Substance Abuse and Mental Health in Arkansas

Arkansas is home to approximately 3 million people. It has been reported that 400,000 residents of Arkansas, which makes up about 13.13% of the state population, use illegal drugs while 133,000 (4.41%) residents abuse alcohol in a given year. A report in 2015 showed that the majority of individuals who reported using illicit drugs were men, with just 27.4% of users being women. The most prevalent illicit drug used in the region is methamphetamine with cocaine and marijuana coming in a close second.

Many Arkansas residents find themselves suffering from a mental illness as well as a substance abuse issue. When these issues are occurring simultaneously, this is referred to as a dual diagnosis or co-occurring disorders. Either disorder may develop first. Recovery is absolutely possible for those with co-occurring disorders, however swift and right action must be taken. Untreated co-occurring disorders create many problems within family units as well as the larger community. Community based intervention within Arkansas has recently been under development, with the Arkansas Division of Behavioral Health Services spearheading the project. The organization aims to improve outcomes for those presenting with co-occurring mental and substance abuse disorders.

Topography of Mental Illness in Arkansas

Recent studies have shown that the current system to handle mental heal issues in Arkansas is not sufficient to address the state's true needs. According to Mental Health America, Arkansas is ranked 47 out of 50 states in terms of its ability to provide services to those residents with mental illness. This means that the state has a higher than average prevalence of mental illness combined with a lower than average access to care. MHA also reported that only about 46% of people with a mental illness in Arkansas received treatment, the remaining percentage received no treatment at all.

Why do mental health issues and substance abuse co-occur?

There are many reasons that a person may present with co-occurring disorders such as a mental illness and a substance abuse disorder. Most have to do with the fact that these two clusters of disorders are interrelated. This means that one has a direct effect on the other. For instance, if a person has a mental illness with uncomfortable symptoms, often times they are driven to self-medication as a form of relief. Self-medication most commonly involves the use of alcohol or drugs to suppress unwanted feelings, emotions or serious psychological symptoms. While this method does indeed provide a respite from the relentless symptoms of a psychological disorder, the issue is that a dependency or addiction is created because these substances are harmful as well as addictive. Therein lies the pathology; it is not a sustainable nor a healthy method of treatment. On the other hand, if a person develops a substance abuse problem, it may have a triggering effect for a mental illness. If a person is predisposed to psychiatric disorders it may be that drug or alcohol abuse causes the disorder to present itself. For instance, if an individual with a genetic predisposition for depression were to abuse alcohol, the likelihood that depression manifests is greatly increased because alcohol acts as a depressant on the nervous system. Once depression develops, the person would be considered to have co-occurring disorders for a dual diagnosis.

The most common types of mental illness that co-occur with substance abuse are mood disorders, anxiety disorders and psychotic disorders. The category of mood disorders includes bipolar I and II, major depressive disorder, and seasonal affective disorder. Anxiety disorders include panic, social anxiety, and generalized anxiety disorder. The most common psychotic disorder to co-occur with substance abuse is schizophrenia due to the heavily intrusive symptoms. Hearing voices and having visual hallucinations are tough to cope with leaving many to seek out drugs or alcohol to numb themselves to it.

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What are the signs and symptoms of a dual diagnosis case?

The signs and symptoms that a person is facing a co-occurring can be tough to spot, since many of the signs overlap between conditions. Despite the overlap, there are still ways to determine if you or someone you love may be experiencing co-occurring issues with mental health and substance abuse. The symptoms and signs can differ between teens and adults. For teens and young adults, watch for the following:

Adults can also exhibit the same signs that teens do when it comes to a dual diagnosis. However, Adults can have signs and symptoms that a teen would not necessarily have, such as the following:

Facing a dual diagnosis is not easy for anyone. Those experiencing these symptoms should talk to a trusted friend or medical professional for support and to step foot on the path to recovery. No one needs to go through something like this alone.

What treatments are available for a dual diagnosis?

Treatment and recovery is absolutely possible for those with a co-occurring mental illness and substance abuse. There are some methods that have been found to have especially good efficacy in these cases. An integrated approach has been found to be very effective for a dual diagnosis case. Integrated treatment plans address both disorders/issues at once.

If a patient will potentially experience acute or dangerous withdrawal symptoms, they may need to be admitted into a detoxification center before any therapies can be applied. Dedicated detox facilities offer a safe space for a person to physically come off a substance. Highly trained staff have the authority to administer tapered doses of a substance in order to slowly wean a patient off a particularly destructive drug. Patients are monitored on a 24/7 basis and are kept safe from their own potentially destructive behaviors.

Once an individual is physically off the substance, this is when the behavioral and cognitive therapies would begin. Patients can most effectively receive these therapies in an inpatient rehabilitation facility. Sometimes it is necessary to remove a person from their environment in order for therapies to be most effective. The structured environment of an inpatient rehab provides patients the ideal space in which to heal. Checking into a rehab removes one from situations and people who may be triggering or enabling for an addict.

One example of how an integrated approach works is outlined by Kathleen M Carroll published in the scholarly journal Biol Psychology. According to Carroll, many advances have been made in this area in recent years. She posits that behavioral therapies usually intended to treat mood disorders also have a positive and healing effect on substance abuse. The idea behind this is that substance abuse is known to exacerbate mental health issues so when the behavioral therapies alleviate some of the bothersome symptoms, the individual may experience less of a compulsion to use a substance to self-medicate. There are also some cognitive-behavioral therapies (CBT) that have been found to be effective at treating both co-occurring disorders at once. CBT therapy helps the addict to identify the patterns in their lives that enable them to stay in the current cycle of abuse and mental illness. When addressing mood disorders, CBT helps an individual to identify the cognitions that are maladaptive and offers solutions to correct those. These therapies have even been found to be effective in group therapy settings.

Once a person has completed an inpatient rehabilitation program, it is a wise decision to move into transitional housing as opposed to returning back home. Transitional housing is an excellent way to ease back into your everyday life. These types of housing situations provide support and a healthy network of people to connect with who are the same path of recovery. Making this decision will lessen the probability of relapse, as one will learn techniques to cope with triggers and stressors. The structured environment will not be as stringent as would be found in a rehab, but structure will still exist and many thrive in these environments. Individuals will be taught the proper skills so that they may go back to their homes with the confidence that the sobriety and healing they received in rehab will stick.

Continuing therapy may be a good decision for many individuals on the road to recovery. Once they are finished with inpatient and have graduated from a supported living situation, it is prudent that they take steps to ensure they continue walking a healthy path.


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