Tag Archives: dual diagnosis

Trauma, PTSD, and Substance Use Disorder

trauma

Trauma can dramatically impact the course of one’s life; if it is left unaddressed, adverse experiences can lead to premature death. A new report on mortality from the Centers for Disease Control and Prevention (CDC) indicates that childhood trauma is a public health issue that we must address. The report shows that one in six people across the United States has experienced four or more kinds of adverse childhood experiences or ACEs.

Trauma can take many different shapes: neglect, abuse, familial separation (i.e., adoption), and exposure to mental health or substance abuse problems. Each person is different; an event may be more traumatic for one person than it is for another. There is no way to predict how an experience will influence a young person.

Author Junot Díaz, writing for The New Yorker in a piece titled: The Legacy of Childhood Trauma, said, “Trauma is a time traveller, an ouroboros that reaches back and devours everything that came before.” His writing lays out how an adverse childhood experience influenced everything, from relationships to employment.

In the field of addiction medicine, professionals are acutely aware of the correlation between childhood trauma and substance use and abuse. Paradoxically, many will use drugs and alcohol to cope with untreated trauma, but the practice has the unintended effect of placing such people at risk of being re-traumatized. It’s a vicious cycle, an ouroboros: a snake eating its tail.

Childhood Trauma and Addiction

Traumatic events, at any point in life, can have disastrous consequences like the development of post-traumatic stress disorder. However, when traumas or ACEs occur during one’s formative years, the risk of experiencing more significant problems is much higher. A previous study from the CDC on adverse childhood experiences found:

  • For each ACE, the risk for early initiation of substance abuse increases two to four times.
  • Individuals with three or more ACEs have higher rates of depression, domestic violence, sexually transmitted diseases, and heart disease.
  • Men and women with five or more ACEs are seven to 10 times more likely to become substance abusers.
  • Almost two-thirds of intravenous drug users report ACEs in their history.

Trauma, whether it occurs as a child or in adulthood, must be addressed by professionals. Too often, the lingering effects of trauma are left untreated; PTSD becomes a person’s reality, and self-medication ensues. Drugs and alcohol can provide temporary relief, but the practice places people at risk of developing alcohol and substance-related issues. PTSD and addiction are common co-occurring disorders.

The Substance Abuse and Mental Health Services Administration (SAMHSA) reports that about one-third of people exposed to trauma develop PTSD. Moreover, 75 percent of people in substance abuse treatment report having experienced abuse and trauma. While men are more likely to be exposed to traumatic events, women are at a higher risk of developing PTSD.

Veterans with PTSD and Substance Use Disorder

With Veterans Day around the corner, we must discuss rampant PTSD and substance use disorder (SUD) in the military. As we pointed out, exposure to adverse events can lead people down a precarious path. If an individual doesn’t receive care and support for their condition, then they are likely to resort to drugs and alcohol for temporary relief.

The U.S. Department of Veterans Affairs reports that more than 2 of 10 veterans with PTSD also have SUD. What’s more, almost 1 out of every 3 veterans seeking treatment for SUD has PTSD as well.

Fortunately, effective treatments exist to address both PTSD and SUD simultaneously. Those who experience trauma as a child or in adulthood, who develop use disorders can and do recover.

We have found that both posttraumatic stress disorder and substance use can be treated concurrently [meaning, at the same time].” — Ronald E. Acierno, Ph.D., Vice-Chair For Veteran Affairs and Executive Director Of The UTHealth Trauma And Resilience Center

Orange County Dual-Diagnosis Treatment

If you are struggling with PTSD, SUD, or both, then please contact PACE Recovery Center at your earliest convenience. We specialize in the treatment of men who face challenges related to addiction and mental health disorders. We offer several different types of programs to serve the unique needs of each client best.

Recovery begins with a phone call or email to an admissions counselor. Please take the first step: 800-526-1851.

Mental Illness Alerts on HBO and the “It’s OK” Campaign

mental illness

Talking about mental health is paramount; we need to have discussions about mental illness to combat stigma and encourage people to seek treatment. Historically, Americans have shied away from conversing about mental health disorders, sweeping them under the rug in hopes they will disappear. However, with one in five American adults facing the realities of mental and behavioral health problems, we can no longer ignore this public health crisis.

