Post by deepthi on Jun 4, 2016 16:11:53 GMT
Dual Diagnosis
Dual diagnosis is a term used to describe when a person is experiencing both mental health and substance use issues. The substance abused can be alcohol, illegal drugs, tobacco or even prescribed medication. It is also commonly referred to as co-morbidity. Sometimes people suffering from mental illness resort to abusing substances in order to ease their symptoms. There has been instances where the use of particular substances have triggered mental illness. Example-the abuse of Ice or Marijuana can trigger psychotic episodes. The recovery of a patient can be prolonged for someone who has dual diagnosis and the chances of relapse is more likely. Statistics show that around 75% of people with a drug and alcohol issue may have a mental health problem and that 64% of psychiatric inpatients have trouble with alcohol and substance abuse. Atleast one Australian dies everyday due to Opoid overdose. It also says that 90% of the male population with schizophrenia may have a substance use issue. This dependence almost always leads to physical or psychological health deterioration, problems with civil law, stable accommodation, finances, education , employment and disruptions in relationships.
Withdrawals and appropriate management of them is one aspect of the training that I found interesting. They are time-limited and specific to each substance, the duration of its usage and the tolerance of the individual. It can confuse the clinical picture and requires appropriate use of the withdrawal scale. The pharmacological treatment of substance abuse is by administering Antidepressants and Antipsychotics. The substitute pharmacotherapy for alcohol abuse is Naltrexone, Acamprosate and Dislufiram . Thiamine is essential for the body to produce energy and the transport, storage, absorption and utilization of Thiamine is disrupted by alcohol and can lead to a high risk for Wernicke-Korsakoff Syndrome. So Thiamine is also supplemented for chronic alcoholics. Australia has developed a unique program of mandatory thiamine fortification of bread and wheat flour to combat this deficiency. Triggers can be of many types and they increase cravings. So a low-stimulus environment is preferred for treatment. Opoid withdrawal is mainly treated by administering Suboxone and Methadone is the substitute drug for Heroin and Morphine addiction. Other types of interventions are: Mindfulness, CBT, Motivational interviewing, Collaborative therapies, health promotion, harm minimisation, linking the clients with community services and promotion of engagement with a group of people dealing with the same problem, example-AA meetings. A person suffering from dual diagnosis must be provided care for his mental illness and also his substance abuse simultaneously. This is a vicious cycle and relapse can occur at any time and therefore a community of acceptance and understanding is essential in its treatment.
Education about Dual diagnosis is easily available and is essential. The Southern Dual Diagnosis team of Monash health offers a range of programs and workshops for clinicians working with dual diagnosis clients and for people who are generally interested. They are offered free of cost to people working in the Public mental health sector, AOD and MHCSS services. The loved ones or family members of an individual suffering from dual diagnosis also require support, adequate communication and must be in partnership with the treating team to develop an optimal care plan. They must also be linked in with supportive community organisations.
Dual diagnosis is a term used to describe when a person is experiencing both mental health and substance use issues. The substance abused can be alcohol, illegal drugs, tobacco or even prescribed medication. It is also commonly referred to as co-morbidity. Sometimes people suffering from mental illness resort to abusing substances in order to ease their symptoms. There has been instances where the use of particular substances have triggered mental illness. Example-the abuse of Ice or Marijuana can trigger psychotic episodes. The recovery of a patient can be prolonged for someone who has dual diagnosis and the chances of relapse is more likely. Statistics show that around 75% of people with a drug and alcohol issue may have a mental health problem and that 64% of psychiatric inpatients have trouble with alcohol and substance abuse. Atleast one Australian dies everyday due to Opoid overdose. It also says that 90% of the male population with schizophrenia may have a substance use issue. This dependence almost always leads to physical or psychological health deterioration, problems with civil law, stable accommodation, finances, education , employment and disruptions in relationships.
Withdrawals and appropriate management of them is one aspect of the training that I found interesting. They are time-limited and specific to each substance, the duration of its usage and the tolerance of the individual. It can confuse the clinical picture and requires appropriate use of the withdrawal scale. The pharmacological treatment of substance abuse is by administering Antidepressants and Antipsychotics. The substitute pharmacotherapy for alcohol abuse is Naltrexone, Acamprosate and Dislufiram . Thiamine is essential for the body to produce energy and the transport, storage, absorption and utilization of Thiamine is disrupted by alcohol and can lead to a high risk for Wernicke-Korsakoff Syndrome. So Thiamine is also supplemented for chronic alcoholics. Australia has developed a unique program of mandatory thiamine fortification of bread and wheat flour to combat this deficiency. Triggers can be of many types and they increase cravings. So a low-stimulus environment is preferred for treatment. Opoid withdrawal is mainly treated by administering Suboxone and Methadone is the substitute drug for Heroin and Morphine addiction. Other types of interventions are: Mindfulness, CBT, Motivational interviewing, Collaborative therapies, health promotion, harm minimisation, linking the clients with community services and promotion of engagement with a group of people dealing with the same problem, example-AA meetings. A person suffering from dual diagnosis must be provided care for his mental illness and also his substance abuse simultaneously. This is a vicious cycle and relapse can occur at any time and therefore a community of acceptance and understanding is essential in its treatment.
Education about Dual diagnosis is easily available and is essential. The Southern Dual Diagnosis team of Monash health offers a range of programs and workshops for clinicians working with dual diagnosis clients and for people who are generally interested. They are offered free of cost to people working in the Public mental health sector, AOD and MHCSS services. The loved ones or family members of an individual suffering from dual diagnosis also require support, adequate communication and must be in partnership with the treating team to develop an optimal care plan. They must also be linked in with supportive community organisations.