Seeking Treatment

April 03, 2014

“When choosing a dependency treatment program, it’s a real benefit to have an integrated approach that can treat the addiction and recognize and treat psychiatric and medical issues as well,” explained Crescenzo Pisano, MD, medical director and certified addictionologist at the Recovery Center. “We’re unique in that regard.”

“When a person is ‘detoxing’ from drugs or alcohol, mood swings and agitated behavior are not unusual,” said James Brust, MD, medical director of the Bridges psychiatric program. “It takes special training to discern between what’s normal in addiction withdrawal and what’s actually a symptom of another underlying co-occurring issue. We’re experts at that have all the expertise in one place to treat it all simultaneously. Our psychiatric and medical doctors work together, involving other specialists when needed, to ensure that each patient receives the highest quality of care and is able to optimize their recovery.”

The most common psychiatric problems occurring in tandem with alcohol or drug dependency include depressive disorders (such as depression and bipolar disorder); anxiety disorders (including generalized anxiety disorder, panic disorder, obsessive-compulsive disorder, and phobias); and various forms of schizophrenia and personality disorders.

“People often wonder which develops first, the emotional problem or the substance abuse? It depends,” Dr. Brust explained. “Often the psychiatric problem develops first and as the person attempts manage it, they knowingly or unknowingly try to ‘selfmedicate’ by drinking or using drugs. They’re trying to cope.” This can lead to dependency on the alcohol or drugs and then the person suffers from not just one problem, but two. In adolescents, however, drug or alcohol abuse on its own (without psychiatric symptoms) may stunt maturation and brain development, continuing into adulthood, contributing to the later development of emotional difficulties and psychiatric disorders. “In other cases, alcohol or drug dependency is the patient’s primary condition and recovering from the addiction also addresses psychiatric symptoms like episodes of depression, hallucinations, fits of rage, or suicide attempts,” Dr. Pisano explained. “It’s important to work with experts who can discern the difference between a psychiatric disorder that stands on its own and needs treatment versus symptoms that are part of the substance abuse.”

The patient is medically supervised during withdrawal and detoxification which can take from a few days to a week or more. Doctors can administer carefully chosen medications to substantially ease withdrawal symptoms, making it safer and less traumatic than most people realize.

After detoxification (if there is an underlying psychiatric diagnosis), dual treatment begins.

Rehabilitation for the substance abuse problem involves individual and group psychotherapy, education, exercise, proper nutrition, and participation in a 12-step recovery program. Treatment for the psychiatric problem depends upon the specific diagnosis, but may involve a combination of individual and group therapy as well as medications.

 As with any illness, a person with dual diagnosis can improve with proper care. If you know someone who may be suffering from alcohol or drug dependencies and emotional or psychological problems, encourage them to seek help. Please call the Recovery Center at Providence Little Company of Mary Medical Center San Pedro at 1.310.514.5300.