What to look for in a Treatment Setting if You Have Substance Abuse and Depression or Anxiety

September 27, 2013 —
Thomas N. Franklin, M.D.

Associate Medical Director, the Retreat at Sheppard Pratt

Medical Director, Ruxton House

Treatment of people with substance abuse issues along with mental illness is most often poorly integrated despite the fact that about 40% of those who suffer from addiction also have an independent psychiatric disorder as well. Too often someone will land in a drug rehabilitation setting, all of which claim to treat dual diagnosis, and may see a psychiatrist a time or two in consultation but 95% of their treatment is focused on substance abuse. Meanwhile, people who are admitted to most psychiatric hospitals fare little better. They are detoxed, but then told to go to AA or NA after discharge from the psychiatric facility with little attention paid to their substance abuse issue while their psychiatric condition is stabilized. Many psychiatric residential treatment centers will not even accept someone unless they have a period of sobriety prior to admission. What should one look for if they or their loved one has a true Dual Diagnosis?

In a word, integration. While 20 years ago it was thought that treatment should be done sequentially, years of experience has taught us that to be most effective people should be engaged at a high level for both problems at the same time. This makes intuitive sense since both sets of problems are intimately connected to each other and feed off of one another. While it is tempting for both patients and treaters to put one issue on the back burner, this is not how the patient experiences them. Depression and anxiety can both lead to substance abuse, and are made worse by it.

At the Retreat at Sheppard Pratt treatment of substance abuse and other addictions is seen as an integral part of a person’s treatment experience while they are also being engaged around their psychiatric disorders. Many of our staff has additional qualifications in addictions treatment, and we offer several groups as part of our core curriculum for the addicted patient. For those that need it, we have a partnership with the KOLMAC program such that one can be exposed to an entire outpatient drug treatment program while at the same time taking advantage of the richness of the Retreat’s diagnostic capabilities and treatment offerings. Those who are contained in a supportive treatment setting longer do better, so we have Ruxton House for those that need it to move on to while they continue their recovery. At Ruxton House people can be monitored and continue to see their trusted Retreat providers while they begin to orient themselves back toward the community, family, and work.

If you have decided to pursue residential treatment for your dual diagnosis, congratulations for making this courageous decision. Choose a treatment setting with a fully integrated treatment program that will address all of your issues fully, and give you the best chance for a full recovery.