Mental Illness and Substance Abuse
Mental health problems and substance abuse often go together.
Finding the Treatment That Works continued...
"There is a relatively small window of opportunity in which
to get the mental health problem under control before the patient ends up right
back into substance abuse," says Frye.
As such, many doctors are now turning to a dual treatment
approach -- a program that integrates detoxification of addictive substances
with simultaneous identification and treatment of any coexisting mental
"This approach can be particularly effective because even
if you get a clear history of a patient, even if you are certain that the
substance abuse led to the mental illness, or vice versa, treating the first
problem doesn't necessarily lead to the cessation of the second problem, "
Unfortunately, the dual approach is still considered somewhat
specialized, and frequently only available in pricey private hospitals. The
next best thing, say experts, is to integrate patient care among the
professionals dealing with each part of the illness.
"If one doctor or clinic is treating the mental illness and
another is treating the addiction, there has to be some kind of coordinated
effort in order to get both problems under good control," says
When the patient isn't able to coordinate that care on their own, experts say
family members should intercede to make certain all the doctors involved work
But what if there is a relapse -- of either the
addiction or the mental health problem?
Doctors say that a slip up in one area frequently leads to a
decline in the other area as well -- but this doesn't mean the patient is
doomed to repeat their destructive behaviors indefinitely. The answer, says
Hayden is the development of a doctor-patient alliance that both can trust.
"The goal is to engage in a true therapeutic alliance
between doctor and patient, to establish a rapport that is strong and honest
enough so that the patient tells the doctor what they are really up to,"
When this is the case, experts say relapses of both the
mental health problem and the substance abuse can often be circumvented in the
earliest, most easily treated stages -- or some cases, even prevented from
occurring at all.
Originally published June 2, 2003.
Medically updated June 2006.