Dual Diagnosis: The Problem Impersonator – Hawaii Nurses CE


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Dual Diagnosis: The Problem Impersonator

“Even a one rupee coin have two sides.” 

― Allan Bridjith

37% of Alcohol Abusers & 53% of Drug Addicts Have at Least 1 Mental Illness

Aloha Colleagues!

We nurses know that drugs make people crazy – at least temporarily. We see
patients in the clinical setting and people in the community. I do not know about you, but some are my family members and friends! We hope they can be safely managed and the behavior does not become chronic. Physical problems like liver and neurological damage also concern us.

Substance Abuse Disorder was formerly known as addiction. It occurs when a person’s use of alcohol or another drug leads to health issues or problems at work, school, or home. Its cause is not known, although genetics, drug effects, social pressure, emotional distress, anxiety, depression, and environmental stress have all been implicated. Many people with substance abuse disorder also suffer from depression, attention deficit disorder, post-traumatic stress disorder, or another behavioral health problem. A stressful or chaotic lifestyle and low self-esteem are also common. Children who grow up with parents who use alcohol or drugs are at higher risk – whether from heredity, environment, or both.

Research informs us that a large number of people with severe mental illness also suffer from the co-occurring disorder of substance abuse or dependence on drugs and/or alcohol. This combination, known as Dual Diagnosis or Co- occurring Disorders, makes symptoms worse, increases levels of violence and resource utilization, decreases adherence, and increases risk of HIV. Other research informs us that dual diagnosis patients experience more physical illness. For this reason, nurses and other health professionals working both in and outside the arenas of behavioral health and addiction need to be knowledgable about the care and treatment of patients with dual diagnosis.

Psychosis is a condition that disrupts a person’s thoughts and perceptions and makes it difficult for an individual to differentiate between what is real and what is not.

Symptoms of psychosis may include:
■ Delusions (false beliefs)
■ Hallucinations (seeing or hearing things that others do not see or hear)
■ Incoherent speech
■ Memory problems
■ Trouble thinking clearly or concentrating
■ Disturbed thoughts or perceptions
■ Difficulty understanding what is real
■ Poor executive functioning (the ability to use information to make decisions) ■Behavior that is inappropriate the situation

Given the statistics, it is important for all nurses to be aware of Co-occurring disorders and keep informed about asssessment and interventions.

For more information, visit Substance Abuse and Mental Health Services Administration to down load SAMHSA’s October, 2019 Guide to Co-Occuring Disorders, or join us on November 13 in Waikiki to earn continuing education contact hours for Addiction and Mental Health and learn more about co-occurring disorders.

Children who grow up seeing their parents using drugs may have a high risk of Double Trouble.

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