Substance Use and Mental Health Care, Can They Co-Exist?

Posted on 18/05/2011 | 0 Comments

I remember once seeing one of my patients who had a psychotic illness. He was doing very well and was very engaged in his recovery process. Unfortunately, a “friend” of his was providing him with free and easy access to illegal drugs – mostly marijuana. This was having a negative impact on his well-being and about a week before our visit his employer had let him know that if he appeared to be “stoned” once more at work, that he would be let go. In our discussion, I raised the opportunity for him to attend a drug discontinuation group that we had been working with. It provided young people with a support system and framework to help them get off and stay off illicit drugs. Mike (not his real name) became annoyed when I suggested that. “I have a psychotic illness” he said, “I am not a drug addict”.
 
What Mike was voicing was in some way a stigmatizing perspective about people who struggle with drug misuse and abuse. This is the topic that another friend of mine just recently wrote about. It’s worth a read and you can find it here: http://www.huffingtonpost.com/dr-harold-koplewicz/is-drug-addiction-mental-illness_b_858815.html. His point is well taken. There is a lot of stigma about drug use in young people and this stigma can get in the way of getting help. I agree.
 
This is why it is so important to make sure that we have both substance abuse and mental health care easily available in the primary health care system. A young person with either one or both of these problems should be able to get help without going into a stigmatizing separate program. We will know we have finally broken the stigma about substance abuse and mental disorders when anyone can go to their primary health care provider (general practitioner, nurse practitioner, psychologist, nurse, etc.), and get the help and the care that they need. Much as they now go for a sore throat, high blood pressure or diabetes treatment. 
 
That is our goal. It will take lots of work to get there, but it will be worth it.

-Stan

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Recent Comment

This is a great set of comments and rings very true. 

I totally agree that scientists (just like everyone else) have their biases and foibles.  After all, scientists are human beings too!  But science is different than scientists. 

The scientific method is the most objective frame that we have by which to evaluate and predict.  Science is not about finding truth.  It is only about being less wrong most of the time.  The scientific method (experimental design and mathematics) gives us the ability to test what we believe.  The scientific method is not used to prove something is correct, on the contrary, the scientific method is designed to prove that something is not correct!  It is designed to test what is called the “null hypothesis”.  It takes ideas that come out of left field (or wherever else they come from) and puts those ideas to an independent test.

t does not drive our beliefs.  It does however challenge our beliefs.  In that way it is self-correcting. Of course scientific inquiry and understanding lives within a wider social context.  That is one of the great features of science. 

But gravity is gravity, social context notwithstanding.  And thus it is nasty, brutish and long.  As Brecht said, (something like this) - the purpose of science is to save us from everlasting error.

By Christina Carew on May 11th

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