If a person is dually diagnosed with a severe mental illness and a substance abuse problem, are improvements in their mental health or in their substance abuse more likely to reduce the risk of them being violent in the future? Dual diagnosis is a term used to describe people with mental illness who have co-existing problems with drugs and/or alcohol. Some may think that treating the mental illness is more likely to reduce the chance of future violence, a study from the University at Buffalo Research Institute on Addictions (RIA) suggests that reducing substance abuse has a greater influence in reducing violent acts by patients with severe mental illness.
Clara Bradizza, senior research scientist and co-author of the study says, “We were surprised to find that the severity of the patient’s psychiatric symptoms was not the primary factor in predicting later aggression. Rather, the patient’s substance abuse was the factor most closely associated with future aggression.”
Although certainly not all patients with mental illness have episodes of violence, the risk of violence among the mentally ill is greater than that of the general population. The link between severe mental illness, substance abuse and aggression is definitely a concern for community safety, treatment programs and government policy.
Bradizza says, “Our findings suggest that treatment attendance is very important for these individuals and treatment programs should include interventions that are likely to decrease substance abuse, as this may provide the additional benefit of reducing the risk of later aggression among dual-diagnosis patients. This not only improves the lives of affected individuals and their families but also provides a safer environment for society as a whole.”
Drugs and alcohol can be a form of self-medication. In such cases, people with mental health disorders may have untreated or improperly treated conditions, such as anxiety or depression that may be made less painful by drugs or alcohol. Sadly, these provide only temporary relief and ultimately make it worse. A person suffering from depression may become suicidal when drinking alcohol and a person prone to panic attacks may have worsening symptoms during heroin withdrawal. Drugs and alcohol can cause a symptomless person to experience symptoms of mental illness for the first time.
When patients with mental health disorders abuse drugs or alcohol the prognosis is always poor. They are much less likely to follow a course of treatment and to take their medication on a regular basis. They often miss appointments with therapists which can lead to a worsening of their condition and possible hospitalization. Active users are also less likely to get prompt medical attention when needed and are more likely to suffer medical complications and premature death. People with mental illness and substance abuse are at an increased risk of impulsive and violent acts, but most concerning is they are more prone to attempt suicide and die from the attempt.
People with mental illness and substance abuse are also less likely to achieve lasting sobriety. They may experience severe complications from substance abuse and end up in legal trouble while unable to refrain from using. Treatment is difficult and the primary need is to take care of any life threatening symptoms. These might include severe cases of intoxication needing emergency medical treatment, use of drugs such as crack, amphetamines, cocaine and other drugs can cause heart failure, stroke and death. Use of benzodiazepines, opiates and other ‘downers,’ can result in extreme drowsiness and death if overdose occurs.
Drug and alcohol withdrawal can lead to medical emergencies requiring immediate treatment. This occurs when an addict abruptly stops using. Alcohol withdrawal can result in heart problems such as arrhythmias, seizures or delirium tremens, all of which can be potentially fatal. Benzodiazepine withdrawal can lead to tremors (the shakes), seizures and even death. Opiate withdrawal is not thought to be life-threatening but can be very traumatic and painful. Assistance for such patients can include inpatient detox at a hospital or treatment center and medications to ease the pain of withdrawal. Once the patient is clean, treatment for the mental health disorder can take place. Although that treatment can take place while the patient is still using, it is much more effective when they are not. Patients are much better able to participate in their treatment when they are clean of drugs or alcohol.
For the newly sober there are options, for some, inpatient rehab is best while others can manage in a sober living house or a residential treatment facility. Others are able to return home and with the support of family and friends, can hopefully maintain sobriety. The support of family and friends is crucial to maintaining sobriety; the continuing encouragement supports the goal of remaining sober.
Cognitive behavioral therapy can work wonders and certain medications prescribed by the patient’s doctor can assist in maintaining recovery. If family members can accompany the patient to the doctor and discuss the situation and possible medications it is to the patient’s benefit.
Sovereign Health Group understands the treatment of the patient and the disease are paramount when dealing with dual diagnosis. It is this very reason that Sovereign has only the best in the field to help those who are in trouble and are in need of assistance. For further questions, please call 866-554-5504.
Written by Veronica McNamara, Sovereign Health Group writer