KL 200 word reply Doweiko (2015) defines a dual-diagnosis patient as one that has both a substance use disorder and a mental illness. For many years the belief was a person would develop a mental disorder as a result of their substance abuse, however, evidence disproves that theory and it is important to treat both disorders. Four various models have attempted an explanation for dual-diagnosis, in which the first model suggests both disorders point to an undiscovered factor, the second suggests substances were used by mental illness patients to treat their disorders, the third suggests the substance use disorder will go away when the mental illness is treated, and the fourth suggests patients with a mental illness are more sensitive to the effects of drugs (Doweiko, 2015). The fourth theory does have some evidence to back it up. Within the United States, it is estimated that 4 million people have been dually diagnosed, however, the process of deinstitutionalization has caused my psychiatric facilities to close, and many physicians remain uneducated in dual-diagnosis (Doweiko, 2015).              Psychiatric disorders such as ADHD, depression, anxiety, eating disorders, dissociative disorders, OCD, and schizophrenia are all common within dual-diagnosis patients. An estimated 21% of patients who have depression have an alcohol use disorder, while 9% have a substance use disorder (Doweiko, 2015). Treating patients with both depression and an SUD costs five times more than treating a patient with just an SUD, and becomes complicated when the substances being used either increase the depression or mask the prescriptions being used to treat it (Doweiko, 2015). Similarly, diagnosing patients with both a substance use disorder and schizophrenia also proves to be a challenge. Approximately 40-50% of patients diagnosed with schizophrenia develop an SUD, and as such have a 460% higher chance of developing an SUD than the average person (Doweiko, 2015). Diagnosing a patient with an SUD and schizophrenia becomes difficult when the symptoms of the substance use become confused with the symptoms of the schizophrenia (Doweiko, 2015). Other disorders, such as eating disorders, are also common within dual-diagnosis patients. Alcohol is most commonly abused in patients with an eating disorder to suppress the appetite (Doweiko, 2015).              Dual-diagnosis patients become complicated in their treatment, as they are 8.1 times more likely to resist their treatment than the average person by refusing their medication, continuing their drug use, and taking medications that only enhance their desired effect (Doweiko, 2015). The stages of treatment for a dual-diagnosis patient includes establishing the client-counselor relationship, helping the client gain motivation for change, active treatment for both disorders, and relapse prevention (Doweiko, 2015). Within the addiction cycle, the person suffering from a dual-diagnosis can become more susceptible to the ef ...

1. KL 200 word reply
Doweiko (2015) defines a dual-diagnosis patient as one that has
both a substance use disorder and a mental illness. For many
years the belief was a person would develop a mental disorder
as a result of their substance abuse, however, evidence
disproves that theory and it is important to treat both disorders.
Four various models have attempted an explanation for dual-
diagnosis, in which the first model suggests both disorders point
to an undiscovered factor, the second suggests substances were
used by mental illness patients to treat their disorders, the third
suggests the substance use disorder will go away when the
mental illness is treated, and the fourth suggests patients with a
mental illness are more sensitive to the effects of drugs
(Doweiko, 2015). The fourth theory does have some evidence to
back it up. Within the United States, it is estimated that 4
million people have been dually diagnosed, however, the
process of deinstitutionalization has caused my psychiatric
facilities to close, and many physicians remain uneducated in
dual-diagnosis (Doweiko, 2015).
Psychiatric disorders such as ADHD, depression,
anxiety, eating disorders, dissociative disorders, OCD, and
schizophrenia are all common within dual-diagnosis patients.
An estimated 21% of patients who have depression have an
alcohol use disorder, while 9% have a substance use disorder
(Doweiko, 2015). Treating patients with both depression and an
SUD costs five times more than treating a patient with just an
SUD, and becomes complicated when the substances being used
either increase the depression or mask the prescriptions being
used to treat it (Doweiko, 2015). Similarly, diagnosing patients
with both a substance use disorder and schizophrenia also
proves to be a challenge. Approximately 40-50% of patients
diagnosed with schizophrenia develop an SUD, and as such have
a 460% higher chance of developing an SUD than the average

