LGBT Drug Treatment Blog

What is a Dual Disorder? 

A dual disorder occurs when an individual is affected by both an emotional or psychiatric illness and chemical dependency. Psychiatric illness and chemical dependency both effect an individual physically, psychologically, socially, and spiritually. Although the two illnesses are separate and independent, they do interact in ways that make diagnosis, treatment and recovery more complex. 

What Causes a Dual Disorder? 

The specific causes of psychiatric illness and chemical dependency are not fully understood at this time. Family history, genetics, brain chemistry, and environmental factors all appear to play important roles in the development of both psychiatric illness and chemical dependency. 

What Problems are Associated with Dual Disorders? 

• family problems 

• employment or school problems 

• high risk behavior on the highways (DUI) 

• multiple admissions for chemical dependency due to relapse 

• multiple admissions for psychiatric care due to reoccurrence of psychiatric symptoms 

• increased emergency room admissions 

• increased need for acute health care services 

• legal problems and incarceration 

Are Dual Disorders Common? 

During the past ten years, researchers and mental health and chemical dependency treatment providers have found that dual disorders do occur with regular frequency. The National Institute of Mental Health sponsored two large-scale research studies. The studies provided significant information about dual disorders. 

• 10 million Americans are affected by a dual disorder each year. 

• 56% of individuals with a bipolar disorder, (Manic depressive illness) abuse substances 

• 47% of individuals with a schizophrenic disorder, abuse substances 

• 32% of individuals with a mood disorder other than bipolar, abuse substances 

• 27% of individuals with an anxiety disorder, abuse substances 

Other researchers looked at individuals who were in treatment and experienced a severe mental illness. They found that 40-60% of the patients also had a co-existing substance abuse disorder. 

Investigators who looked at individuals in treatment for substance abuse found them to have co-existing mental disorders in rates of over 60%. 

Clearly, there are a substantial number of men and women who experience dual disorders each year. Research and clinical findings illustrate that it is not a rare occurrence, but rather a problem that occurs with consistent frequency. Therefore, it is important that specialized programs and ongoing community based support groups be available for men and women who experience dual disorders. 

Is There a Single Type of Dual Disorder? 

There is no single type of dual disorder. This is due to the fact that there are many forms of emotional or psychiatric illness. Some forms of psychiatric illness can severely impair an individual’s ability to function effectively and relate well to others. Creating a need for ongoing case management and a variety of other supportive services. Others may be impaired during ongoing periodic episodes or cycles. The degree of impairment due to psychiatric illness may vary greatly from mild or moderate to severe, or it may occur in mixed patterns. 

The nature of dual disorders becomes even more complex when alcohol and drug use is considered. For example, there are many types of intoxicating chemicals that people can choose from today. Some people may choose to use a single type of drug while another person may use many different types of drugs. Some people use large amounts for the effects while other people use smaller amounts. Some people use daily, while others use on periodic binges. It becomes evident that there are many different forms of dual diagnosis when the different types of psychiatric illnesses and different patterns of alcohol and drug use are all taken into account. However, in terms of dual recovery, they do share one thing in common: an individual will need to focus their recovery efforts on both their emotional or psychiatric illness and their chemical dependency within a comprehensive personal program of recovery. 

What are the Goals for Dual Recovery? 

There are three basic goals for dual recovery: 

• Develop a lifestyle that is free of alcohol and other intoxicating drugs and prevent relapse. 

• Learn ways to manage the symptoms of emotional or psychiatric illness in a healthy and constructive way. 

• Learn ways to improve the quality of life. 

Some people may require medical care to safely withdraw from alcohol or street drugs. They may also need medical care to stabilize their acute psychiatric symptoms. Many people may want to participate in self-help programs such as Dual Recovery Anonymous (DRA) where they can feel accepted when discussing recovering issues that are related to both their psychiatric illness and their chemical dependency

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