Monthly member blog: Dual Diagnosis explained

We continue our series of monthly member blogs, with this month’s blog coming to us from Dual Diagnosis Ireland.

‘Dual Diagnosis’ is the term used when a person suffers from both a substance addiction problem and another mental health issue, such as depression or an anxiety disorder. Most mental health services and addiction treatment centres in Ireland are currently not organised to treat such people holistically. For example, if you have difficulties abstaining from alcohol due to anxiety, you can not enter rehabilitation services (most residential drug services insist you must be “dry” before entry). Yet you can not get your anxiety problem treated until your addiction to alcohol has been addressed.

According to figures from the American Medical Association, up to 37% of alcohol abusers and 53% of drug abusers also have at least one serious mental illness, and 29% of people diagnosed as mentally ill abuse either alcohol or drugs.

A study by the UK Dept. of Health put the figures even higher, suggesting that 75% of users of drug services and 85% of users of alcohol services experienced mental health problems. 44% of mental health service users reported drug use. (Weaver et al, 2002)

Despite this, there is currently little awareness of the problem in Ireland.  In February 2008, we decided to set up a not for profit organisation aimed at raising awareness of the lack of services for the many, many people with both a mental health problem such as depression and addiction issues. We believe that if you don’t treat both together, you can’t beat either.

Although the treatment of dual diagnosis may be thought to be “complicated” it is being done abroad, the “Foundation Recovery network” (USA) has a success rate of 70 to 80%, based on follow up with clients one year after treatment.

This is in contrast to lower success rates of 24% to 51%, based on different approaches which do not take into account a dual diagnosis. (Bauer, L.O. 2001)

A quick trawl through the relevant websites would suggest that Dual Diagnosis programmes are the norm in the United States rather than the exception.

“What if you broke both legs, and doctors only treated the left one? You certainly couldn’t run any marathons, right? In fact, you’d probably have trouble just standing up. That’s what life is like for those suffering from both mental illness and substance abuse. Often times, only one of their legs is being treated, causing them to stumble and fall on their journey through recovery” (Cliffside Treatment Centre, USA.)

A service user who had been in an Irish residential treatment centre for alcohol addiction and who later was diagnosed with depression and social anxiety described his experience in treatment as follows:

“It’s like if your car broke down, you bring the car to a mechanic. He tells you it has no oil because there is an oil leak.  He fills your car back up with oil and sends you on your way.  At some point down the road you are going to break down again because he hasn’t fixed the leak”

New services are not necessarily required in Ireland; existing services can be adapted with training and education. Is streamlining services less complicated than dealing with the revolving door of services for a person with a dual diagnosis or the impact on society?

For more information on Dual Diagnosis Ireland please go to our website


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