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Dual Diagnosis: Alcoholism and Other Substance Use Disorders

    Dual Diagnosis: Alcoholism and Other Substance Use Disorders

    It’s common for alcoholism to exist with other substance use disorders. Where this is the case, there are increased health risks and also serious implications in terms of a person’s mental health.

    A variety of factors influence whether a person develops alcoholism alongside misuse of other substances. In terms of treatment, the substances themselves as well as the person’s circumstances in relation to the physical and psychological, need to be addressed.

    Treatment is available and healing is possible. Whether you or someone you love is misusing alcohol with other substances, it’s important to understand the side effects and long-term consequences.

    What makes people use more than one substance?

    Each person is an individual and as such will have their own particular reasons for using substances the way they do. However, there are certain factors that make this more likely to happen.

    For some, it might not necessarily matter too much what the other substance is. There might be preferences around particular combinations, however, this isn’t always the case. Some people might seek a particular feeling gained from mixing certain substances.

    The side effects of alcohol might exacerbate or increase the effects of other drugs. This can be very desirable to a person with an addiction.

    Where severe addictions exist and where increased tolerance occurs, some might combine substances in order to feel more of an effect. Some people might want to “get totally out of it” in order to escape or avoid feelings of pain.

    Signs that a person might be using alcohol and drugs

    There are various signs that imply a person might be using both alcohol and drugs. If you’re worried about someone you love, care for, or work with then there are things you can look out for.

    Signs of combining alcohol and drugs include (but aren’t limited to):

    • Slurred words or not being able to speak clearly
    • Confusion
    • Unbalanced
    • Mood swings
    • Paranoia
    • Restlessness
    • Insomnia
    • Asking to borrow money
    • Trying to hide things
    • Unusual paraphernalia in the house
    • New friends
    • Loss of weight (or gain)
    • Looking washed out

    It can be very distressing when you discover that someone might have an addiction. Where a person is combining substances, it might feel even more stressful due to how this can increase health risks.

    There are a couple of things you can do if you’re worried about someone using alcohol and other substances:

    • Remember that addiction is an illness. It’s a disease and a person can’t “just stop” taking the substances
    • Speak to the person. If you do this, it’s helpful to remain calm and compassionate. If you’re emotionally involved, this can be difficult. In which case, seeking advice helps
    • Get in contact with local 12 Step groups. Here you can join sessions that will support you. Looking after yourself and learning how to set boundaries is incredibly important in how you then care for the person with the addiction
    • Contact us at OK Rehab to find out about local treatment centres. We ensure confidentiality

    The nature of addiction

    Addiction is a disease that changes the structure of the brain. It forms compulsive behaviours. For many people who have an addiction, it’s common that there will be problems with a variety of substances.

    Both alcohol and drugs change the chemical and hormonal balances in the brain and body which keep a person functioning normally. Therefore, when the substance starts to leave the body, the person will crave it in order to get back to the state they are used to.

    Many people will have preferences on which substances they take, but if a person is unable to get the substance they want and another is available then they are very likely to take that instead. It doesn’t necessarily matter what the substance is, so long as a person can take it and feel the effects on the mind and body.

    Common factors that influence an addiction developing

    For the majority of people who struggle with alcoholism and addiction to drugs, there are factors that commonly run like a thread in the background. Addiction isn’t chosen. Drinking and taking drugs is a coping mechanism people discover, which turns into a compulsion.

    Factors that influence an addiction development include:

    • A history of addiction in the family
    • Genetics
    • Individual personality. For instance, those with lower self-esteem are more likely to develop an addiction
    • Historic trauma
    • Social aspects related to coercion or pressure

    Dual diagnosis: addiction and mental health

    There is an incredibly high correlation between addiction and mental health problems. A dual diagnosis is where the two exist at the same time.

    Many people who have depression, anxiety, and bipolar will turn to alcohol and drugs to try and ease the symptoms. This is known as self-medicating. Of course, when a substance is relied on to regulate moods it can form an addiction.

    On the other side of this is the fact that taking substances really upset the body’s natural systems which regulate mood. Therefore using alcohol and drugs actually makes mental health worse in the long run.

