Jennifer Fugate manages the adult division of LifeSkills’ Warren County Service Center. When asked about her specialty, dual diagnosis therapy, she said dual diagnosis is a term used to describe co-occurring substance abuse and mental health disorders in an individual. Therefore, dual diagnosis itself is not a diagnosis, but rather a specific combination of diagnoses.

“A good example,” Fugate said, “is someone who suffers from anxiety who also has a substance use disorder. Either one of those diagnoses can come first, but research indicates most often the mental illness occurs and then the person tries to self-medicate. Unfortunately, research also shows us that the more a person uses drugs and alcohol, the more severe their mental illness becomes.”

The National Institute of Mental Illness said dual diagnosis symptoms can vary widely because of the multitude of combinations that can occur. Symptoms of substance use disorder may include:

  • withdrawal from friends and family.
  • sudden changes in behavior.
  • using substances under dangerous conditions.
  • engaging in risky behaviors.
  • loss of control over use of substances.
  • developing a high tolerance and withdrawal symptoms.
  • feeling like you need the drug to be able to function.

Symptoms of a mental heath condition can also vary greatly. Warning signs – such as extreme mood changes, confused thinking or problems concentrating, avoiding friends and social activities and thoughts of suicide – may also be reasons to seek help.

NAMI’s statistics show there are more than 7.9 million people affected by dual diagnosis or co-occurring disorders in the United States. Treatment is complex and unique to each individual. Integrated intervention is cited as being the most effective form of treatment. That is when a person receives care for both their diagnosed mental illness and their substance abuse.

The idea that “I cannot treat your depression because you are also drinking” is outdated. Current thinking requires both issues to be addressed simultaneously.

Several treatment options are available, according to Fugate.

“Initially, when someone comes into our program, they begin by receiving one-on-one counseling with a clinician,” Fugate said. “An assessment is conducted to document their history and determine their needs. Because co-occurring disorders can often lead to desolate situations, if a client presents with homelessness, domestic violence, lack of transportation, etc., targeted case management services are available to assist in locating resources to help remove any barriers that could hinder treatment.”

Other available services include a wide array of substance use recovery groups (including groups that target the needs of people with dual diagnosis), peer support and behavioral health support.

“A treatment team is built around the client with the goal of achieving success in recovery … and success looks different with each client,” Fugate said. “Person-centered therapy as well as motivational interviewing – which helps encourage people to change behaviors that prevent them from making healthier choices – are used to assist clients in identifying their treatment track, and individuals are in charge of setting their own goals for treatment.”

NAMI sponsored groups include:

  • Double Trouble in Recovery is offered at the Wellness Connection and is a 12-step fellowship for people managing both a mental illness and substance abuse.
  • Alcoholics Anonymous and Narcotics Anonymous are 12-step groups for people recovering from alcohol or drug addiction. You are encouraged to find a group that understands the role of mental health recovery.
  • Smart Recovery is a sobriety support group that is not based in faith for people with a variety of addictions.

In addition to the treatment options mentioned above, LifeSkills will soon be opening an outpatient-based opioid treatment program.

“Please know,” Fugate said, “if you or someone you love is struggling with an addiction, we are here to help … without judgment, and at your own pace.”

– For more information, call 270-901-5999.

– Maureen Mahaney coordinates public information for LifeSkills Inc.


Eugene Embry is news editor at the Daily News. He supervises the copy desk. Eugene is in his second stint at the Daily News, having served in various roles as a news reporter, sports reporter and copy editor from 1990-99.

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