Co-occurring Disorders

Early in my career, I was a treatment provider for an Intoxicated Driver Resource Center (IDRC) location; I had a client who was mandated for treatment due to having several driving under the influence (DUI) convictions. In our initial meeting he stated that he was not an alcoholic, he was a ‘social drinker’, I asked him his definition of ‘social drinker’, he stated ‘If you are having a drink, so shall I’. His definitive statement raises for me two broader questions: why do we use substances, to conform to social standards, or for deeper reasons? And when does utilization move from social conformity to addiction and self-medication for mental health issues?

The 2013 National Survey on Drug Use and Health (NSDUH) estimated that 44%, or 140 million citizens are alcohol consumers and close to 3 million adults tried an illegal drug for the first time. In September 2014 the NSDUH report stated that in August 2014 one out of ten people who are 12+ years old abused an illegal drug, this adds up to roughly 27 million people.

These statistics reveal that we routinely reach to drugs and/or alcohol. It has been suggested that we do this out of curiosity, social pressure, a desire to feel differently, as a way escape our current reality, ease stress, relieve physical or emotional discomfort, to forget a traumatic event or reduce symptoms of mental illness. It is broadly agreed upon that the sensation of psychological distress (anxiety, apprehension, fear, stress, trauma, etc.) is communicated through physical discomfort (body aches, pains, pressure, etc.). A popular belief is that taking a drink or drug will help with a person relax, be less nervous and ease physical and/or emotional discomfort. The fact the matter is that while taking the substance may temporarily lessen the discomfort, it does not address the root cause(s) that established the discomfort and the continuation of taking the substance creates a physical and psychological addiction.

Visualize the equation: discomfort is felt + a substance is used to reduce the discomfort + feelings of discomfort occur more often + the substance is used more frequently and in greater dosages = addiction to the substance.

I return to my opening thesis questions: why do we use substances, to conform to social standards, or for deeper reasons? And when does utilization move from social conformity to addiction and self-medication for mental health issues? The term self-medicating is used when substances, drugs or alcohol, are abused to mediate symptoms occurring from a mental illness. Having both a addiction to a substance and having a mental illness is clinically spoken about as having a co-occurring disorder; having diagnosable mental illness and substance abuse disorders together. In our society, while labels like alcoholic, substance abuser and addict hold such negative stigmatization; they are more readily embraced over the label of mental illness. Concentration on the addiction is addressing the symptom, which needs to be done, but, we need to jointly focus on those issues that led to the creation of the symptom; the underlying dis-ease, the causes of the discomfort, ultimately, the mental illness.

Many times mental health care is portrayed as time limited managed care treatment focused on betterment of a disorder characterized by an impersonal checklist of symptoms rather than the mental health practitioner being fully involved, partnering with a client who is in pain and suffering.   Changes in the way mental health conditions are diagnosed, excitement about the latest developments in neuroscience and psycho-pharmacology (especially when contrasted with the slowly accruing benefits of psychotherapy), health insurance companies efforts to cut costs by limiting reimbursements for psychotherapy, a poor economic climate, and a general cultural shift away from self-reflection, and towards easily quantifiable “results” have all contributed to this state of affairs. The treatment approach The Kraft Group Inc., utilizes to work with clients suffering with a co-occurring disorder is client centered and integrative, we collaborate with a team of holistic health care providers to assist the whole client ensuring we address the clients physical, mental, social and emotional needs.

To arrange an initial consultation, please call The Kraft Group at 973-727-1597.

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