Co-Occurring Disorders Case Study

Concurrent disorders (clients with mental health and addiction) have different treatment needs for a number of reasons and one reason is that they differ in terms of their mental health diagnoses and their substance abuse. To illustrate this, consider the client who is diagnosed with anxiety and they use marijuana versus the client who has bi-polar disorder and they use cocaine (Courseware). The symptoms of their mental health are very different as are the drugs and the reactions of the drugs on their mental health (cocaine is a stimulant and alcohol can be both a stimulant and sedative depending on the amount being ingested).

The best treatment centers will typically offer dual diagnosis programs. Often, addicts have co-occurring mental or health disorders that make it difficult to recover from an addiction. During dual diagnosis

Addiction to drugs and alcohol has taken epidemic scale in the recent decades, the number of people affected by this disease has been increasing steadily and the age of drug and alcohol use initiation has sadly been decreasing, children as young as 12 years old are reported as addicts. The Substance Abuse and Mental Health Services Administration (SAMHSA) estimated that 22.5 million Americans aged 12 and older self-reported needing treatment for alcohol or illicit drug use in 2014. Drug abuse and mental health disorders are commonly seen as coexisting conditions. They are among the top conditions that cause disability and carry a high burden in society.

If the individual tries to quit using, they may run into problems. Before, drugs and alcohol alleviated some of the depression and anxiety. Without substance abuse, the patient still has to

It now is by, and large recognized that these patients have needed to explore divided frameworks and that they have gotten treatment that is less open and less compelling than the medical services framework can convey. For quite some time the presence of a co-occurring disorder diagnosis has been ignored, overlooked or misdiagnosed, health care providers and policymakers now perceive that these conditions are prevalent and that the dominant part of patients with substance abuse issues doubtlessly has a co-occurring disorder.

There are several variables that effected whether or not use of force was present. Within the same study, variables like race, sex, firearm present, or some type of escape, influenced whether or not some type of injury was sustained from police encounters. Results suggested that white subjects were 33% more likely to sustain some type of injury then non-white subjects (Morabito). Gender also presented a significant difference in injuries sustained. Male individuals were 63% more likely to sustain injuries from police contacts that women.

Jacobs past medical history is significant for bipolar II disorder. In addition, she has a history of alcohol and marijuana use. Ms. Jacobs in under the stress of living in a new city and attending a graduate level program away from home and the support of her family. Her current episode of symptom onset coincidences with these events.

A “Substance Use Disorder” is new to the DSM-5. Previously, the terms “abuse” and “dependence” where used instead. In general, the DSM-5 considers a Substance Use Disorder to be recurrent drug use that causes impairment and continued use despite substance use related problems. The DSM-5 also focuses on how substance use causes a change in brain functioning. The change is primarily responsible for intense drug cravings, as well as repeated relapses. Finally, the DSM-5 divides the criteria for Substance Use Disorder into four groupings: impaired control (Criteria 1-4), social impairment (Criteria 5-7), risky use (Criteria 8 and 9), and pharmacological criteria (Criteria

There are many variables when it comes to talking about substance abuse and addiction. According to (L. Lagoni, 2010), links are present between mental illness and self-medication referred to as the self-medication hypotheses. The research in this peer reviewed article was comprehensive and viewed psychiatric disorders from many different angles. They looked at illicit drug and alcohol users and found that many mental health disorders such as Thought, Depression, Anxiety, Bipolar, PTSD, ADHD, and APD are connected to many societal issues which include homelessness, health issues, unemployment crime, and early deaths.

Substance abuse disorders is easily defined when an “individual continues to use the substance despite experiencing negative consequences from their use. These negative consequences can include health problems; difficulties in their family, work, and social life; and financial and legal problems. They are said to be dependent on the substance when,” in addition to theses negative consequences, they build tolerance and experience withdrawal if they stop using the drug” (Martin, 2007, p. 265). Substance abuse dates back to the early Americans colonies with beer that was brought over by the pilgrims and more popularly the ratification of the Constitution to prohibit the use of alcohol

Substance use disorder in mental health patients poses a major concern to clinicians in psychiatry. The disorder generally is associated with an underlying mental health condition(s), however, there are multiple theories suggesting psychological to neurological and probably multifactorial etiological profile. Substance abuse and substance dependence which are the former terms that were used to define one with the disorder has been grouped into a set category of substance use disorder by the 2013 Diagnostic Statistical Manual of Mental Disorders, Fifth Edition (DSM-5) (APA, 2013). Furthermore, there is a certain number of diagnostic criteria as well as severity that must be met to best guide care services of the patient with a substance use or polysubstance use disorder.