Right now, millions of Americans are suffering in silence from mental illnesses; such individuals feel isolated and alone in their struggles. Many have trouble relating to their peers at school and at work. When individuals feel apart from society, they are more likely to engage in self-defeating and self-harming behaviors.

Connection is the key to keeping mental illness at bay; those who feel disconnected will often use drugs and alcohol to escape their feelings. The practice can lead to dependence and addiction, and self-medication puts people at risk of overdose. Conversely, when individuals feel like they have support and compassion, they can find the courage to take action and seek treatment.

Several recent national observances have highlighted the need for having conversations about mental and behavioral health disorders. As we pointed out last week, October is National Depression Education & Awareness Month. Campaigns to raise awareness about mental health get more people talking about the benefits of compassion and how it gives people the strength to seek help.

Advocating for mental health in the 21st Century goes beyond annual awareness campaigns. A number of companies are doing their part to open up discussions about mental illness. Television and streaming networks are among those who hope to encourage people to seek treatment and recovery.

HBO Tackles Mental Illness Stigma

The premium network HBO has a history of creating programs that deal with sensitive subjects. Several HBO documentary series have helped raise awareness about addiction and treatment in America.

HBO Shows like In Treatment and, more recently, Euphoria are two examples of series that deal with mental illness and addiction. The hit show Girls touched on mental health disorders as well; the main character Hannah struggled with obsessive-compulsive disorder. Tony Soprano of The Sopranos battled anxiety and panic attacks. The network understands the importance of featuring characters in their shows who face the same problems as millions of Americans.

HBO has a new initiative to get more people talking about mental illness and encourage struggling men and women to reach out for support, The New York Times reports. The “It’s OK” campaign will involve beginning certain shows – that deal with mental health – with an alert that points out the challenges a character is facing.

The campaign will not only apply to new shows; the alerts will be applied retroactively to older shows like The Sopranos, according to the article. The alerts will conclude with imploring viewers who require assistance to reach out to the National Alliance on Mental Illness (NAMI).

We are not saying ‘viewer discretion is advised,’” Jason Mulderig, HBO’s Vice President of Brand and Product Marketing, said in a statement. “We are saying ‘viewer conversation is encouraged.’”

In conjunction with “It’s OK,” the network is releasing a series of videos called “Doctor Commentaries.” The short videos feature Dr. Ali Mattu, a clinical psychologist, unpacking specific show scenes that deal with mental health disorders. The first episode is available; Dr. Mattu examines OCD in the show Girls. Please take a moment to watch below (please be advised, there is some adult content):


If you are having trouble watching, please click here.

California Addiction and Mental Health Treatment Center

It’s a promising sign that HBO is committed to the awareness and destigmatization of mental health issues. Other streaming services like Netflix added disclaimers to their programs that deal with mental illness and suicide. Providing resources before and after shows that focus on mental illness can encourage men and women to seek assistance.

Please contact PACE Recovery Center if you are an adult male who is struggling with behavioral or mental health disorders. Our gender-specific treatment center can help you begin the healing process and teach you how to lead a healthy and fulfilling life in recovery. If you meet the criteria for mental illness and a co-occurring substance use disorder, we offer a dual diagnosis program that treats both conditions simultaneously.

Mental Health in Teens and Young Adults: A New Guide

Mental Health

The Child Mind Institute is a nonprofit dedicated to assisting adolescents struggling with mental health and learning disorders. The Center for Addiction is another vital organization—working to change society's understanding of and response to the disease of addiction. In January, both the Child Mind Institute and Center for Addiction merged with the Partnership for Drug-Free Kids. For those who are not familiar with the Partnership, it is a non-profit organization spearheading campaigns to prevent teenage drug and alcohol abuse in the United States.

Each organization, individually, plays a crucial role in helping children and young adults living either with mental illness, addiction, or co-occurring mental health disorders. Together, it is likely that the tripartite will affect even more change at this critical time in our history. Addiction, anxiety, depression, post-traumatic stress disorder, bipolar disorder, and dual diagnosis plague millions of Americans.

