Even with its vast and serene landscapes, Alaska is not without mental health and substance abuse issues. As of 2018, the population in Alaska exceeded 735,000, with over 30,000 living with a serious mental illness while the rate of illicit drug use in Alaska is well above national averages and has been since 2007. According to The Substance Abuse and Mental Health Services Administration (SAMHSA) survey in 2015-2016, 17.6% of Alaskans aged 12 years and older reported using illicit drugs in the last month. Many of these cases are co-occurring, meaning that those with a mental illness also have a substance abuse issue and vice versa. These are also referred to as dual diagnosis cases.
Of the roughly 30,000 people living with a mental illness in Alaska only about 35% of adults sought treatment from either governmental services or private organizations according to SAMHSA. Mental Health America, a non-profit organization dedicated to addressing the needs of the mentally ill, reported that Alaska ranked 46th out of 50 states overall in terms of prevalence of mental illness in adults and teens as well as the ability to provide access to proper treatment for mental illness. This means that Alaska has both a high prevalence of mental illness and lower rates of access to care per capita. This may be due in part to the vastness of the land and that much of the population lives a remote lifestyle.
18% of the adults who sought treatment for mental illness issues in Alaska presented with a co-occurrence of substance abuse. 8% of Alaskan teens treated for mental health issues were diagnosed with a substance abuse issue, or had a dual diagnosis.
Having an undiagnosed mental illness often times drives people to alleviate the symptoms through self-medicating with drugs or alcohol. Sudden symptoms such as depression, anxiety or hearing voices sometimes drive one to want to change one's feelings or moods to achieve some sense of normalcy or peace. They may even want a way to block any feeling at all. These individuals are often unaware of the reasons why they are seeking out relief.
On the other hand, while causation for most mental illnesses has not yet been established, if one is predisposed to developing a mental illness it may be that drug and alcohol abuse triggers the onset. If one such individual never picked up a drink or a drug, they may never have developed the latent illness at all. The potential for the illness would be present in the genes, but it would never physically manifest.
This intertwined relationship between these two conditions is an unique dynamic that must be understood both by the patient and the treatment provider before any healing is possible. The SAMHSA reported that if one of the co-occurring conditions go untreated, both will usually get worse over time even to the point that conventional treatments will no longer be effective. In addition, the patient will be at an even greater risk of developing a serious medical illness such as hepatitis, HIV and cardiopulmonary disease.
There are certain challenges that arise when attempting to diagnose co-occurring diseases such as substance abuse and a mental illness. Training is necessary to discern which behaviors are due to which condition. Often times, providers find this task next to impossible due to the nature of the way these conditions depend on the other. Some signs and symptoms are inextricable from one or the other because the nature of these conditions can be so convoluted. However, there are general signs and symptoms which may indicate a co-occurrence.
The person has a history of mental illness or a history of mental illness in the family:
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It has been established that an integrated approach is the best method for treating a patient with a dual diagnosis. If one of the co-occurring conditions goes untreated there are dire consequences not only for the patient, but also for society as a whole. These untreated conditions result in excess costs associated with inpatient care, emergency room visits, the criminal justice system, homelessness, joblessness, welfare and child welfare. In addition to these areas of society that are impacted when mental illness or substance abuse issues go untreated, there is a large impact on the patient's family and friends. Recovery is possible, however an integrated approach must be considered. Providers should not wait until one illness is treated to start treatment for the other.
Personalized integrated treatment plans are created and tailored for each patient. Certain methods are tried and true and have been used with some success. Most commonly these methods include detoxification, inpatient rehabilitation, transitional housing, continuing psychotherapy, medication and support groups.
Before any meaningful recovery is possible, many drug or alcohol addicts require detoxification in order to move forward with any type of treatment. A medical professional will evaluate each individual and determine what the best way to detox would be. There are certain withdrawal symptoms that can be life threatening and need to be handled by medical professionals to ensure safety. Detoxification staff are also authorized to provide tapering doses of a substance in order to wean patients off of their drug of choice. Sometimes this is the best course of action as opposed to a sudden cessation. Highly trained medical staff will monitor the individual on a 24 hour/7 day a week basis in an inpatient detoxification facility. Should any complications arise or unwanted behaviors manifest, the staff is trained to handle these situations in a safe manner.
If the detoxification facility used is a standalone facility, one will want to be transferred to an inpatient rehabilitation. However, many inpatient rehabilitation centers have a detox center available in house. Whichever path was chosen, admission to an inpatient rehab will ensure that the 24/7 monitoring from detox continues. Addicts with mental illness are in a fragile state and require a lot of support which the rehab is prepared to provide. Patients in such facilities take advantage of many treatment options to address the co-occurring conditions they are experiencing. These include group and individual therapy sessions, acupuncture, massage, art therapy and medication therapy if prescribed. Each of these modalities is helpful in the treatment of mental health issues and substance abuse problems. Staff is on hand 24/7 to provide care and support for patients during a difficult time. Patients are able to focus on healing and recover from their illnesses.
When patients are released from their inpatient programs, they often find themselves in a vulnerable state and will likely require assistance for re-entry into their lives. It may be not be the best idea to be immediately reunited with friends and family, as some of these relationships are triggering or unhealthy. Those in recovery from substance abuse and mental illness have a much higher chance at success if they seek out transitional housing after completing a rehabilitation program. Continuing structure and support is helpful in allowing a recovering addict to gracefully re-enter their lives. These types of housing communities also provide a way to meet like-minded folks who are walking a similar path in life and are striving to be their best. Finding support from others in recovery can be invaluable in continuing one's sobriety and maintaining the level of mental stability they worked so hard to achieve in an inpatient rehab.
It is imperative that a person who has received a dual diagnosis stay connected with others. Isolation is often the harbinger of relapse. There is a plethora of groups available to suit almost any taste. Groups are available which are specific to women, men's only groups, LBGT groups, addicts only groups, as well as illness-specific groups to name a few. The type of group is inconsequential; it is in their existence that their value lies. These groups are essential to a person in recovery. There they will find solace, understanding, companionship, fellowship, community as well as recovery support.
References
https://www.rtor.org/directory/mental-health-resources-in-alaska/
http://dhss.alaska.gov/dph/HealthPlanning/Documents/scorecard/2017TrustScorecard.pdf
https://www.samhsa.gov/data/sites/default/files/cbhsq-reports/Alaska-2018.pdf
https://pubs.niaaa.nih.gov/publications/aeds/healthconditions/healthconditions.htm
http://www.legislature.mi.gov/documents/2003-2004/resolutionadopted/House/htm/2003-HAR-0125.htm
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