Dual Diagnosis Treatment
in California

Substance Use Disorders – Part One of a Dual Diagnosis

A substance use disorder (SUD), also known as an alcohol use disorder (AUD) or a drug use disorder (DUD), occurs when:

• One has strong cravings for particular substances
• People experience withdrawal symptoms when they minimize or discontinue their use of substances
• Individuals can no longer control their use of substances
• Individuals are allowing their substance use to negatively affect their professional and personal lives

Continuing to use drugs or alcohol after experiencing these signs of a substance use disorder can lead to negative consequences.

SUDs range in severity from mild to severe. People with SUDs can also simultaneously suffer from a wide range of mental health issues.

Dual Diagnosis By the Numbers

The National Survey on Drug Use and Health reported that in 2018, more than 9 million Americans struggled with both a substance use disorder and mental illness.

The same study also looked at Americans with AMI (any mental illness), SMI (serious mental illness), and no mental illness and compared each group’s illicit drug use. The dual diagnosis study found that:

• 37% of adult Americans with any mental illness used illicit drugs in the past year
• 50% of adult Americans with serious mental illness used illicit drugs in the past year
• 16% of adult Americans with no mental illness used illicit drugs in the past year

The dual diagnosis study also looked at alcohol use and mental illness and reported that:

• 32% of adult Americans with any mental illness were binge alcohol drinkers in the past month
• 25% of adult Americans with serious mental illness issues were binge alcohol drinkers in the past month

These statistics from the dual diagnosis study show whether people with AMI or SMI are more likely to abuse drugs or alcohol. Of all the people diagnosed as mentally ill, 29% abused either drugs or alcohol. The type of mental health issues in a dual diagnosis can vary from person to person.

Common Dual Diagnosis Mental Health Issues

Anger

Anger is a primal emotion for humans. When someone is offended or experiences injustice or feels a need to protect something, anger can be quite useful. When anger is appropriately expressed, it can help reveal bothersome issues. After the issue is revealed, anger opens the door to solutions. Once those solutions are introduced, anger should fade.

The problem for some, is that anger is often not expressed appropriately, and thus never fades away. As a result, long after an offense or injustice has occurred, anger lingers.

Sometimes the incident that triggered the emotion of anger happened months or years ago, but the anger remains fresh. As a result, any new issues can cause a quick, intense, and overwhelming response. This shows that the anger never goes away.  Instead, it operates at low-levels, causing bitterness in daily life.

Individuals with a dual diagnosis that involves anger are often put in hazardous situations. This is especially true when people’s inhibitions are lowered due to substance use. Coupling people’s lack of control due to substance use with anger issues can lead to serious situations and consequences. Dual diagnosis rehab with an anger management program incorporated within it can help those with anger problems manage their behaviors while simultaneously undergoing drug or alcohol treatment.

Borderline Personality Disorder (BPD)

People with SUDs were found to be 1.8 times more likely to have a borderline personality disorder. Borderline personality disorder is a mental illness characterized by a repeated pattern of shifting moods, behaviors, and self-image. These patterns result in impulsive actions and relationship problems and an increase in the risk of a dual diagnosis. Signs of borderline personality disorder include:

• Intense episodes of anger
• Depression
• Anxiety

People with borderline personality disorders can also experience the following:

• Initiating intimate relationships quickly to avoid abandonment
• Dissolving a relationship in anticipation of being abandoned
• Many unstable and intense relationships with family, friends, and loved ones
• Switching back and forth from loving relationships to hateful relationships
• Unstable and distorted self-image
• Impulsive and often dangerous behaviors, such as unsafe sex, reckless activities, overeating, and substance abuse

Grief

Unhealthy grief can cause individuals to choose to self-medicate themselves through the use of drugs and alcohol. Such drug and alcohol use can then develop into substance addiction and ultimately a dual diagnosis disorder. Different types of unhealthy grief that can put a person at risk for drug or alcohol misuse include:

• Frozen grief (grief on hold)
• Partial grief (parts of grief are expressed, but the deeper parts are held back)
• Survivor guilt (feeling bad about surviving an event where some else died)
• Unfinished business (feeling bad about an issue that was not dealt with before someone died)

People who do not deal with grief in healthy ways can get “stuck.” This can play a big part in how these individuals behave. Common behavioral addictions include process addictions to food, drugs, alcohol, etc.

To heal from unhealthy grief and addiction, dual diagnosis treatment. Dual diagnosis treatment is also needed to properly mourn sorrows and work through unhealthy grief while simultaneously treating substance use disorders.

Impulse Control Disorder

People with impulse control disorders have a hard time controlling their impulses. It’s also difficult for people that suffer from impulse control disorders to overcome urges to harm themselves or others.

Lacking impulse control often leads to drug use and the eventual development of a dual diagnosis. Once individuals develop a dual diagnosis of impulse control disorder and addiction, they must attend dual diagnosis rehab to receive treatment.

Examples of impulse control disorders include:

• Eating disorders
• Compulsive gambling
• Stealing
• Arson
• Rage

Narcissistic Personality Disorder (NPD)

It’s estimated that 50% of people with narcissistic personality disorder(NPD) have a dual diagnosis with some type of addiction. Symptoms of NPD include:

• An overinflated sense of self-importance
• A preoccupation with boundless success
• A belief that one is special and unique
• The exploitation of other people
• A lack of empathy
• An arrogant attitude
• Jealousy of others

These symptoms cause extreme distress in a person’s life, family, job, and more. To get relief from all these forms of distress, people with NPD may drink or take drugs. Such substance use can lead to addiction and the development of a dual diagnosis disorder that requires dual diagnosis rehab to treat.

