Co-occurring disorders require a dual diagnosis approach that is integrated in the detox process, with careful attention to both the physical and mental health aspects of early recovery. This article explains more about how it works.
Key Takeaways
- Dual diagnosis detox goes beyond addressing physical dependency issues. It also considers how clients may react to withdrawal emotionally, considering underlying mental health conditions.
- It can be difficult to determine which symptoms are caused by withdrawal and which are attributed to mental health. Clinicians typically use comprehensive assessments and integrated care to guide treatment.
- After detox is complete, clients move on to rehab, teaching them how to handle their emotions in a healthy manner, without relying on alcohol and drug use.
Table of Contents
- What Makes Dual Diagnosis Treatment Different?
- How Does the Integrated Assessment Process Guide Treatment?
- What Does Dual Diagnosis Detox Involve?
- How Do Common Co-Occurring Disorders Affect the Detox Process?
- What Happens After Detox?
- BlueCrest Detox Offers Dual Diagnosis Treatment for Lasting Recovery
- FAQs
Introduction
Addiction and mental illness often go hand in hand. 2024 SAMHSA statistics reveal 21.2 million adults in the United States had a co-occurring addiction and mental health disorder. As self-medication, drugs and alcohol can temporarily calm emotional distress, but they often lead people on a downward spiral, exacerbating mental health symptoms.
Additionally, when substance use disorders co-exist alongside a mental health disorder, it can complicate treatment. But a dual diagnosis approach can help. It simultaneously treats emotional and dependency issues.
When we think of dual-diagnosis treatment, we often focus on how it’s applied in rehab. We think of detox as treating the physical aspects of addiction, while rehab, which comes next, addresses the underlying mental health conditions. However, specialized care must be applied in all stages of recovery.
This article will explain how it’s done and help patients navigating dual-diagnosis care.
What Makes Dual Diagnosis Treatment Different?
The significance of detox cannot be undermined. However, it’s a very demanding stage of the recovery journey, as the body struggles to adjust to functioning without substances in its system. Mental health issues can make the process even more challenging and complex.
Withdrawal affects a person mentally and physically. Common mental symptoms include anxiety, depression, and irritability, which occur even in patients without emotional disorders.
For people with pre-existing mental health concerns, detox hits particularly hard. The one-two punch of withdrawal and emotional dysregulation causes advanced instability.
But what may be even more concerning is the diagnosis. For medical professionals, it’s difficult to determine which symptoms stem from mental health and which are withdrawal symptoms.
How Does the Integrated Assessment Process Guide Treatment?
Given the complexity of the situation, a comprehensive assessment is often implemented to guide treatment during detox and beyond. It involves an integrated approach, which, according to SAMHSA research, is the best practice for people with co-occurring disorders. Here are some techniques used during this process.
- Intake Evaluation: The intake evaluation becomes more comprehensive with a dual-diagnosis approach. In addition to looking at substance abuse and physical health history, it focuses on psychiatric history. Clinicians will want to know the patterns of the substance use disorder, the client’s physical health status, and prior psychiatric diagnoses, hospitalizations, history of trauma, and their family’s mental health history.
- Standardized Screening Tools: Clinicians may use various screening tools to assess both the severity of withdrawal and the patient’s mental health. For example, CIWA-Ar is a primary tool for checking withdrawal severity during alcohol detox, preventing serious complications. It may be used alongside the Patient Health Questionnaire 9 (PHQ-9), which screens for depression, or the PCL-5, the PTSD checklist for DSM-5.
- Distinguishing Substance Use from Pre-Existing Symptoms: Perhaps the most complex aspect of dual diagnosis treatment, this requires determining which symptoms predate substance use and extend beyond the detox window, allowing dual diagnosis treatment centers to distinguish withdrawal symptoms from mental health challenges. It typically involves monitoring the patient throughout the detox process, talking to family members, and reviewing the client’s medical history.
- Multidisciplinary Team: Patients work with a single multidisciplinary team, ensuring that interventions are synchronized and do not conflict. Various medical and mental health professionals are typically involved in treatment, including psychiatrists, nursing staff, and a licensed clinical social worker. They will work together to guide effective treatment.
What Does Dual Diagnosis Detox Involve?
Once the assessment is complete, clients begin the detox program, which typically combines medical treatment and psychiatric care to address the mental and physical aspects of addiction. The following sections wil provide an overview of what’s involved.
Medical Detox
Medical detox addresses the physical aspects of withdrawal. Medications are used to reduce cravings and the risk of complications.
Medications are essential for alcohol detox, preventing the risk of severe complications, such as seizures and delirium tremens. They are also often implemented for opioid disorder, as they guide a successful recovery. While there are no FDA-approved medications specifically for stimulant disorders, they may be prescribed for comfort.
