Co morbidity refers to the coexistence of a psychiatric disorder with a substance abuse disorder often resulting from self-treatment by the patient for instance using drugs to offset the emotional distress that comes with the psychiatric disorder. It may also occur when in reaction to substance abuse; a patient develops psychiatric disorder like panic or anxiety attacks (Daughters, Bornovalova, Correia, & Lejuez, 2009, p.5). The most common coexistence occurs with mood disorders such as depression and anxiety attacks where patients seek the euphoric or sedative effects of respective drugs such as heroin, marijuana and ecstasy or alcohol and narcotics respectively. Antisocial personality disorders and affective disorders can induce illicit drug use in teenagers both in an effort to cope, and as a way of rebellion. Patients with eating disorders commonly abuse amphetamine-containing diet pills, and may shift to other stimulants when they become dependent on these (Hasin, Muthen, & Grant, 1997, p. 34).
Post Traumatic Stress Disorders (PTSD) often result in alcohol abuse or are a result of such abuse that ended in the inebriation of patients or their assailants. Attention Deficit/ Hypersensitivity Disorder (AD/HD) patients commonly abuse tobacco, marijuana or other CNS stimulating drugs in a bid to cope or fit with their peers. Such adolescents often have learning disabilities that weigh them down and induce drug use. Nevertheless, no matter the cause or reason for co morbidity, it is detrimental to treatment processes as it confounds physicians and therapists as to the extent of the conditions. If detected, both the SUD and the psychiatric disorder need to be treated simultaneously for the patient to be said to have received optimal treatment (Hasin, Muthen, & Grant, 1997, p. 30).
The DSM-IV-TR diagnostic criterion for substance abuse requires a pattern of destructive consumption tendencies by the adolescent that result in clinically significant impairment or distress. By impairment, this criterion refers to “an inability to meet major role obligations, leading to reduced functioning in one or more major areas of life, risk-taking behavior, an increase in the likelihood of legal problems due to possession, and exposure to hazardous situations” (Daughters, Bornovalova, Correia, & Lejuez, 2009, p. 9). This model also treats substance abuse as a residual category which can only be met in the absence of dependence. Patients with this diagnosis are therefore prone to be found on the wrong side of the law, or may be suicidal or even pose a danger to others around them. Consequently, they usually remain restrained or placed into inpatient facilities for treatment. These patients include juvenile delinquents.
The treatment facility I identified and contacted is the White Deer Run, York Pennsylvania Treatment Facility. They use various treatment modalities depending on the nature and condition of individual patients. For instance, In-Patient Non Hospital Detoxification is used to assist patients cope with withdrawal symptoms of drug abuse, In-Patient Residential CD Rehabilitation is a customized procedure that is adapted to suit each individual adolescent patient’s needs. It is features services such as juvenile probation and Youth recreational facilities. Their Mental Health Residential Treatment program caters for adolescents with serious behavioral disorders, emotional disturbances and mental illnesses. Its objective is to stabilize these conditions at the level of the first diagnosis and provide patients with the necessary fortification, and health climate needed for survival in the community. Finally, they also offer outpatient individual, group and family therapy with the aim of preventing stress to affected individuals while supporting the treatment process of the patient. Other therapies are: Reiki; used in treating chronic pain, abuse, and emotion-oriented syndromes; EMDR therapy is used to reduce symptoms that are associated with trauma, psychodrama ranging from social atoms to full dramas; art therapy as an expressive medium for intrapersonal conflict and trauma; and relaxation therapy. All these programs and more range from detox to aftercare. Recently, they introduced the 12-Steps program, which encourages patients to join AA/NA support groups. Their philosophy is that each patient should receive unique treatment, suitable for the condition of their chemical dependency and mental status. They also believe in promoting the autonomy of each patient and providing them with the rewards and gratification of living a drug-free lifestyle. The staff at White Deer Run is multicultural and mostly bilingual to cater for the multiethnic populace of its clients. They are also qualified and licensed to treat the various conditions that are referred to the facility. The amount of time spent at the facility ranges from a few days to months or even years depending on the intensity of the condition, as do the charges. These are dependent on both the treatment procedures to be applied and the duration of stay. In my opinion, this is a very competent facility and it appears to serve the needs of both its population and the general community.
References
Daughters S., Bornovalova, M., Correia, C., & Lejuez, C. (2009). Psychoactive Substance Use Disorders: Drugs. M. Hersen, S. M. Turner, & D. Beidel. Adult psychopathology and diagnosis: Fifth edition. Hoboken, NJ: Wiley.
Hasin, D., Muthen, B., & Grant, B.(1997). The dimensionality of DSM-IV alcohol abuse and dependence factor analysis in a clinical sample. Vrasti, R., ed. Alcoholism, New Research Perspectives. Gottingen, Germany: Hogrefe and Hubner.