Substance Abuse and Mental Health in Iowa

In the event that a person experiences a mental illness and a substance abuse problem at the same time, this is referred to a co-occurring disorders. Many people in the united states suffer from co-occurring mental health and substance abuse disorders. The National Institute on Drug Abuse (NIDA) has estimated that about half of the people who experience a mental illness will also face a substance abuse disorder in their lifetimes. With these staggering numbers, it is no surprise that state and local governments are rallying around these patients in an effort to better serve them.

Topography of Mental Illness and Substance Abuse in Iowa

Iowa is among the few states in the union that does not have a major metropolitan area. The state is dominated by rural communities and faces the deterioration of these rural communities through the breakdown of family farming and ranching lifestyles. Gaming casinos are quickly becoming the majority of the state's economy. Paired with this social shift is the state's lack of funding for mental health and substance abuse treatment. This unique environment is not conducive to an effective mental health and substance abuse treatment system.

A study in Iowa funded by the Substance Abuse and Mental Health Services Administration (SAMHSA) found that nearly 10 percent of adults in Iowa reported episodes of binge drinking in the last 30 days. There was not enough data to report on Iowa teens. In the same survey, teens were asked if they smoked marijuana in the last 30 days, 5% reported that they had used marijuana while 3% reported that they used other illicit drugs.

In 2014, 18% of Iowans reported experiencing a mental illness within the past year. Although this number is down from the 31% in 2011, there may be some data collection issues at play. Of these 18% only about 14.3% of people ever received any type of treatment for their mental health complaints.

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

Many people who have substance abuse problems are diagnosed with a mental illness just as many people with mental illness face addiction. Mental health issues and substance abuse issues share many of the same risk factors. This partially explains why we see these types of disorders co-occurring at such a high rate. For instance, some people possess the gene to develop schizophrenia, but the disease only develops if the person smoked marijuana at a young age. These genes can also dictate how a person reacts to psychoactive substances found within certain types of drugs. This dynamic explains why one person will feel anxious when using a drug while another feels relaxed using the same drug. Environmental stressors can actually cause genetic changes that cause latent mental illnesses to manifest within an individual.

There are some mental illnesses that contribute to drug use and addiction. For example, a person who has a mental illness may be more inclined to pick up a drug or drink than a person who does not have any psychological disorders. This is likely due to the changes that are made in the brain because of a mental illness, making people more prone to addiction. Conversely, substance abuse and addiction can contribute to the development of a mental illness. The harsh and harmful chemicals that act on the brain when a person abuses drugs or alcohol can change the brain itself. These changes certainly can and do lead to the development of mental illness. Some drugs are extremely harmful and toxic for the brain, interrupting the natural flow of chemicals within the brain causing dramatic imbalances that may never be righted.

Signs and Symptoms of Co-Occurring Disorders

It can be tough to tease out a true diagnosis when it comes to people who are living with a mental illness and an addiction. The interconnected relationship between the two disorder types creates a web of symptoms whose lines are tough to follow. While this is true, there are some observable symptoms that could help to identify if someone is experiencing co-occurring disorders.

This is not an exhaustive list of signs and symptoms of co-occurring disorders, but these should be considered red flags and addressed with the person immediately.

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What are the treatment options for co-occurring mental health and substance abuse disorders?

Although having co-occurring disorders certainly poses a challenge, there absolutely is hope for treatment and recovery. The medical community has come a long way in terms of being able to provide treatment to these special patients and there has been a dramatic uptick in positive outcomes for dual diagnosis. This up trend is mainly due to the breakthrough made in the 1990s where it was determined that treatment for all disorders needed to be integrated. This meant that the separate disorders would no longer be treated sequentially. All disorders are treated simultaneously by an unified and multidisciplinary staff of professionals dedicated to treating these patients. It was also determined that individualized plans are necessary to fit the special needs of each patient. Within the individualized plan, there are some common and effective treatments that are used which include detoxification, rehabilitation, supportive housing and continuing care.


Each patient will be assessed in order for their plan to be created. Many times the first and obvious step is that the person needs to be taken off of their drug or drink of choice in a safe manner. Withdrawal symptoms may be so intense that they need to be admitted to a specialized clinic that handles these cases. These clinics allow a person to slowly come off the drug or drink so that their bodily systems are not overwhelmed and thereby further damaged. Staff is on call 24/7 to make sure each patient is safe and healthy, and also to help patients make it through this painful period in their lives.


Rehabilitation can be provided in an inpatient or outpatient program. Research shows that the immersive environment that inpatient programs provide are often times the most effective method for rehabilitation. There are effective outpatient programs, however it is always best to fully invest oneself to the process. Within an inpatient program, patients will live at the facility and embark on the therapeutic portion of their treatment plan. The most effective therapies for treating addiction and mental illness are cognitive behavioral therapy (CBT), talk therapy (group or individual), and medication. CBT has the potential to allow a patient to observe their own harmful thought patterns and interrupt them. Once the toxic patterns are interrupted, there is space created for new and healthy thought patterns to emerge. Talk therapy is very useful in resolving any trauma that is still painful for the patient. They are able to walk through it with a trained professional in a safe space. Underlying these therapies is often time a medication that is providing treatment on a brain chemistry level. Medication has worked wonders for patients who need to be treated for mental illness, and this gives them a leg up in their fight against their addiction.

Supportive Housing

Patients often opt to move into transitional housing once their rehab programs are complete. This move is encouraged because those who choose this path often have more positive outcomes in the long run. Transitional housing allows those in recovery to ease themselves back into society. They are given responsibilities and remain within a certain level of structure such as curfews and required check-ins. The staff associated with these housing units will help those in recovery to learn how to navigate the outside world, which can be jolting for some coming out of a treatment center.

Continuing Care

The benefits of continuing care cannot be overstated. In most cases, it is the people that continue to work on themselves and stay in recovery that succeed the most. There are many self-help avenues to maintain sobriety and mental wellness. These methods include continuing to go to therapy, self-help reading, continuing medications, and seeking out support groups. There are a wide variety of support groups that are available for recovering addicts and mental health patients. These types of peer-to-peer support groups offer a dynamic that is unique. Patients connect with other people who have gone through the same experiences and are able to reach out a hand and connect with newly recovered folks in a way that a clinician simply cannot do. These connections become a network of peer support that is invaluable for a successful recovery.


Learning what treatment is best for you or your loved one is easy. Speak to one of our trained counselors and let them guide you to the best treatment options available for your specific needs.


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