2. person (Doweiko, 2015). Diagnosing a patient with an SUD and
schizophrenia becomes difficult when the symptoms of the
substance use become confused with the symptoms of the
schizophrenia (Doweiko, 2015). Other disorders, such as eating
disorders, are also common within dual-diagnosis patients.
Alcohol is most commonly abused in patients with an eating
disorder to suppress the appetite (Doweiko, 2015).
Dual-diagnosis patients become complicated in their
treatment, as they are 8.1 times more likely to resist their
treatment than the average person by refusing their medication,
continuing their drug use, and taking medications that only
enhance their desired effect (Doweiko, 2015). The stages of
treatment for a dual-diagnosis patient includes establishing the
client-counselor relationship, helping the client gain motivation
for change, active treatment for both disorders, and relapse
prevention (Doweiko, 2015). Within the addiction cycle, the
person suffering from a dual-diagnosis can become more
susceptible to the effects of the drugs being used as evidenced
in the “super sensitivity” model (Doweiko, 2015). The problem
with this, is the patient may begin with pain, seek relief through
their substance of choice, become more susceptible to the
substance because of their pre-existing psychiatric disorder, and
relapse or cycle back through the addiction cycle to try and
overcome their pain again. Simultaneously treating both
disorders have had more success of reaching long-term
abstinence rates, because this form of treatment helps to
diagnose and control the psychiatric disorder without cutting
out the substance use fully, and then being able to explain to the
patient why it is important to abstain from using a substance
(Doweiko, 2015). Relapse becomes a concern as the psychiatric
disorder is controlled, because the substance can become more
enticing, however, the therapist can reduce the harm done this
way, through slowly helping the client abstain from the drug use
after treating the psychiatric disorder (Doweiko, 2015).
When caring for dual-diagnosis patients, I think of the
famous verse in Matthew, “Come to me, all you who are weary

3. and burdened, and I will give you rest (11:28, NIV).” These
particular patients are struggling with more than just one
disorder and are undoubtedly weary and burdened. I think it is
important for the Christian counselor or therapist to embody
this principle of rest, where these clients can comes as they are
and seek treatment and rest. The goal within therapy would be
to diagnose both disorders and treat both disorders, but
ultimately point them to Jesus who can give them the rest and
the healing they are seeking, which causes them to continuously
enter back into the addiction cycle.
DT 200 word reply
A person that suffers from a dual diagnosis is said to
have a mental illness along with a substance abuse disorder also
known as a SUD. Studies show strong data that a person with a
mental illness will also suffer from a substance abuse disorder.
The text talks about four possible models for a dual diagnosis
conditions (Doweiko, 2015). The first model suggests that the
SUD and mental illness both reflect a common undiscovered
factor. The second theory says that those that suffer from a
mental illness will use self-medicating to cope with their
illness. The third theory says that SUD is secondary to the
primary diagnosis of a mental illness and will resolve itself
once the mental illness is controlled. There is limited research
to support this theory. The last model says that those with a
mental illness are more prone to abuse drugs (Doweiko, 2015).
There is research strongly suggests that there is a
relationship between a mental illness diagnosis and a SUD.
The first disorder is ADHD. According to the text ADHD
deflects a dysfunction of the dopamine neurotransmission
system of the medial forebrain region of the brain (Doweiko,
2015). This is said to be the same activity that occurs in the
brain of a person that uses cocaine. Schizophrenia is the next
disorder. This illness has been proven to be difficult to prove
the correlation between SUD and mental illness. However,
research has shown that patients with schizophrenia have a
460% higher chance of developing a SUD than the average

4. person (Doweiko, 2015).
When looking at anxiety disorders many researchers feel
that due to the disorder there is a higher chance that the patient
will self-medicate and this is turn causes a dependence on
substances that can be abuses. Obsessive -Compulsive Disorder
is the fourth most common psychiatric disorder found in the
United States (Doweiko, 2015). The percentage of patients that
have OCD and concurrent SUD is disagreed upon by
researchers. Many patients that have OCD are more likely to be
drawn to alcohol or benzodiazepines.
Depression affects approximately 15 million people in
the United States. The text defines depression as “the subject
experience of profound sorrow, pain, hopelessness, and despair”
(Doweiko, 2015). Patients that experience depression have a
higher chance of developing a SUD than those that do not have
depression. In relation to Posttraumatic Stress Disorder,
research shows that there is a strong correlation between the
disorder and SUD. PTSD can be difficult for the health care
professional to determine if the cause of the SUD is directly
related to the mental illness due to the medications that treat
PTSD can in turn cause a dependence on the drugs.
Treating dual- diagnosis patients can be difficult due to
many of the clients do not have natural supports nor the
tolerance for outside resources. Many of the dual-diagnosis
patients have a sense of denial about their illnesses known as
free floating or interchangeable denial
(Doweiko, 2015). The client must acknowledge their illness
before it can be treated affectively.
Being a person that has a diagnosis of generalized
anxiety disorder/depression and a family line of alcoholics I can
say that by the grace of God I have not been the subject of a
SUD. I find myself depending on scripture for encouragement.
The following scripture is one that I look to for reassurance that
God loves me and that he understands my diagnosis better than
me and that he looks deep in the heart of a person. Psalms

5. 34:17-19 says, “When the righteous cry for help, the Lord hears
and delivers them out of all their troubles. The Lord is near to
the brokenhearted and saves the crushed in spirit.