Trauma and Post-Traumatic Stress Disorder (PTSD)

People with SUD were found to be 1.6 times more likely to have PTSD. Post-traumatic stress disorder (PTSD) is a disorder that develops out of experiencing psychological trauma. Some examples of a trauma event can be the threat of death, an injury, or a sexual assault. The person that experiences a traumatic event often feels helpless, extreme fear, or deep shock when the event happens.

Afterward, if PTSD develops, the experience of living the traumatic event happens again and again. Thoughts and images related to the event pop up frequently. Nightmares, reliving the event in dreams, and sometimes hallucinations, occur.

People living with PTSD often deal with irritability, insomnia, a high level of vigilance, and an overdeveloped response when startled. People with PTSD will always try to avoid anything related to the event such as feelings, thoughts, or acts associated with the trauma event. As a result, the possibility of developing a dual diagnosis disorder made of PTSD and addiction to drugs or alcohol is increased by attempts to “medicate away” thoughts or feelings that are associated with past trauma.

Dual Diagnosis Treatment Programs in California

Dual diagnosis treatment programs can either be outpatient or inpatient.

Outpatient Treatment for Dual Diagnosis Rehab

Outpatient treatment is any treatment program that allows patients to live in the comfort of their own homes in between treatment sessions. Counseling sessions during outpatient treatment occur a few times (or more) a week. Counseling sessions during outpatient treatment can include individual counseling, group therapy meetings, and family therapy sessions.

Outpatient treatment suits people who have a mild to low-moderate dual diagnosis. Outpatient dual diagnosis rehab is a good choice for anyone who has less severe symptoms and needs time to meet work, school, or family obligations.

Inpatient Treatment for Dual Diagnosis Rehab

Inpatient treatment programs are treatment programs that require patients to live in a rehab facility during the period of time that they’re receiving care. Another term for inpatient treatment is residential treatment.

Residential treatment can last anywhere from several weeks to a month, to several months, or longer. Residential treatment involves one-on-one therapy sessions and group meetings.

Inpatient dual diagnosis rehab is best suited to people with mild-moderate to severe symptoms. Anyone with a high risk of relapse is also best suited for inpatient dual diagnosis rehab.

Inpatient dual diagnosis rehab occurs in a highly engaging, rigidly structured, and constantly monitored setting. Triggers and stressors are removed during inpatient forms of rehab to help support healing, growth, and recovery in a protected atmosphere.

MI (Motivational Interviewing)

Motivational interviewing is a team effort between a therapist and a patient to bring about change within the patient and to strengthen his or her motivation. A therapist guides conversations with patients to help them realize their own personal and genuine motivations for changing problematic behaviors caused by their dual diagnosis disorders. Motivational interviewing focuses on inspiring patients to create plans for moving forward to reach their goals.

MI is not a standalone therapy, but it is one way of inspiring change for people who have a hard time changing. MI is a 4-step process that works to:

• Define unique and personalized goals
• Form a plan on how to move towards those goals
• Support regular motivation for change
• Give guidance on how to move forward to make those changes

MET (Motivational Enhancement Therapy) in Dual Diagnosis Treatment

Motivational Enhancement Therapy (MET) is meant to produce quick, internally motivated changes. MET is based on the principles of Motivational Interviewing (MI).

The motivation for how patients are currently living is examined during MET. Then, problem-solving and interpersonal skills are worked on. A MET therapist guides patients to see that they have problems. MET therapists do this by discovering the motivations behind how patients currently live. MET therapists also help patients discover the reasons behind the development of their dual diagnoses.

Meditation and Yoga

An integrated dual diagnosis program will treat the whole person. This includes the physical, mental, emotional, and spiritual aspects of a person.

Treatment programs that treat the “whole” person are known as holistic treatment programs. Holistic treatment programs contain a blend of traditional therapies as well as alternative ones. Meditation and yoga are two popular and effective forms of alternative therapies.

Taking good care of one’s self means taking time to heal and grow. Meditation, or quiet time alone, is a healthy and healing form of self-care. Just 10 minutes of meditation each day can help create positive changes.

Meditation is also a good tool for fighting a relapse. It’s estimated that about 60% of people with SUDs relapse. Meditation can help a person form mindful responses to stresses and triggers to help avoid relapse. Yoga is also a great way to incorporate mindfulness while improving physical health when recovering from a dual diagnosis.

Finding the Right Dual Diagnosis Treatment

Is an inpatient dual diagnosis program right for you or a loved one? First, do some research to see as you make a list of your unique dual diagnosis program requirements.

Important factors you should consider when choosing a dual diagnosis drug rehab are:

• Program length (check the minimum stay requirements as well)
• If the program is really a dual diagnosis program
• Location (a dual diagnosis drug program that’s away from home may be the better choice if somebody wants more isolation from familiar people and places while one recovers)
• Costs and a budget that lays out what your insurance will cover and what your out-of-pocket costs might be
• Gender segregated vs. coed settings
• Any special needs such as needs for pregnancy, ex-military veteran, serious trauma, sexual assault, or homelessness

Attend Dual Diagnosis Rehab At CNV Detox

Take the first step toward sobriety by contacting us at CNV Detox for dual diagnosis rehab. Talk with your doctor, mental health professional, and/or treatment center to see what dual diagnosis program options are best for you or someone you love. Getting sober is the first step towards gaining the healthy and renewed life you deserve.