This subject can
be very challenging, so the most important things that professionals should
address is to make sure that these mental disorders are not mimicking substance
abuse or addiction. Doweiko (2012)
explains some of these challenges. A
health care professional needs to be able to know the differences between
symptoms of a mental disorder and problems that are occurring because of
SUD’s. He further explains that patients
that mention a substance abuse problem will have the same signs as someone that
is battling mental illnesses. Some of
the problem areas will be reduced or subside after the person remains
clean. Doweiko (2012), addresses that it
can take up to two months to accurately diagnosis someone with dual disorders. We can be left with a dilemma of a
misdiagnosis, if the patient is not willing to admit to SUD problems. Before diagnosing these problems accurately
it is very important, because people can be exposed to medications that they do
not need, and also a label of mental illness on their medical record. Extreme caution should be taken before
drawing a conclusion about a dual diagnosis (Doweiko, 2012).
Anxiety disorder
is one that can be mimicked by patients if there is not a correct evaluation
made. Doweiko (2012), again expresses
the importance of proper diagnosis to know whether or not the symptoms are from
the SUD or the mental disorder. Doweiko states “one symptom of alcohol
syndrome is anxiety” (p. 323). It is
more proper to examine patients for at least three weeks of abstinence before
the proper diagnosis can be evaluated correctly. If the anxiety persists without a substance
than most likely the patient will have an anxiety disorder. (Doweiko, 2012).
Bio polar
disorders can also be mimicked if there are signs of amphetamines, alcohol, and
cannabis, and manic expressions or depression can follow withdrawal from these
compounds. According to Doweiko “The
relationship between the bipolar affective disorders and the SUDs is quite
complicated”. (p 325) He further
explains that clinician have an accurate history of the patient in order to
determine whether the symptoms worsen or started after the patient began to
abuse drugs. (Doweiko, 2012). It is of
the up most importance that a complete work up of mental history is done on the
patient. If a patient has a long history
with SUD’s there might not be a way to determine dual diagnosis. In the case of depression it can be extremely
difficult as well, because these problems could be a mask because of the SUD’s.
(Doweiko, 2012).
If someone goes into outpatient treatment and complains of anxiety and have been using drugs and are not being honest, we face a mis diagnosis of this patient. Could the medical model be giving drugs to people that really do not need them? Could it be a factor of enabling them to self medicate. There is a growing problem of addicts playing the system. I know three of them that do this on a regular basis, and have even laughed about the medication they receive while nothing is being addressed about the real issues of their SUD's. Doweiko (2012) also addressed the mislabeling of someone and having it permenately on their medical records. There are most definitely serious dual diagnosis, but I have to question after finding out the lack of training in the medical model concerning SUD's if we are making to many mistakes. In many of the MHMR clinics people can walk off the street and go in to get a diagnosis and walk out with drugs. There are lots of these patients that are simply wanting to self medicate. I pray that we find a way of getting proper evaluations of these people so we do not become enablers of what we are trying to treat.
If someone goes into outpatient treatment and complains of anxiety and have been using drugs and are not being honest, we face a mis diagnosis of this patient. Could the medical model be giving drugs to people that really do not need them? Could it be a factor of enabling them to self medicate. There is a growing problem of addicts playing the system. I know three of them that do this on a regular basis, and have even laughed about the medication they receive while nothing is being addressed about the real issues of their SUD's. Doweiko (2012) also addressed the mislabeling of someone and having it permenately on their medical records. There are most definitely serious dual diagnosis, but I have to question after finding out the lack of training in the medical model concerning SUD's if we are making to many mistakes. In many of the MHMR clinics people can walk off the street and go in to get a diagnosis and walk out with drugs. There are lots of these patients that are simply wanting to self medicate. I pray that we find a way of getting proper evaluations of these people so we do not become enablers of what we are trying to treat.
I know this is
very important, because I have dealt with addicts, and have seen situations to
where they will go into a clinic and fifteen minutes later walk out with a hand
full of prescription drugs. If an
addict wants to self-medicate or cannot get their drug of choice, it is becoming
a problem of working the system, because a proper diagnosis is not being
made. This is an extreme problem, and
according to the research I read this week, it is very clear that proper
diagnosis should be made before evaluating a patient and it can take up to
several months if there is a substance abuse problem that has been
addressed. The biggest challenge is how
to correctly diagnosis someone that is hiding behind there substance abuse
problem. If medical personal are not
getting the proper training in this area, how can we be sure we are not
self-medicating drug addicts and worsening the problem? This is a question I ask myself daily, and
wonder why changes are not being made.
References: Doweiko H. (2012) Concepts of Chemical
Dependency Eighth Edition
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