Dual diagnosis is one of the most important concepts in assessing and diagnosing the complexities of substance use disorders (SUDs) and mental health. Even before the era of COVID-19, it was estimated that upwards of 8.2 million people had dual diagnosis. While dual diagnosis plays a vital part in connecting the puzzle pieces for anyone with an SUD, it turns out that dual diagnosis is especially prevalent among veterans. Here’s how dual diagnosis affects veterans and how we can help.

What Dual Diagnosis Is

The first piece of the puzzle is exploring the question of what dual diagnosis is. On its face, it might sound like a phenomenon to describe different SUDs that people experience at the same time, such as someone who struggles with alcohol addiction and benzodiazepine addiction, for example. This example and any variety of co-occurring SUDs can certainly make up a dual diagnosis. However, while dual diagnosis can speak to the complex condition of multiple SUDs at once, it most commonly refers to the connection between SUD and mental health.

For example, dual diagnosis identifies the co-occurring phenomenon of an SUD alongside mental health issues, such as depression, bipolar disorder, panic disorder, schizophrenia, and post-traumatic stress disorder (PTSD). The effectiveness of dual diagnosis is its respect for the complexities of addiction and the distinction between mental health and substance use.

Often, the mental unhealth of people who struggle with substance abuse is dismissed merely as the side effect of the substances they abuse. While this is certainly possible, it is not always the case, and the failure to distinguish between substance abuse and mental health can often leave people with an inadequate treatment plan and an unsuccessful recovery. Dual diagnosis seeks to investigate, diagnose, and ultimately treat people based on their full medical and personal/family history. On this last point, we can begin to sense the importance and the connection between dual diagnosis and veterans.

Dual Diagnosis and Veterans

The U.S. Department of Veterans Affairs (VA) shares on its website the mental health resources available for veterans. Moreover, mental health crises are so common among enlisted and veteran military service members that a military mental health crisis line is available, too. Common mental health conditions that military veterans experience include:

• Anxiety
• Bipolar disorder
• Depression
• Sexual trauma
• PTSD
• Schizophrenia
• Traumatic brain injury (TBI)
• Suicidal thoughts
• Substance use

When we think about the demands and complexities of military service, it’s easy to understand why this is the case. Perhaps the most common mental health crisis military veterans experience is PTSD. The reason for this is complex, but it includes issues such as combat experience, isolation, traumatic dreams, and the service era that veterans served in the military, such as World War II or the Vietnam War.

Military service members face a complex set of problems, risks, and deadly threats. Unfortunately, suicide is a regular threat for those who cannot cope with the mental and physical demands of military service, and suicide deaths are predicated by substance use in as many as 45% of army suicide attempts alone. After serving faithfully in the military, these problems do not simply go away with certificates or service medals; they carry on in the mental experience of those who transition from enlisted to veterans.

What to Do

It cannot be understated just how important dual diagnosis is among the military veteran community. However, dual diagnosis is only part of the problem. What can and should follow dual diagnosis is treatment. In this way, we should all be reminded of the crucial part we play, both in understanding and supporting the complexities of SUDs and mental health among our beloved veterans.

The better we understand the complex nature of what military veterans struggle with, the better we can support them in their recovery. Additionally, the better we understand the role of dual diagnosis among veterans, the more we can serve those who struggle with SUD and mental health conditions that have not yet received treatment. If you or someone you love is a veteran with an SUD and mental health issues, it is vital to seek out the medical help you need — medical help that takes the concept of dual diagnosis seriously.

Sources

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