Causes and Treatment of Dual Diagnosis of Substance Use Disorder and Mental Illness: The Role of Social Psychiatry and Social Work

About this Research Topic

Background

Care and treatment are still inadequate for people suffering from substance use disorder and other mental illness, and the traditional, sequential approach of ‘first the addiction, then the mental illness’ is not effective. For people with dual diagnoses (e.g. alcohol and drug addicts, poly-drug addicts, or drug addicts), dependence is often a failed attempt to cope with a psychiatric impairment, which the affected individuals experience as painful and restrictive in their everyday lives.

Addictive disorders frequently occur and interact with personality disorders (paranoid, schizoid, antisocial, emotionally unstable, histrionic, dependent, anxious-avoidant and borderline personality disorders), psychotic, affective, and anxiety disorders. The psychoactive substance initially offers protection against fears, inner tensions, and conflicts, eventually leading to self-destructive coping in the form of excessive consumption. Due to constant use of psychoactive addictive substances, through psychosomatic disorders and neglecting healthcare, a range of serious physical damage occurs in chronic cases. This population is extremely heterogeneous and is characterized by different symptoms, poorer adherence, more frequent relapses, homelessness and a highly problematic social situation (e.g. isolation, finances, prison experiences, stigmatization, criminalization). There is also a higher risk of aggressive behavior, including suicidal tendencies, and this combined overwhelms the possibilities of many established offers of help. Confrontational or demanding communication styles, high-threshold entry requirements (e.g. proof of motivation as a condition for admission), or rigid regulations on the part of the facility contribute to this population often falling out of the care system.

The following is needed:
• inclusion of all conditions in the concept and in the specific care; that is, integrative care concepts
• a conceptually described, vulnerable initial phase
• individualization of offers
• a multidisciplinary approach
• specialist treatment and medication.

In short, people with this dual diagnosis of substance-use dependence and mental illness need differentiated offers of support with a conceptually based specialization dependent on their particular needs.

This Research Topic welcomes submissions that can assist in answering the following questions relating to the issue of treatment for people with substance-use dependence and mental illness as dual diagnosis:
• what is the current state of research and practice?
• what suggestions does psychiatric care have for improving treatment in this population?
• what role does social work play in improving treatment in this population?
• how are the different socio-cultural contexts to be included?
• what is the situation under conditions of repressive behavior towards users of illegal psychoactive substances (such as opioids or stimulants)?

Important Note: All contributions to this Research Topic must be within the scope of the section and journal to which they are submitted, as defined in their mission statements. Frontiers reserves the right to guide an out-of-scope manuscript to a more suitable section or journal at any stage of peer review.

Keywords: dual diagnosis, substance use disorder, mental illness, social psychiatry, social work

Important note: All contributions to this Research Topic must be within the scope of the section and journal to which they are submitted, as defined in their mission statements. Frontiers reserves the right to guide an out-of-scope manuscript to a more suitable section or journal at any stage of peer review.

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