Dual Diagnosis and Opiate Addiction: Unraveling the Links Between Drug Abuse and Mental Health

Waismann Institute on Dual Diagnosis and Opiate AddictionIn the United States, an estimated 23.5 million people struggle to control their use of drugs or alcohol.  Individuals dealing with opiate dependence represent a significant proportion of the total drug abusing population.  Among people who need treatment for opiate dependence, approximately 37% also have another mental health problem, reports the Substance Abuse and Mental Health Services Administration.  These so-called “dual diagnosis” situations make it important to receive responsible, scientifically validated treatment for opiate dependence.

What Is Dual Diagnosis?

Simply put, dual diagnosis is a situation in which a person has one or more other mental health problems in addition to opiate dependency.  This might include a diagnosis of major depressive disorder, an anxiety disorder, posttraumatic stress disorder (PTSD), or serious mental illness such as bipolar disorder or schizophrenia.

From a diagnostic point of view, a mental health professional will ask careful questions about the timeline of drug use, mood, anxiety, and symptoms of psychosis.  This is important to gain a good picture of what might be affecting a person.  For example, if periods of depression occur only when a person is under the influence of prescription opiates, he or she would not necessarily be given a depression diagnosis.  Rather, depression may be viewed as a side effect of the drug use.  If, however, the person has been experiencing a dark and depressed mood during times without drug use, a depression diagnosis might be appropriate.

Which Comes First, Mental Health Problems or Opiate Abuse?

The dual diagnosis label often leads patients to ask the “chicken or the egg” question.  Which comes first, the mental health problems or the opiate dependence?  The answer is complicated, and scientists continue to research how opiate use and mental health are related.

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In some individuals, prolonged use of opiates causes them to sink into a depressive spiral or triggers episodes of anxiety.  When opiates cross into the brain, they change the structure and function of the brain’s reward circuitry.  This may make a person more sensitive to changes in mood, anxiety, and responses to traumatic events.  As a result, prolonged opiate use may trigger episodes of mental health problems.

In other people, mental health problems come first.  Living with depression, bipolar disorder, schizophrenia, and other mental illness is immensely challenging.  As a result, many people turn to opiates and other drugs to dull their pain.

Why Dual Diagnosis Makes Treatment More Challenging

Unfortunately, the Substance Abuse and Mental Health Services Administration estimates that just 7.4% of dually diagnosed people receive treatment for both conditions.  More than half receive no treatment at all.  Fortunately, with proper care, people with a dual diagnosis can recover from substance abuse and mental health problems.

Most treatment experts believe that it is best to treat both problems — the opiate dependence and the mental health issues — concurrently.  In fact, many people find that making progress in one realm of functioning also affects the other.  For example, learning new coping strategies to deal with depressed mood sometimes decreases a person’s drive to take drugs.  Similarly, undergoing a sedation-assisted detoxification procedure alleviates acute withdrawal symptoms, which may result in improved mental health status.

If you or a loved one has been struggling with opiate use and related mental health problems, do not wait to seek treatment.  The Waismann Method offers a state-of-the-art approach to opiate detoxification and compassionate after-care.  All clients who come to our facility receive a detailed, personalized treatment plan with specific goals that match their unique needs.  Contact us today to see how we can help.