Without proper evaluation, diagnosis, treatment, and recovery services the result is despair and premature death—families needlessly shattered. Sadly, the youngest and most vulnerable members of our society receive no special dispensation from diseases of the mind. An adolescent battling mental illness continues to do so in his or her adult years. On the upside, evidence-based treatments are available, and clinicians can help transform the lives of young people.

Substance Use and Mental Illness in Young People

Treating a mental health condition, on its own, is both complicated and challenging to manage. When a patient is experiencing comorbid disorders or dual diagnosis (i.e., more than one mental illness), proper diagnosis and treatment are even more demanding. It is vital that mental health professionals also have expertise in substance use conditions. Addiction medicine specialists must also have overlapping mental health expertise, according to Harold S. Koplewicz, M.D., President at the Child Mind Institute and Fred Muench, Ph. D., President at the Center for Addiction.

In a commentary appearing in the Partnership for Drug-Free Kids website, Dr. Koplewicz and Muench point out that one in five young people struggle with a mental illness. Moreover, there are millions of teens and young adults engaging in alcohol and drug misuse; studies indicate a 30 percent to 65 percent overlap between the groups mentioned above.

It is vital to acknowledge the above findings because when young people misuse mind-altering substances, it is often for self-medication. Simply put, mental illness like depression can precipitate addiction; and, the same is accurate in the opposite direction. Drugs and alcohol can significantly impact the developing brains of young people, potentially resulting in comorbid disorders.

A New Guide for Clinicians and Parents

Doctors Koplewicz and Muench point out, rightly, that parents are the first to notice changes in their kids and adult children. What’s more, they play a critical role in seeking out treatment and encouraging long-term recovery. Parents with concerns about their loved ones can find an invaluable amount of information in a new guide from the Child Mind Institute and Center for Addiction | Substance Use + Mental Health in Teens and Young Adults: Your Guide to Recognizing and Addressing Co-occurring Disorders.

This guide, a collaboration of the Child Mind Institute and Center on Addiction, which merged with Partnership for Drug-Free Kids in January 2019, provides information on common mental health disorders in young people (and the medications that are often used to treat these), tips on identifying substance misuse and steps to making informed decisions about evaluation and treatment for co-occurring disorders.

Substance Use + Mental Health in Teens and Young Adults Guide Highlights:

  • 30% – 45% of adolescents and young adults with mental health disorders have a co-occurring substance use disorder, and 65% or more of youth with substance use disorders also have a mental health disorder.
  • Untreated, co-occurring disorders increase risk for self-harm.
  • Thorough evaluation, diagnosis and treatment planning of co-occurring disorders requires a professional with expertise in both mental health and addiction.
  • Symptoms of substance misuse and mental health disorders mimic each other.
  • Mental health disorders often lead to “self-medication” with substances. Certain substances are often associated with specific disorders.
  • Parents are instrumental in encouraging treatment for their child or young adult and supporting a treatment program.
  • Integrated care — combining primary care, mental health and substance use services — for co-occurring disorders offers the best long-term prognosis.

PACE Residential and Outpatient Mental Health Program for Young Men

As a pioneer in mental health and dual diagnosis treatment services, our clients work with a team of master’s- and doctorate-level clinicians, psychiatrists, and clinical psychologists. Our staff of mental health professionals can identify the specific needs of each client and chart a path toward long-term recovery.

Please contact us today to learn more about our gender-specific mental health programs for young men. Our seasoned team can help you or a loved one manage mental health conditions and heal from trauma—setting you on a course to lasting recovery.

PTSD and Addiction Treatment for Veterans

PTSD

Veterans Day 2018 in the United States of America is Sunday, November 11; but, the country will officially observe the holiday on Monday. Each year, the Gentlemen of PACE Recovery Center like to express our gratitude for those who serve bravely in the military. As a treatment center specializing in bringing the light of addiction recovery into the lives of young men, the coming holiday is acutely important. We understand that many people who come back from armed conflict overseas struggle in civilian life. The prevalence of mental illness among such people is high, conditions that include anxiety, depression, post-traumatic stress or PTSD, and substance use disorder.

