Rate of occurrence
There are several paradigms that relates to addiction and treatment. The first paradigm argues that the problematic and chemical involvement of a person is actually a response to, or a symptom of either a family dysfunction, or a psychiatric problem. The other paradigms are more involved with the use of the dependency on chemicals as being the real problem. A lot of studies have indicated that the rate of dependency on substance abuse among those members of the population that are mentally ill to be between 32 and 85 percent. (Schwartz & Goldfinger, 1981).
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The mentally ill patients, besides being dually diagnosed, have reportedly been shown to engage in increased hospitalization rates, criminality, homelessness, as well as the exhibition of suicidal behavior (Safer, 1987). The abuse of substances is often associated with legal implications. Substance abuse often results in generalized anxiety, as well as panic symptoms. In addition, the course of chemical dependency is often affected by anxiety disorders.
According to Brook et al (1996), those patients with psychiatric illnesses have more than a double chance of becoming smokers, in comparison with the general public. Furthermore, Brook et al (1996), have also reported that schizophrenia patients have a smoking prevalence rate that is 3 to 4 times greater than that of the general population. Psychiatrists have reported high depression rates among those individuals who are addicted to such drugs as cocaine, heroine, and alcohol.
According to research, about 50 percent of the mentally ill population also happens to be drug abusers, with the most commonly abused drugs being alcohol, cocaine, and marijuana. Additionally, such prescription drugs as sleeping medicine and tranquilizers are also likely to be abused. Males of the age brackets between 18 and 44 years, and who are also mentally ill, have been shown to be the greatest abusers if drugs (Abbott 2000).
Protective factors related to chemical dependence
Protective factors, in the context of substance dependency, have been taken to mean those variables that bear an association with a reduction in the use of drugs.
Bio/ psycho/ social issues of the mentally ill population
According to the biopsychosocial addiction model, addictive disorders are often characterized by a biologically-induced element, as well as an inherited one. In addition, the same model also posits that both the social-cultural and the psychological-behavioral factors also comes into play, in as far as the cause, course, and the consequences of being substance dependent are concerned (Brook et al 1996).
By abusing substances, the mentally ill population is also complicating the possible care given to them. To start with, it is very difficult to engage such substance abusers into treatment. In addition, there is a difficulty in their being accommodated either at home, or at a health facility. Not only are they likely to lose their support system, they also suffer hospitalization and relapses on frequent basis. Mentally ill patients who use chemical substance are more likely to be violent, especially for those who end up in prisons and jails.
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It has been postulated that a majority of the mentally ill patients abuse drugs as a way of countering the side effects of their medication, or as a means of treating their symptoms. Depression and anxiety normally recedes, albeit for a short while, upon the use of such chemicals. With regard to social factors, the mentally ill patients have been shown to be victims of ‘downward drift’. The implication here is that by virtue of their mental conditions, such patients have a higher chance of being marginalized to drug-prone neighborhoods (Brook et al 1996). Their difficulty in the development of social relationships also means that such patients will often find companionship and acceptance among fellow drug users.
Socio economic justice
It is important that those mentally ill patients who abuse drugs are accorded the proper medical attention that they so rightly deserve. They should not be discriminated against on grounds of their medical conditions. As such, all the social benefits such as health care should be shared impartially with them (Abbott 2000).
Protecting the mentally ill from chemical dependence
These could involve arrangements for detoxification, the attendance of skill-building classes, involvement of family, group therapy, involvement in activities meant to prevent relapse, as well as a referral to a 12-step program (Safer 1987). Since chemical dependence in itself is a disease, it is important to ensure that a recovery program besides being successful and safe, is also based on abstinence from all chemicals that are capable of altering the mood.
Implications of the knowledge for social work practice
When the health practitioners that are working in those facilities that deals with the mentally ill patients that are also abusing substances are fully aware of the bio/ psycho/ social issues that often accompanies this disease, together with the need to observe the socioeconomic justice when handling such patients, then it is possible to aid such patients in their attempts to get themselves rod of chemical dependent, while at the same time also maintaining their dignity. It also means that the social workers are aware of the fact that this is a case of dual diagnosis (mental illness, and substance abuse), and so the most comprehensive and relevant treatment program will be put to use.
- Abbott, Ann. Alcohol, tobacco, and other drugs: challenging myths, assessing theories, individualizing interventions. North Carolina: NASW Press, 2000
- Brook, J. S. Brook, D. W., Whiteman, M. & Gordon, A. S. “Pathways to addiction: opportunities in drug abuse research” Journal of chemical dependency treatment 1(1996):123-161.
- Drake Robert, Wallach, Michael 1989. “Substance abuse among the chronically mentally ill”. Hospital and Community Psychiatry 40 (1989):1041-1046.
- Safer, Daniel. (1987). “Substance abuse by young adult chronic patients”. Hospital and Community Psychiatry, 38 (1987): 511 514.
- Schwartz, Samuel. & Goldfinger, Simon (1981). “The New Chronic Patient: Clinical Characteristics of an Emerging Subgroup”. Hospital and Community Psychiatry 32(1981): 470- 474.