    It’s important to remember that alcoholism can also be dangerous when mixed with prescribed meds as well.

    Suicidal thoughts and behaviours

    Research evidences time and time again that people living with alcoholism, addiction and mental health issues have higher risk factors around suicide.(1) Where the three exist together this situation is even more likely.

    These conditions can literally be a struggle to live with. If you’re worried about someone you care about, it’s best to approach them with kindness and compassion and with some useful information about where they can seek help. If you contact your local GP or OK Rehab, you can seek advice around this.

    If you’re worried someone might hurt themselves in the immediate instance, then you should call emergency services on 999.

    How lifestyle influences concurrent alcohol and substance use

    There are various lifestyle factors that can make people more likely to use alcohol and other substances.

    1. Building a tolerance

    A tolerance is built when the body becomes used to a substance. When this happens a person with an addiction is likely to start taking more and more of substance.

    In the case of alcohol, they might drink stronger drinks or take drugs that feel similar. For instance, alcohol is a depressant, a person might therefore seek a depressant drug such as heroin or ketamine to try and experience the feeling they’re seeking.

    Mixing two depressants can be extremely dangerous as they both slow down bodily functions, including heart rate. Sadly, thousands of people have died by combining two depressant substances and their hearts slowing down to the point of stopping.

    2. Environmental influence

    Films and the media, clubs, illegal raves, festivals, even certain cities can influence how people view alcohol and drugs. Certain environments can make a person more likely to experiment.

    There is a rise in young people mixing alcohol with cocaine as cocaine becomes increasingly available. People will often mix alcohol with prescribed meds. People who are into “partying” might indulge in a “cocktail” of substances.

    As well as this, when under the influence, inhibitions are lowered and higher risk behaviours occur, which might include mixing alcohol and drugs.

    The social aspect of substance misuse is extremely powerful. Friends often “advise” taking substances that will feel a certain way and will combat the effects of or enhance the effects of other drugs.

    This is often seen where people take cocaine to “straighten them out” if they have drunk a lot of alcohol.

    3. Seeking comfort

    A vast amount of addictions are formed because a person is trying to cope with their thoughts and feelings in relation to painful events. Many are looking for comfort in a distressing place. When a habit is formed, it can be difficult to see how to break it and what else to do with life.

    The impact of alcoholism and substance use disorders

    Alcohol and drugs are toxic and affect the body and mind. These toxins build up in the system as the body becomes unable to metabolise and eliminate them as quickly as they are consumed.

    Long-term physical effects of substance misuse and alcohol include:

    • Generic increased health risks
    • Severe damage to vital organs, especially the liver and pancreas
    • Heart problems
    • Various types of cancer
    • Unexpected death

    Although substances might be used to ease the symptoms of mental health issues, they actually cause serious psychological problems, such as:

    • Low mood and depression
    • Restlessness, panic, and anxiety
    • Alcohol-related dementia
    • Hallucinations
    • Delusions
    • Psychosis

    What are the treatment options for people living with alcoholism and substance use disorders?

    Throughout the UK, there are many treatment options for people living with addiction. Whatever the substance and whether a person uses more than one or not, there are rehabilitation programmes to treat this illness.

    Rehab clinics offer a total approach to recovery. A full package of care is provided addressing the physical, psychological, and “spiritual” needs of a person. Along with a detox, evidence-based therapies take place, such as cognitive behavioural therapy.

    On top of this, patients are provided with holistic therapies such as art, music, yoga, and mindfulness. 12 Step group work is also a key part of accommodating the healing process.

    Final thoughts…

    Thousands of people are living with a drinking problem while using other substances. Alcohol and drugs are combined for various reasons, sometimes to try and feel a stronger effect if tolerance has been built, others might fall under peer pressure, while some might be trying to escape emotional pain.

    Mixing substances has many health implications due to how they react in the body. Prolonged use severely damages vital organs and bodily systems.

    Recovery is possible. Rehab clinics provide an immersive and safe environment where people are supported to heal. To find out your local options, contact OK Rehab.

    References

    1. https://onlinelibrary.wiley.com/doi/abs/10.1111/j.1600-0447.2005.00643.x

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