Research Paper
Individuals with dial diagnosis suffer from higher health risks and higher rates of relapse, hospitalizing, suicide, and non-adherence to treatment attempts. This paper discussed the implications of the addictive cycle and its impact on the issues it creates for patients who have reoccurring addiction issues as well as an overlying psychiatric diagnosis that may be poorly managed, especially without proper treatment and support from trained professionals. Christian counselors can play a key role in the treatment of said individuals, although there are areas of freedom and caution that will be addressed.
Psychiatric Commodity in Individuals with Substance Use Disorders Epidemiological studies Of substance use disorders among individuals with mental illness provides evidence that the two disorders often co-exist and that the majority of psychiatric patients also have a co-occurring substance use disorder. (Clinton and Scale, 2013) It is important to clarify that the addiction experienced by such an individual is not the root cause of their psychiatric disorder, even though it may be intricately intertwined with it. The presence of these two disorders has been associated with poorer outcomes.
Dual diagnosis is associated with more frequent relapses and hospitalizing, higher suicide rates, and risk of violence, as well as higher rates of combine medical illnesses and higher risk for non-adherence to treatment. (Bass, Karakas, & Motto, 201 3) It is imperative to treat each co-occurring patient individually and to treat both the mental illness and substance abuse independently. As Christian counselors attempt to support these individuals in their journey to recovery, there are areas of freedom and caution associated with the treatment process.
Description of the Issue Biological aspects of Dual Diagnosis The high commodity of psychiatric and substance use disorders may be related to gender, age, reward deficiency, neurological factors, individual vulnerability to certain substances in patients with psychiatric disorders. The high prevalence of SUDS in patients with psychiatric disorders has sometimes been interpreted as self-medication, but only a small amount of evidence supports this theory. Port that personality traits can influence substance abuse in patients with psychiatric disorders; Individuals with a dual diagnosis show higher levels of sensation seeking, impulsively, antisocial personality raids, harm avoidance and neurotics, compared to psychiatric patients with no addiction. “Childhood trauma and post-childhood chronic/repeated stress could increase the risk of a substance use disorder. Stress and substances of abuse both activate stress and deprogramming motivation systems, and childhood trauma and post-childhood stressful events are more chronic and occur more frequently in people who use substances.
Stresses increase risk to initiate early use potentially by affecting trait-like factors Of risk-taking, decision making, and behavioral control. Stresses increase risk for abuse and penitence, attenuate motivation to quit, and increase relapse risk potentially by intensified assassination Of motivational systems. ” (Margin, Song, and Alan, 2014).. Social factors that could play a role in an individual’s substance use such as, but not limited to: visualization, stresses of parenting, hopelessness, music, religion, advertising, and life goals. Dowdies, 201 5) Diagnostic Challenges and Treatment The majority of individuals admitted to a substance abuse treatment facility will exhibit symptoms of a psychiatric disorder and the time of admission. Active substance abuse and/withdrawal from these substances can magnify r simulate symptoms of psychiatric disorders. Diagnosis can be further complicated given that each condition is often viewed as a stigmas which could cause the client to experience shame, fear as a result of forceful questioning. A client may refuse access to psychiatric care.
Because many dual-diagnosis clients feel hopelessness, they have little personal motivation to stop abusing the chemicals that bring them relief from their emotional distress. “A co-occurring patient’s diagnosis is an ongoing process that will need to be modified as the client recovers from the substance withdrawal. Generated psychiatric symptoms can serve as a relapse trigger fir renewed substance abuse. ” (Dowdies, 2015) Mock and Aria, (2011) suggest that mental health and socioeconomic status partially explain the association of childhood trauma with chronic illness in adulthood.
They report that as a result of experimentation that mental health shows a stronger effect. Also, higher socioeconomic status is a potential protective factor for those with a history of trauma. Cumulative disadvantage socioeconomics following trauma may lead to chronic illness and suggest the need for resources such s counseling and income supports to prevent or reduce psychological harm and chronic illness resulting from traumatic events.
The Importance of Treating Dual Diagnosis Clients Expert and Inform (2004) report that, “as a whole, this population has worse treatment outcomes, higher health care utilization, increased risk of violence, trauma, suicide, child abuse, and neglect, and involvement in the criminal justice system; more medical commodity, particularly Of infectious diseases; and higher heath care costs than people with a single disorder. ” (p. 03) Dowdies (2015) suggests that substance abusers seek to self dedicate their emotional pain by abusing alcohol and drugs and perhaps, some individuals with mental illness are drawn to substance use for the same reasons that others do. Many dual-diagnosis clients believe that the stigma associated with substance abuse is less severe that that associated with mental illness. Therefore, many of these individuals substitute the less severe stigma of having and Substance Abuse Disorder for that of the mental illness.
