The cause of the problem is not essential in certain mental illnesses, but it is vital to find the most effective treatment in other cases. This is known as the dual pathology in which the lack of knowledge about the psychiatric causes behind addiction to drugs can result in unsuccessful treatment.
In the words of Miguel Casas, professor of psychotherapy of the Autonomous University of Barcelona and the president of the Spanish Society of Dual Pathology (SEPD) Dual pathology refers to “a way of seeing drug addiction and psychiatry in an integrated way.” Accept the fact that there is an undisputed connection with mental health and substance abuse.
Ignacio Benito, a psychologist at the Ita Addictions and Dual Pathology center located in La Garriga (Barcelona), clarifies that dual pathology can be known as “the concurrence in the same individual of, at least, one substance use disorder and another psychiatric disorder”. The expert states that dual pathology sufferers “are frequent and more serious, both from a clinical and social perspective, than subjects who only suffer from one type of disorder (addictive or another psychiatric illness)”.
The issue is: what is the cause and what are the consequences? For instance, do those who suffer from mental illness are more likely to take in addictive substances or is it the addiction to drugs that causes the development in mental illnesses?
A mental health issue as risk factor
Casas clarifies the most frequently occurring pattern of the elements. According to estimates, as high as 25% of people is likely to suffer from a severe mental disorder at some time throughout their lifetime. “These problems are the main vulnerability factor for people who come into contact with drugs to get hooked,” the doctor says, adding that, in comparison to the vast majority of people who have tried cigarettes, alcohol and heroin as well as other narcotics there are fewer who develop an addiction.
An excellent illustration is alcohol drink: a large portion of people consume at least once in a while or at least has tried it. However, there are people (although the number isn’t minimal) who are alcohol addicts. “Usually the psychiatric pathology appears first and then the drug addiction” is the conclusion of the psychiatrist.
Benito states the following “people who have a genetic predisposition to suffer from a mental illness, that is, they have a certain vulnerability – the pathology is dormant or latent – and due to the consumption of a certain substance, they end up developing it”.
The most suitable treatment
The treatment of these patients can be complicated There are some effective treatment options. For instance, Casas considers that the most important thing to do is “to locate the psychiatric pathology and treat it; it is essential to look for the origin of drug abuse, which is almost always a mental illness”.
However, Benito points out that “to work in multidisciplinary teams and tackle both problems at the same time is very important.” The initial stage is “performing well in stabilisation and detoxification for a proper differential diagnosis. There are those who, because of their consumption, develop a different mental disorder, as well as others whom the underlying pathology disappears”.
The profile of patients who are affected by dual pathology
In terms of the appearance of the addicts is concerned, experts believe it is important to dispel the myths linking addiction to education as well as cultural or social class.
The perception of a person who is suffering from a mental disorder, using drugs due to being separated of their family members, living in broken families or living in an secluded area isn’t reality for dual patients who could be from any social class. “Having adequate social and family support can be important to get out of this situation, but not for the beginning” says Casas.
Nowadays, there is an increasing tendency among these people to polydrug polydruguse (using several substances at the same time) however Benito affirms his assertion that “alcohol, cannabis and cocaine are the most common substances”.
How do you deal with patients
The way in which the environment is perceived of the patients affected has an enormous influence on the beginning and the proper monitoring of the treatment for dual pathology. Here are some aspects to be considered:
The people who suffer from addiction often refuse treatment and often stop using substances. When they are in a state of vulnerability they may seek help, but later reject the idea.
Family involvement in the course of treatment is crucial They must be aware of the condition, understand it and adhere to the experts’ directions.
The idea of labelling patients as violent or lazy is not helping to comprehend their condition and to initiate the best treatment.