Drugs, alcohol and mental health
I’ve worked with people who have problems with drugs and alcohol (I’ll refer to both as drugs for this blog) for over a decade. I had some brilliant training years ago around dual diagnosis. This term refers to people who have been diagnosed as having mental health problems at the same time as problems with alcohol or drugs.
Which problem was there first?
I believe that people use substances because of the consequences from using them, whether they are positive or negative, resulting in positive or negative consequences. Interestingly, a positive consequence includes the following:
- What somebody likes about using drugs and alcohol (these are called positive reinforcers)
- Things that drugs and alcohol helps them to avoid (these are called negative reinforcers)
This is where we can start thinking about mental health. If someone has mental health issues that are possibly undiagnosed or diagnosed, then substance use might help them to alleviate some of the negative ways they are feeling. We call this self-medication. So, the drugs are beneficial to them. In these cases, the mental heath issues may have been the problem that was either undiagnosed or not treated properly in the first place and then the drugs came along after.
We then move onto the negative consequences of drug use. These are:
- The problems caused by taking drugs
- The things that people miss out on because of drugs
When we think about the negative consequences of drug use and mental health, some typical problems that may be caused from drug use is that it can exacerbate mental health problems, so even if someone gets short term relief, their problems overall can increase through their drug use. Drugs can also cause mental health problems for people who have possible had no mental health problems prior to taking drugs. This can be due to many factors like sleep deprivation, hallucinations, anxiety, paranoia, stress and in some cases, drug induced psychosis, accidents, physical health problem- the list goes on.
How do we help people with a dual diagnosis?
When I’ve supported people who have problems with both mental health and drugs, it has been challenging trying to get them the help they need. This is because services in mental health often find it hard to treat people who are intoxicated with drugs. This makes sense, because it is tricky to assess someone who perhaps isn’t able to communicate all that well.
Drug and alcohol services can also have difficulty because if a person is self-medicating with drugs, once they are removed as a coping mechanism, we need to get the right support in place, the right medication if needed and the right therapies. The recovery journey needs very careful planning in partnership with all the required services involved.
We often think that once people stop using drugs, then life will be immediately better. Recovery doesn’t work like that. Stopping using drugs is just the start of that journey. Each recovery journey is individual to that person and they need to lead it themselves. This is why professionals and family members must understand the goals that a person with dual diagnosis wants to achieve themselves, rather than imposing this upon them. If everyone works together to meet these goals, then the individual is more likely to want to change. Read more here on recovery.
There is a lot of support out there for anyone who is feeling unwell. There is also lots of work being done around breaking the stigma of accessing help for mental health and substance use. Asking for help is the best thing anyone can do if they need it.
Click here for some services who can help.
I can help
My service, The Vesta Approach, supports families affected by a loved one’s substance use. You can access confidential support from me wherever you are in the world. I will help you to get your loved one into treatment and lead a better life. I offer face to face sessions in the Manchester (UK) area.
You can also get help via Skype and my online group therapeutic programme which I’ve launched this week! Take a look here
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