Substance abuse disorder is a great social concern. It is defined as dependent on substances that alter or affect the functioning of the Central Nervous System (CNS) and brain function, producing alterations in behavior, perception, judgement, and emotions. Various drugs have varying effects depending on the type, quantity consumed, and frequency of consumption.

 A person with a poor state of mental health has a higher chance of falling into the grasping clutch of various addictions. Substance Use Disorders (SUD) is one such problem. People with major depression, anxiety and panic disorders, ADHD, and other behavioral disorders are common victims of this situation. Some other mental health issues that often coexist or lead to substance use disorders include Post Traumatic Stress Disorder (PTSD), Borderline Personality Disorder, Bipolar Disorder, Conduct Disorders, and schizophrenia.

Although drug use and addictions can happen at any point in an individual’s life, they are mostly known to start in adolescence, a period when the first signs of mental illness commonly appear. Having a mental health issue in childhood or adolescence can increase the risk of the same symptoms being exhibited in adulthood, especially if neglected. The brain continues to develop throughout adolescence. Parts of the brain that are responsible for controlling executive functions, such as impulse control and decision-making, are among the last areas to develop. This enhances vulnerability to drug use and the development of other dangerous addictions.

During the COVID-19 crisis a couple of years back, a situation arose that put the entire section of healthcare workers, including psychiatrists and psychologists, into an entirely new reality. Care that relies on telecommunication. Telehealth, or the use of technology to deliver healthcare and engage with patients outside traditional facilities, can play an important role in addressing the management of various health issues, including mental illness and SUDs.

Relationship between mental illness and substance abuse:

The relationship between mental illness and substance abuse is complex. A mental illness may make a person more likely to use drugs as an attempt to self-medicate the symptoms associated with mental illness. Conversely, substance use may be a contributing factor to the initial symptoms of mental illness. Certain drugs are also known to cause drug-induced psychosis, which can last up to days or weeks together.

Dual Diagnosis:

Dual-diagnosis refers to the presence of a substance use disorder (SUD) as well as other co-occurring mental health disorders. This condition is characterized by the interplay of two complex issues: mental health challenges such as depression, anxiety, bipolar disorder, or schizophrenia, and substance use problems involving alcohol and addictive drugs. When a person has both a mental health issue, such as depression, bipolar disorder, or anxiety, along with substance abuse, it can be called a co-occurring or dual disorder. As such, dealing with addictions or substance abuse such as alcoholism is not easy. It becomes even more complicated when the person is also struggling with mental health issues.

According to reports published in the Journal of the American Medical Association, roughly fifty percent of individuals with mental disorders have substance abuse. Also, of all people diagnosed as mentally ill, approximately thirty percent abuse alcohol or drugs.

The best treatment for co-occurring disorders is an integrated approach where both substance abuse and mental health disorders are treated simultaneously. Depending on the specific presentations of the patients, treatment for mental health may include medical management, therapy in the form of individual or group counseling, cognitive behavioral therapy, self-help measures, lifestyle changes, and peer and family support. Treatment for substance abuse includes detoxification, management of withdrawal symptoms, behavioral therapy, and support groups to maintain sobriety.

The need for comprehensive and individualized management led to the development of integrated dual management. This model refers to treating two or more conditions simultaneously and using multiple treatments, such as the effective combination of psychotherapy and pharmacotherapy.

Scenario in the Sunshine State of Florida:

Florida is famous for its beaches and warm weather, and it has quickly become an ideal vacation spot for tourists worldwide. The dark side of this Sunshine State is the widespread use of alcohol and other illegal substances. According to the Substance Abuse and Mental Health Services Administration (SAMHSA), overdosing and drug-related deaths in the state were estimated to be a whopping three thousand annually.

Florida has also been grappling with a severe opioid crisis, fueled mainly by the abuse of synthetic opioids such as Fentanyl, which is primarily used for severe pain management. The state has implemented various measures to address drug and alcohol addictions. State-sponsored laws such as the Florida Good Samaritan Act, the Prescription Drug Monitoring Program, Drug-free Workplace Program, etc.

The state also has treatment centers that offer programs that include medical management, outpatient rehab, telepsychiatry, Residential treatment, and other holistic treatments. Rehabilitation centers offer both inpatient and outpatient services that provide dual diagnosis or dual management, using medicines to simultaneously manage substance abuse and mental health issues, along with counseling and other behavioral therapies.