It has been said that people do not use drugs to feel good, but that they use them to avoid feeling bad. Regardless of anyone’s opinions on drug abuse, this concept holds a lot of truth in regards to substance abuse in those with bipolar disorder. Many times this abuse is referred to as “self-medicating”. This means the use of medicine (or drugs) without medical supervision to treat one’s own ailment. While self-medicating can be healthy, like taking pain killer for a headache, it can also be detrimental to someone’s health as many drugs have nasty side effects. Self-medicating can relieve psychological symptoms, but many people with bipolar end up abusing substances more often than those without it. In both manic and depressive states somebody with bipolar may be motivated to use. Someone in a manic state may be more impulsive, and feel invulnerable, inclining them to take illicit substance. Someone who is depressive may use to escape their feelings. Using illicit substances and finding pleasure or short-term symptom alleviation has, many times, lead to addiction or a substance abuse disorder. Bipolar disorder and substance abuse disorder are considered separate mental illnesses, but research has found a strong comorbidity between the two.

Bipolar disorder and substance-use disorders commonly occur in the same individual. In fact, bipolar disorder has a higher prevalence of substance-use disorders than any other psychiatric illness. Individuals with both disorders have a more severe course of bipolar disorder, including earlier onset, more frequent episodes, and more complications, including anxiety- and stress-related disorders, aggressive behavior, legal problems, and suicide. Bipolar and substance-use disorders share common mechanisms, including impulsivity, poor modulation of motivation and

The initial indication of schizophrenia being a factor of dopamine was amphetamine consumers. Amphetamine causes several symptoms of schizophrenia including: delusions and hallucinations. In schizophrenics there is an unsteady, high amount of dopamine in the brain. Antipsychotic drugs work to lower the presence of dopamine on the brain by impeding dopamine receptors. There are two primary dopamine receptors, D1 and D2. In schizophrenic patients the latter is split into D2, D3 and D4 subtypes. Dopamine activators are found in the striatum, prefrontal cortex and limbic system of the brain. Clinical research has observed an increase of dopamine in the emotion controlling striatum through PET and SPECT brain scans. Unfortunately there is no one pinpointed cause of high dopamine levels. Many of these causes are: Agitation, anxiety, cognitive acuity, feeling of pleasure, hedonism, high energy, high libido, insomnia, paranoia and

The major sources of these outcomes arise from psychotic characteristics, episode density, neurocognitive deficits, depression, medication side effects, and low social support. Furthermore, Balanza-Martinez and Dias (2013) proved that neuro-cognitive deficits persist even after episode resolution. A meta-analysis by Bourne et al., (2013) revealed that BD had permanent impact on processing speed, attention, executive functions, verbal memory, and intelligence. BD and substance abuse have been linked in several prior studies with a follow up study commissioned by the Massachusetts General Hospital showing that the risk of cigarette use and substance abuse increased five years after a positive diagnosis. In the study, individuals whose bipolar symptoms persisted from adolescence to adulthood had the highest risk of developing substance abuse disorders. Due to the extreme changes in moods and personalities in patients suffering from the condition, most individuals resort to drugs and substances such as opiates and alcohol which seem to offer temporary relief to the symptoms. The self-medication theory suggests that people choose drugs and substances that relieve their symptoms. For example, individuals feeling uncontrollable rage may choose opiates due to their relaxing effects while those experiencing depression episodes would opt for cocaine for its energizing effects. However, this theory is criticized due to a lack of empirical scholarly research and the fact that individuals with BD use sedatives when depressed and stimulants when experiencing manic episodes which typically worsens the symptoms rather than offering relief. Due to this critique, other theories have been posited to explain the relationship between bipolar disorder and substance abuse. While the self-medication approach assumes that bipolar disorder precedes substance abuse,