only mentally ill but suffering from the disease of addiction to be adequately treated for a number of reasons. Leventhal & Zimmerman (2010) assert that often patients who have been given a dual diagnosis “receive partial care-receiving all their treatment in either a psychiatric clinic or a substance abuse clinic-or fragmented care by attending two separate programs” (p. 363). The therapists and facilities responsible for treating these patients may not have the resources to treat them effectively. Leventhal & Zimmerman (2010) point out that individuals who abuse drugs seem to require more treatment and have poorer outcomes than other patients with mental disorders. They further assert that this complication to mental illness by substance abuse compounds both direct and indirect costs of the illness to society.

There are several different theories to why those with existing mental disorders may be more susceptible to drug addiction. Among the hypothesis for an increased vulnerability to drug dependence among those with pre-existing psychiatric disorders is an individual’s desire to self-medicate to relieve their symptoms (Dixon, Sweeney, & Frances, 1999).

Drugs like heroine or dilaudid which increase the release of neurological transmitters such as dopamine may give individuals with psychiatric disorders temporary relief by reducing psychotic and depressive symptoms (Dixon, Sweeney, & Frances, 1999). Though these individuals may receive temporary relief of their symptoms for a time, prolonged abuse of opiates will inevitable increase the symptoms of their mental illness due to altering brain chemistry as well as producing compounding problems associated with drug addiction. Bradizza et al., (2009) claims “individuals with a severe mental illness (SMI; I.e., schizophrenia, bipolar disorder) and a substance use...

References: Bizzarri, J., Rucci, P., Vallotta, A., Girelli, M., Scandolari, A., et al. (2005). Dual Diagnosis and Quality of Life in Patients in Treatment for Opiod Dependence. Substance Use & Misuse, 40, 1765-1776.
City of Alabaster. (2013). Retrieved from:
Dixon, L., Haas, G., Weiden, P., Sweeney, J., & Frances, A
Leventhal, A. M. & Zimmerman, M. (2010). The Relative Roles of Bipolar Disorder and Psychomotor Agitation in Substance Dependence. Psychology of Addictive Behaviors, 24(2), 360-365.
Lyvers, M. (1998). Drug Addiction as a Physical Disease: The Role of Physical Dependence. Experimental and Clinical Psychophaimacology, 6(1), 107-125.
Mueser, K. T., Bellack, A. S., & Blanchard, J. J. (1992). Comorbidity of Schizophrenia and Substance Abuse: Implications for Treatment. Journal of Consulting and Clinical Psychology, 60(6), 845-846.
Mueser, K. T., Drake, R. E., Ackerson, T. H., Alterman, A. I., Miles, K. M., et al. (1997). Antisocial Personality Disorder, Conduct Disorder, and Substance Abuse in Schizophrenia. Journal of Abnormal Psychology, 106(3), 473-477.
Salloum, I., Williams, L., & Douaihy, A. (2008). Diagnostic and Treatment Considerations: Bipolar Patients with Comorbid Substance Use Disorders. Psychiatric Annals, 38(11), 718-723.
Siris, S. G. (1990). Pharmacological Treatment of Substance-Abusing Schizophrenic Patients. Schizophrenia Bulletin, 16(1), 111-122.
United States Census Bureau. (2012). Retrieved from:
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