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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 health problems.


"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, " says Hayden.


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 Manevitz.

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 together.


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," says Hayden.


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.




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