The rates of substance abuse or use disorders for male veterans aged 18–25 years are higher compared to civilians, according to a recent study. Substance use disorders can precipitate the development of coöccurring mental illness or can emerge secondary to conditions like depression or post-traumatic stress disorder (PTSD). PTSD is common among individuals who witness or experience trauma; without evidence-based treatment, men and women are more likely to self-medicate.

The order in which a psychological disorder presents itself pales in importance compared to the need for therapy. Veterans who are unable to access the care they need are likely to continue misusing drugs and alcohol. Continued substance abuse does little to ameliorate PTSD symptoms, leads to or worsens a substance use disorder, and significantly increases one’s risk of self-harm. Veterans who commit suicide have drugs and alcohol in the system regularly.

Young males, struggling with substance use and coöccurring mental illness like PTSD, are encouraged to seek help. Immediately! The more extended treatment is put off, the more deleterious it is to the individual.

PTSD Treatment That’s Right For You

A new study appearing in the American Journal of Psychiatry shows that PTSD patients, including veterans and survivors of sexual assault, who have a say in the form of treatment they receive, fare better. The researchers found that patient preference in the course of treatment impacts the efficacy of cognitive behavioral therapy and use of antidepressants, according to a University of Washington press release. The study was the first large-scale trial of hundreds of PTSD patients.

This research suggests that prolonged exposure and Sertraline are both good, evidence-based options for PTSD treatment -- and that providing information to make an informed choice enhances long-term outcomes," said study lead author, Lori Zoellner, a UW professor of psychology and director of the Center for Anxiety & Traumatic Stress.

Analysis indicates that SSRI antidepressants and prolonged exposure therapy show promise in mitigating the symptoms of PTSD. However, the group of patients who were offered a choice in the type of treatment they receive exhibited:

  • Fewer symptoms;
  • a greater ability to follow their treatment plan;
  • and, some no longer met the criteria for PTSD two-years later.

Almost 75 percent of patients who underwent their preferred method of treatment, completed the program, according to the article. Whereas, fewer than half in the non-preferred group saw their therapy through to the end.

Dr. Zoellner and our team showed that we've got two effective, very different interventions for chronic PTSD and associated difficulties," said study co-author Norah Feeny, a psychology professor at Case Western Reserve University. "Given this, and the fact that getting a treatment you prefer confers significant benefit, we are now able to move toward better personalized treatment for those suffering after trauma. These findings have significant public health impact and should inform practice."

Addiction and Dual Diagnosis Treatment

Approximately 50 percent of veterans who need treatment for mental health conditions seek it, according to the Substance Abuse and Mental Health Administration. However, just more than half who receive treatment receive adequate care. Mental health conditions among veterans are no small issue; approximately 18.5% of service members returning from Iraq or Afghanistan have PTSD or depression. According to the U.S. Department of Veteran Affairs, more than 2 of 10 Veterans with PTSD also have substance use disorder.

Studies, like the UW/Case Western, are vital and should help guide screening, diagnosis, and the determination of a treatment plan. It’s also worth mentioning that a large number of veterans are unable to access evidence-based treatment where they live. Such individuals can benefit from seeking help in another area. If you are a male veteran who is struggling with substance use disorder or coöccuring mental illness (dual diagnosis), please contact PACE Recovery Center.

Veterans Day 2018, we would like to honor two of our staff members who served in the U.S. Marine Corp, our Chief Operations Officer Sean Kelly and our Lead Resident Manager Victor Calzada. Additionally, our PACE team members Helen O’Mahony, Ph.D., Hisham Korraa, M.D., and Ryan Wright, M.D. all have extensive experience working with veterans with PTSD and substance abuse issues.

Again, the gender-specific environment at PACE enables men to share openly and without fear of judgment or social pressure. Our team works together with referring physicians and healthcare providers to create individualized dual-diagnosis treatment plans that emphasize continuity of care. Please call 800-526-1851 or submit a confidential online inquiry, to learn more about our innovative program for men.

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