When my son Michael required inpatient or residential treatment for addictions and bipolar disorder, I carefully discovered the treatment approaches of available facilities.
Early in our years-long journey I learned that some treatment philosophies denied the existence of biologically-based mental illness
. Others eschewed drugs of any sort, regardless of who prescribed them and why.
And still others functioned under the assumption that every addiction was caused by childhood trauma, not biology or choice
Finding treatment centers that respected the concept of dual-diagnosis and treated the whole person proved challenging.
Finally a well-respected scientific entity, The National Institute on Drug Abuse
(NIDA), part of the National Institutes of Health
, released a new report, Comorbidity: Addiction and Other Mental Illnesses
that verifies what I know to be true and that will hopefully revolutionize the treatment model for dual diagnosis.
Documenting phenomena that doctors, families and some treatment programs have known for decades, the report summarizes the science underlying the complex relationship between substance abuse and other mental disorders
, a phenomenon often referred to as dual diagnosis.
"We do not know enough yet to predict precisely whether one disorder will lead to the other(s) or how to prevent comorbidity," said NIDA Director Nora D. Volkow, M.D
. "We do know, however, that the high rate of comorbidity means that we need a comprehensive approach to intervention that identifies, evaluates, and treats each disorder concurrently."
The report describes factors leading to comorbidity or dual diagnosis, including biology and genetics, issues of gender vulnerabilities, brain function abnormalities and similarities, and the influence of developmental factors.
The report also addresses diagnosis and treatment. Several examples of behavioral therapies tested in patients with comorbid conditions — as well as potential medications — are outlined, as are the challenges of treating these conditions concurrently.