Dual Diagnosis: Dual Brain Disease
Brain disease results from chemical imbalances. Two conditions are commonly experienced, namely; drug addiction and mental illness (Rehab Media Network, 2017). The relationship between these two results from their mechanism action, whereby both of them affect the same chemical pathways and regions of the brain. Apparently, it is not clear if substance abuse can cause mental illness, though conditions such as hallucinogen persisting perception disorder, which result from long-term dependence on hallucinogen drugs exhibit similar symptoms to schizophrenia. Individuals engage in drug use for relaxation and entertainment. However, individuals who are healthy may turn to substance use to drive away boredom or suit in a social group, contrary to those who are mentally ill, who sometimes use drugs to get rid of their self-medicating distressing symptoms.

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Screening and assessment/diagnostic tools for substance use disorders
Screening of drug use disorders is categorized into two, namely; brief screens performed verbally using interviews, and written screens which uses questionnaires that a respondent has to respond to. Oral screens are preferred for fieldwork and home visits, whereas written screens suit office settings due to the limited time respondents tend to have to attend interviews. One limitation associated with both screens is the inability to address the immediacy issues in regard to responding to urgency, especially if there is need to examine intoxication, withdrawal or to determine impaired functioning of the brain. However, this problem can be handled through combining observational outcomes and systematic screening result.
The commonly used assessment tool is the psychosocial interview, which typically includes unstructured interviews made by a therapist to determine a diagnosis. Various tools are applied to the diagnosis of both mental illness and substance abuse. Such a diagnosis is well referred to as a co-occurring disorder (American Addiction Centers, 2019), which simply imply any combination of mental illness and drug abuse disorder. Some of the examples of co-occurring diagnosis include anorexia and cocaine reliance, depression and alcoholism, anxiety and prescription drug dependence, and post-traumatic stress disorders and heroin. An important point to note is that the tool used to diagnose an adolescent differs from that which is applied to adults. Using the egg and chicken dilemma to determine what comes first between mental illness and substance abuse, the answer is relative to the patient. The reason for this is that some individuals turn to drug use to self-medicate their distressing mental disorders, which means that mental illness came first, and thus, the cause for substance abuse. In other cases, individuals abuse drugs, which in turn affect their mental stability severely.

Diagnostic considerations
Some mental illness need to satisfy a certain criterion before a definite diagnosis can be applied. The best period is during gestation due to the persistence of symptoms for sometimes before an appropriate diagnosis can be attained (Rehab Media Network, 2017). This is the time some individuals turn to substance use to minimize adverse effects of the symptoms they experience.

Treatment for substance use disorders
Treating substance use disorder involves the combination of medical and psychosocial methods. Therapeutic treatment for substance use disorder include hospital inpatient programs, detoxification, pharmacotherapy-based approaches like methadone programs applied to opioid addicts, employee-assisted programs, and community-based rehabilitation program among other methods (Goodwin, 2009). Given the availability of various treatment approaches, they vary from one individual to the other. Thus, the substance abuse counsellor determines a suitable approach for each patient.


1. American Addiction Centers. (2019). Co-Occurring Disorders Treatment Guide. Retrieved from
2. Goodwin, L. (2009). Treatment of substance use disorders. The professional cournselor's desk refeence , 703-723.
3. Rehab Media Network. (2017). Dual Diagnosis: Which is the Chicken and Which is the Egg? Retrieved from

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