Addiction & dual diagnosis

Addictive disorders are common disorders that involve the overuse of alcohol or drugs. The number of people experiencing an addiction problem in Ireland is large and this number continues to rise.

Alcohol consumption has risen more in Ireland than in any other country in Europe and we are currently one of the highest consumers of alcohol per head of population in the world.

There has also been a rise in the abuse of other drugs including marijuana and tranquillisers. At present, approximately 5% of the adult population is alcohol-dependent and a further 7% is alcohol abusive. There has also been a notable rise in binge drinking among young men and young women.

Addictive disorders are treatable

For some individuals it is enough to give information and feedback for them to tackle the addiction themselves. For others, a full treatment programme is required. Although there is no single cause of an addictive disorder it can arise in someone with:

  • A strong family history of addiction
  • Someone with an early exposure 
  • Someone who starts drinking at an early age
  • Someone with a high individual tolerance to alcohol
  • Someone who grows up in a highly permissive culture for alcohol and other substances of abuse
  • Some people self-medicate anxiety or a depression problem and this fuels the addiction.

Signs and symptoms

Alcohol addiction signs, symptoms or behaviours may include:

  • Being unable to limit the amount of alcohol you drink
  • Wanting to cut down on how much you drink or making unsuccessful attempts to do so
  • Spending a lot of time drinking, getting alcohol or recovering from alcohol use
  • Feeling a strong craving or urge to drink alcohol
  • Failing to fulfil major obligations at work, school or home due to repeated alcohol use
  • Continuing to drink alcohol even though you know it's causing physical, social or interpersonal problems
  • Giving up or reducing social and work activities and hobbies
  • Using alcohol in situations where it's not safe, such as when driving or swimming
  • Developing a tolerance to alcohol so you need more to feel its effect or you have a reduced effect from the same amount
  • Experiencing withdrawal symptoms, such as nausea, sweating and shaking, when you don't drink, or drinking to avoid these symptoms.

Drug addiction signs, symptoms or behaviours include, among others:

  • Feeling that you have to use the drug regularly; this can be daily or even several times a day
  • Having intense urges for the drug
  • Over time, needing more of the drug to get the same effect
  • Making certain that you maintain a supply of the drug
  • Spending money on the drug, even though you can't afford it
  • Not meeting obligations and work responsibilities, or cutting back on social or recreational activities because of drug use
  • Doing things to get the drug that you normally wouldn't do, such as stealing
  • Driving or doing other risky activities when you're under the influence of the drug
  • Focusing more and more time and energy on getting and using the drug
  • Failing in your attempts to stop using the drug
  • Experiencing withdrawal symptoms when you attempt to stop taking the drug.

Dual diagnosis

Dual diagnosis is a term that indicates the presence of two medical conditions. Within the area of mental health and psychiatry, the term dual diagnosis is used to describe the co-existence of a mental health disorder and an alcohol or drug problem. The psychiatric problem simply will not go away unless it has been treated, regardless of the treatment done on the actual addiction. There is evidence to support that if both the addiction and the underlying psychological problem are treated, the prognosis for recovery is very good.

  • About mood disorders

    Mood disorders are extremely common. Current evidence suggests that 8% of women and 4% of men are experiencing a depressive disorder in Ireland.

    Depression can be defined as the onset of lowness in mood, which takes up a significant amount of that person's daily life.

    Symptoms may include:

    • A feeling of being sad, unhappy or dull
    • A reduction in energy
    • A reduction in activity
    • Appetite loss
    • Weight loss
    • Sleep disturbance
    • Poor concentration and poor memory
    • Feelings of guilt
    • Loss of pleasure (anhedonia)
    • Loss of motivation and interest
    • Feelings of pessimism and hopelessness
    • Suicidal ideas.
  • About bipolar disorder

    This affects between 0.5%-1% of the population and there is an equal incidence in men and women. It is characterised by a period of mania, elation or an extreme feeling of wellbeing which can be short lasting but associated with increased energy, increased rate of speech, significant insomnia, racing thoughts, distractibility, change in behaviour, irritability, lack of judgement, restlessness, over spending and grandiose ideas.

    With bipolar disorder there can be a switch between episodes of elation and episodes of depression, or there can be episodes of mixed mood with features of both depression and elation at the same time.

    The risks for mood disorders include:

    • A strong family history
    • Significant traumatic life events
    • Childbirth
    • Childhood neglect
    • Childhood abuse
    • Some personality traits. 
  • Mood and alcohol

    There is a very significant interaction between alcohol dependence and other addictions and mood disorders. Abstinence from alcohol for a period of weeks may be all that is required to lift somebody's mood in a significant number of addicted service users.

    Alcohol, even in moderate quantities, can cause a depressive episode in a vulnerable person. This can occur on the same night, the next day or even a few days later.

    Alcohol can also make suicidal ideas more intense in someone with a history of depression.

    Alcohol and other addictive substances may also lead to episodes of elation in vulnerable people.

    Some people can become depressed even as they successfully battle an addiction. Some can experience craving as a feeling of depression and others can become depressed as a result of problems which worsen during the period of addiction.

Useful resources

Useful resources for Addictions & Dual Diagnosis

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