Psychiatric Care
While detox isn’t typically the time to delve deeply into a client’s mental health issues, psychiatric care is used to stabilize acute symptoms like psychosis, severe anxiety and depression, PTSD flashbacks, and suicidal ideation. Various methods may be used, as follows:
- Mental Health Meds: A careful approach is required when prescribing and continuing mental health meds alongside medical detox. Typically, clients continue taking pre-existing meds and may begin taking meds that serve dual purposes, such as anticonvulsants and antipsychotics. New psychiatric meds that take a while to work are rarely prescribed.
- Crisis Intervention: Clients are carefully monitored for risk assessment, and potential self-harming instruments are removed from their environment. If risks are detected, the client may be moved to an inpatient facility, such as a psychiatric ward.
- Therapeutic Contact: While mental health therapy is not a focus, it may be lightly integrated through psychoeducation and supportive sessions.
How Do Common Co-Occurring Disorders Affect the Detox Process?
Mental health conditions affect the detox process in various ways, as follows:
- Anxiety disorders: One of the most common co-occurring disorders in people with addiction, individuals with anxiety are often extremely sensitive to withdrawal symptoms. Detox can be especially dangerous for people with panic disorders, as it can elevate symptoms like a racing heartbeat, shortness of breath, and dizziness, and trigger a full panic attack.
- Depression: This mental health condition is concerning because it often triggers suicidal ideation. The risk is especially high when detoxing from opioids and stimulants.
- Post-traumatic stress disorder (PTSD): PTSD symptoms, such as hyperarousal, sweating, insomnia, and elevated heart rate, also commonly occur during withdrawal, leading to complexity in the diagnosis process. Furthermore, the clinical detox setting often triggers these symptoms. Clinicians take a trauma-informed therapy approach, avoiding triggering words and actions.
- Bipolar Disorder: Withdrawal can destabilize mood and cause a manic episode. Mood stabilizers can help, but dosage should be carefully monitored throughout the detox process.
What Happens After Detox?
Once patients have stabilized, they move on to rehab addiction treatment, truly addressing the underlying cause of substance use disorders. Various therapies may be integrated, including:
- Cognitive behavioral therapy CBT: Addresses negative thought processes and teaches patients healthy coping mechanisms so they can better manage their emotions.
- Dialectical behavior therapy DBT: Takes a more mindful approach to emotional regulation through distress tolerance.
- Trauma-Informed Therapy: Exposure therapy is typically used, involving patients recalling traumatic memories in a safe space to make them more manageable.
- Group Therapy: Support groups help clients learn from one another and understand they are not alone.
- Family Therapy: Families are often brought into therapy sessions to learn how to create a supportive environment for their loved one.
- Holistic Approaches: Facilities like BlueCrest are attentive to our clients’ overall well-being and integrate yoga, meditation, and art therapy in the healing process. We also pay attention to diet during detox, understanding that nutrition plays an integral role in recovery.
After the initial therapy is complete, clients move on to aftercare planning, which is essential for maintaining recovery from dual diagnosis by providing ongoing support and resources tailored to individual needs. Effective aftercare planning may include outpatient therapy, support groups, and continued psychiatric care to ensure long-term recovery from dual diagnosis. Research indicates that individuals who engage in aftercare programs have higher success rates in maintaining sobriety and managing their mental health conditions.
BlueCrest Detox Offers Dual Diagnosis Treatment for Lasting Recovery
BlueCrest Detox of New Jersey provides optimal care through our dual diagnosis treatment. Beyond considering the mental and physical aspects of addiction, we also address the spiritual and emotional factors, combining evidence-based treatment with a holistic approach. Our comprehensive program encompasses rehab and beyond, ensuring lasting sobriety and optimal mental health.
Contact us to learn how we can help you achieve a higher quality of life.
FAQs
How is dual diagnosis detox different from regular detox?
Dual diagnosis detox requires a specialized approach to address both addiction and underlying mental health conditions. It typically dives deeper into the psychiatric aspects of care, with a full exploration of the individual’s mental health and substance use history.
How long does dual diagnosis detox take?
Dual-diagnosis detox typically takes about a week, with most symptoms entering remission during this time. However, the timeline can vary depending on the severity of addiction and mental health conditions.
How do I know if a detox program is equipped to handle dual diagnosis?
Most clinics will state upfront whether they offer dual diagnosis. However, these clinics typically offer on-staff psychiatrists, mental health symptoms monitoring and documentation, a formal protocol for crisis intervention, and a process for transitioning patients from detox to rehab.
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