Clinical Issues Substance Abuse Treatment Theories Stemming from the discovery in the late sass that most common diseases ere the product of bacterial infections, the biomedical model has taken the forefront in the understanding of most medical issues. However, Substance use Disorders have called for numerous explanations encompassing biological, psychological, and societal theories. (Dowdies, 201 5) Addiction is best understood as a convergence of a number of factors.
There is no agreement about a particular disease process or pathway to addiction or recovery. (Jenkins, Addictions and Recovery: Addiction Models) It can be understood that “no single factor alone, is a reliable predictor of an individual’s future substance abuse behaviors”. Dowdies, 2015). The biological components of a Substance Use Disorder are the effects of that disorder on the biological functioning of the individual: referring to the anatomical, structural, and molecular substrates of a disease. In the early sass, E. M.
Jelling made an argument that alcoholism was a disease, just like cancer or pneumonia. He reasoned that alcoholism presented specific symptoms that included loss of control over and individual’s drinking habits, progressive physical and psychosocial problems, and if left untreated, it could lead to death. (Dowdies, 2015). Dry. David Jenkins, Sys D. Cuisses what he calls the “Dispositional/ Disease Model” of addiction by referring to the causes of alcoholism or addiction as solely biological, rooted in heredity and physiology. He describes behavioral, family, and personality disturbances as mere symptoms of the disease, representing the underlying physical abnormality in the body that is especially reactive to the substance/behavior. The psychological components of Substance Use Disorders can be characterized by theoretical approaches that explore the impact of psychodrama forces, learning, motivation, interpersonal interactions, and rationalist on an individual’s substance use behaviors. Dry. David Jenkins, Sys. D. Emphasizes that personal choice and individual responsibility are responsible.
Additional models stress that there is an underlying disturbance in the person’s personality which contributes to addiction, addiction exists because the individual has learned to engage in substance abuse, or that Us absence abuse may be a learned coping mechanism for those who suffer from a variety of stresses or other issues. (Dowdies, 201 5) The sociological perspective of Substance See Disorders use various horses to try to identify systemic issues within society that may influence an individual such as cultural, environmental, and familial elements of a person’s life. Dowdies, 2015) Dry. David Jenkins explains in his presentation that larger social forces and factors such as peer pressure, social policies, availability of substances, etc. Contribute to the development of addiction. The Addictive Cycle and Dual Diagnosis Patients When a person engages in addictive behavior or drug use and abuse, they usually fall victim to an addictive cycle. Clinton and Scale (2013) insist that hen a person experiences an unmet need in their life, or a significant source of pain, they eventually hit bottom.
This pain or unmet need could be the result of a multitude of events. A person who experiences the symptoms Of a mental illness could feel the need to self-medicate or utilize a substance to cope with these unpleasant symptoms. Once a person finds themselves in a miserable and desperate state, they begin to seek relief from their pain or their symptoms. The seeking motive results in the individual using and/or doing something that he/she believes will bring about a level of relief which exults in a level of reprieve.
However, this result is generally short-lived and the individual feels consequences such as guilt or shame resulting in a crash. Realizing that their temporary reprieve did not eliminate their problem, they must then again, seek relief. After the cycle has been completed, the individual then experiences an even greater pain or need and they then hit bottom even harder, which means that they long for relief even more, and thus, they then require more of whatever they have used or done in order to achieve the same level of relief that they previously experienced. (Clinton and
Scale, 2013) Dual diagnosis patients often experience difficulty in seeking and receiving adequate treatment which all too often results in a “revolving door” where a patient is admitted for stabilization, discharged with prescription medication, would stop taking these medications due to a multitude of reasons, decontaminates, and require re-hospitalizing. (Dowdies, 2015) Therefore, psychiatric disorders and substance use disorder must be addressed independently as to reduce the involvement of an individual’s participation in the addictive cycle. Christian Worldview implications Spiritual Model of Addiction
Supporters of the spiritual model of addiction, suggests that Substance Use Disorders rest in part upon a spiritual weakness with in the individual. Dowdies (2015) describes a “Disease of the Human Spirit” which does not fit with the biological models given that the human spirit, as this author calls “spirit’s” cannot be explored though science and does not exist. Psychologically, disease of the human spirit has potential for acceptance given that a person’s mind is thought to control their addiction. If a person is a believer in a higher power and their addiction is taking over, then they will e psychologically impacted.
