In the upcoming episode of the Addiction Masterclass series, Evan Lieberman, MSW LICSW LADC, sheds light on the intricate world of dual disorders, delving deep into the symbiotic relationship between substance use and mental health. With a keen focus on how these conditions often coexist and amplify each other, Evan unveils the complexities of comorbidities and the unique challenges they present in both diagnosis and treatment. This masterclass is essential viewing for anyone seeking a comprehensive understanding of the delicate interplay between addiction and mental health, and the path to holistic healing.
About 8 million Americans struggle with co occurring disorders. If you have a substance use disorder, you're far more likely to have an underlying mental health disorder. Two to four times more likely if you have one, to have the other.
SAMHSA estimates that somewhere between 40 and 50% of people with addictions also experience severe trauma. What's often really sad is that you see a strong connection with severe and persistent mental illness. It's so crucial that we no longer separate them, that we view them as one integrated phenomenon.
Throughout most of our history of addiction treatment, we viewed substance use disorders and addictions as a singular issue, a problem in and of itself. Therefore, in the addiction treatment field, we often had folks that were more specialized in chemical health or mental health. They were viewed as very much a separate problem. But that couldn't be further from the truth. Some of the symptoms of addiction seem so wild and dramatic. If you've ever been around anyone with a severe addiction, their life can be in absolute shambles, and it brings other people down with them.
And that's why it's so easy to be hyper focused on the addiction, because it's that shiny problem right in front of you, or it's kind of like a matador that's holding this red flag that's misdirecting the bull. And we're the bull. We're missing the matador that's behind it, and that is mental health. And often adverse childhood experiences, including things like trauma and PTSD. According to the governmental organization SAMHSA, the Substance abuse and Mental Health association, about 8 million Americans struggle with co occurring disorders, meaning they have a substance use disorder and any other mental health disorder.
And I think that number is probably skewing more on the low end. However, what they found is that if you are someone with a mental health disorder, you are more than twice as likely to develop a substance use disorder, and the inverse as well. If you have a substance use disorder, you're far more likely to have an underlying mental health disorder. Now, this becomes complicated, because when you're deep in the throes of addiction, when you are throwing off your brain chemistry and creating all these various issues in your life, well, it's easy to fall into depression or even things that look like ADHD or bipolar.
And this is why, as a clinician, I don't diagnose anyone with a mental health disorder. If they were struggling with a substance use disorder the whole time, it's a very confounding variable. However, these two things are very associated, and if there is that underlying mental health disorder, it's likely they're still going to struggle with it after they get sober. On the other end, if someone's mental health symptoms are based solely on the substances and the effects it's had on their life, they're likely to just go away on their own.
So if I have a client coming in, sometimes it's better to just sit and wait. Another big category is depression, also known as depressive disorders. Now, these are highly correlated with addiction as well. Two to four times more likely if you have one, to have the other. And this makes a lot of sense, because if you're feeling sad, down, or depressed, any kind of substance that increases dopamine or other neurochemicals going to give you good or very temporary relief. Now, one area of mental health we've neglected for far too long is the association between severe trauma, or PTSD, and addiction.
For example, SAMHSA estimates that somewhere between 40 and 50% of people with addictions also experience severe trauma. Now, let's go ahead and look at people who have been in an inpatient substance use treatment, indicating their addictions are more severe for those individuals. For men, it's about 40%. 50% have experienced severe trauma, childhood abuse, or for women, it could be as high as 80 and 90%. These things are so closely related that we cannot neglect that connection. We have to address that underlying issue when that client is ready.
What's often really sad is that you see a strong connection with what we would call severe and persistent mental illness. Things like schizophrenia, that thought disorder, or something like bipolar, a mood disorder that could be extremely severe. There's a very strong connection, and these individuals are already struggling so much to cope with life and just to function. And their symptoms are so severe that they often turn to substances, which often makes the problem worse. Like, for any of these disorders, it's like taking a bucket of gasoline and throwing it onto a fire.
Well, I hope you feel like you have a better understanding of the interplay between mental health and chemical health and why it's so crucial that we no longer separate them, that we view them as one integrated phenomenon. So we could best serve every client coming to us and address their unique needs.
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