Problematic Substance Use/ Dual Diagnosis - Essay Example

?Problematic substance use/ dual diagnosis By Dual diagnosis The manifestation of mental illness, which is accompanied by a serious addiction to drugs and or alcohol is referred to as dual diagnosis. They are often confused to be one problem because the general assumption is that the psychiatric disorders manifested by a patient are the resultant effects of excessive and heavy use of drugs (Phillips, 2009). It has, however, been opened by medical researchers that the two are separate illnesses that tend to be manifested concurrently in patients of this nature. They have an effect on the physical and psychological health of the individual and also tend to affect their social behavior. Medicine has found remarkably few lines between the two illnesses. The symptoms that are exhibited in each instance are also difficult to tell apart. Most of the time, use of drugs has the same effects that would otherwise be characteristic of psychiatric illness and the vice versa is also true (Smith, 2007). It is challenging for health care providers to decipher the exact problem because the illnesses often occur in overlap. Another challenge is that the two correlate and one is often the cause of the other with no particular illness been traced as the original source of the problem. A drug abuser will most likely develop mental illness after prolonged intake of the addictive chemical component (Smith, 2007,). The effects of mental illness such as hallucination will often lead the patient back to resort to drugs in an attempted auto correct. When an individual makes an effort to treat one of the illnesses if they overlook the possibility of suffering from the other, then it might be the reason frequent relapses are observed. Self confidence is eroded, and this is where the complication becomes worse having acquired a social-psychological dimension. Sebastian presents a typical case of dual diagnosis (Butcher, Mineka, Hooley 2008). He is already showing lack of self esteem and social withdrawal from his low moods and avoiding friends. A keen evaluation of his case shows that he has schizophrenic disorders. He, in turn, tries to suppress the audio hallucinations by taking alcohol and cannabis to make him feel better. A closer probing reveals that he had an earlier history of substance abuse from a remarkably tender age and perhaps the same reason he has developed mental illness (Pereira, 2011). Medical Assessment The greatest challenge faced by health care providers is in the assessment of these individuals who are proven to have both a history of mental disorder and substance abuse and addiction (Smith, 2007). The critical question is whether to deal with the case from the perspective of mental health or from that of substance addiction. A bi-angular approach, therefore, has to be employed when dealing with such cases. That is the essence of dual diagnosis, which is to examine the complication in both perspectives at a go (Daley, 2009). An integrated health care system will ensure that patients do not move in circles of treating one illness and relapsing to the other due to focus on only one side of the problem. An integrated approach looks at the holistic way of providing the patient with care and treatment. Medical practitioners and nurse in particular need to the medical assessment of the patient that will provide information on the effect of the drugs on physiology and overall health and the underlying factors of the mental illness. In the case of Sebastian, it has been revealed that he has a history with alcohol and drugs. The long term effects of these drugs can only be revealed through performance of medical assessment (substance abuse and mental health administration, 2012). it is important to do an analysis on the effects of the drugs on the nerves, brain and other vital parts that may contribute to mental health problems such as psychosis, schizophrenia and other abnormal psychological manifestations (Frodl, 2010). The understanding of these will aid in knowing the potentiality of the patient developing severe cases of mental complications thus better planning on how to care and treat Sebastian (Smith, 2007). Social And Psychological Assessment It is worth noting that he presents a case of social seclusion and a sudden development in a more introvert and withdrawn personality. The analysis of the recent eventualities that are unfolding in Sebastian's life in college and at home are major indicators of how far the drug use and mental disturbance has gone (Frisher, Crome and Martino, 2009 ). The assessment of the reasons for lack of interest in his hobby (playing the guitar), withdrawal from friends and sudden desire for solitude are major indicators of the downward trend in terms of Sebastian's social life (Cantwell, 2008). Lowered self esteem, paranoia, insecurity, drug dependence and suicidal thoughts are psychological issues that have to be taken into consideration as a means of finding the root cause and treatment and care plan for the patient (Smith, 2007). It is also vital to asses Sebastian’s history to determine if there are periods in his life where he experienced psychiatric disorders even when he was not using the substance. Sometimes acute depression may be seen to be the cause of substance use while, in a real sense, the excessive abuse of substance for a long period may be the cause of this depression. Not to be overlooked also is the presence of a social or psychological depressive disorder that the patient is trying to treat with substance intake (Weston, 2009). An assessment of the social and psychological aspects as manifested in the patient and an understanding of the correlation is as important as finding a care and treatment plan for the patient, whom, in our case is, Sebastian. Historical And Drug/substance Use Assessment For Sebastian’s case, the relevant substances would be alcohol and cannabis and also putting into consideration the tender age from which he was predisposed to these substances this would provide a vital starting point. For instance, it is worth considering for how long Sebastian's hallucination has been in existence in relation to the time he started using cannabis. Cannabis, as is well known, induces hallucinatory episode which progressively becomes irritating and unbearable to the user (Frisher, Crome and Martino, 2009) The rationale for keen assessment instead of jumping to induce treatment is what sometimes appears to be mental illness may be effects of chemical addiction and psychosocial disorders (Shives, 2008). The understanding of the psychotic and psychological effects of alcohol and the periods of use help to discern whether the mental illness is as a result of drug use or mental disorder (Butcher, Mineka, Hooley 2008) The knowledge of this would then prove an existing mental disorder that leads to a spiral of events that lead to alcohol and cannabis addiction together with social withdrawal. Alternatively, if the symptoms were manifested past the period when he had started drinking and smoking cannabis, then the disorders can be traced to substance abuse (substance abuse and mental health administration, 2012). Conclusion Mental illness and drug and substance abuse have been found to be broad but intertwining with each other. As a result the onset, manifestations and effects can only be understood through a thorough assessment of the patients historical, social, medical and drug and substance use in a bid to find a proper and effective plan to treat and provide medical care to the patient (Sebastian). The in depth knowledge of these aspects go a long way to decide whether the patient needs mental illness care, rehabilitation from drug use, guidance and counseling among other kinds of treatments for psycho-social disorder hence a well designed plan for care aimed at giving Sebastian a solution. Reference list Butcher, J.N., 2007, Abnormal psychology; dual diagnosis. Pearson/Allyn and Bacon: London, U.K Cantwell, R., 2008 Scottish Comorbidity Study Group. "Substance use and schizophrenia: fects on sefymptoms, social functioning and service use". British Journal of Psychiatry 182 (4): 324–9. 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