Dual Diagnosis Treatment Effectiveness

Treatment centers are quick to brag that they offer dual diagnosis treatment

The concept is simple - they claim that many people with addictions also have some other mental disorder (such as bipolar) which contributes to the addiction, so they offer to treat you for both of these issues concurrently. Thus the jargon 'dual diagnosis treatment' suggests an advanced treatment plan. Ominous talk of misdiagnosis suggests people miss out on the proper dual diagnosis treatment, and fail to get sober as a result. We're led to believe that only the proper dual diagnosis treatment can help.

That would be nice, if the evidence were there, but it's not. Researchers noted in 2009 that [1] "Few studies have investigated whether dually diagnosed patients with co-occurring substance use and psychiatric disorders (DD) respond as well to substance use disorder (SUD) treatments as patients with SUD do." So while dual diagnosis treatment has been promoted for some 30 years, there hasn't been much research into whether it actually helps the people it's intended to help!

Common treatment methods for addiction don't work- this is acknowledged by addiction counsellors themselves when they commonly tell a room full of patients "look to your left, and look to your right - only one of you will stay sober" indirectly admitting no more than a 33% success rate. This makes the following conclusion from the same 2009 study (a large study with nearly 2500 test subjects) about dual diagnosis treatment all the more laughable:

"residential SUD programs are relatively effective in reducing [dual diagnosis treatment] patients' substance use problems; however, they are less successful in... addressing their psychiatric problems."

Dual diagnosis treatment patients face nearly the same horrendous chances for success with treatment as singly diagnosed clients - yet they fare even worse at overcoming their psychiatric problems in these supposedly innovative programs. It's easy to say that in hindsight, dual diagnosis treatment is not a good idea. Yet, that would be too generous - everyone should've known with glaring foresight from the birth of this modality that dual diagnosis treatment was an ill-conceived idea. It's not surprising that the same professionals who routinely fail at helping people with addictions, would also fail at helping people with mental health disorders in the same settings relabeled as dual diagnosis treatment.

Moreover, it was also found that dual diagnosis treatment patients were far less satisfied with the treatment than non-DD patients. Whether they liked the treatment or not may seem like a trivial issue, but considering the fact that those who liked the treatment had the best outcomes, dual diagnosis treatment really misses its mark. This is likely due to the control model approach to treatment - an approach that comes down hardest on dual diagnosis treatment patients - pressuring them to conform to counsellors demands - rather than freeing them up to make new life choices.

Dual diagnosis treatment is not all it's cracked up to be. While dual diagnosis treatment is the norm, there is no standardized criteria for diagnosis. The reality is that dual diagnosis treatment is recommended haphazardly at the whim of individual counselors.

[1] Dually diagnosed patients' responses to substance use disorder treatment. Boden MT, Moos R. J Subst Abuse Treat. 2009 Dec;37(4):335-45. Epub 2009 Jun 21.