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September is National Alcohol and Drug Addiction Recovery Month. This year’s theme is “Join the Voices for Recovery: Celebrating Health.” Recovery Month is an occasion to raise our personal awareness about addiction and recovery issues and to take action with friends and neighbors to affirm the gravity of chemical dependence and also our confidence in the possibility of recovery. In that spirit I’d like to offer something to learn more about and a way to get involved.

One subject of growing attention among treatment professionals is the interaction of substance use disorders and mental health disorders when people experience both at the same time. This co-occurrence, as it’s called, is actually quite common. For example, The Surgeon General’s 1999 Report on Mental Health found that as many as 65 percent of people with a history of substance abuse or dependence also had a history of some mental health disorder. Similarly, 51 percent of people with a history of mental health concerns also had a substance use disorder in their lifetimes.

People with co-occurring disorders – also called MICA (mentally ill chemically addicted) or dual diagnosis – are at high risk for many poor outcomes, including: homelessness, criminal involvement, suicidality, vulnerability to trauma and violence, relapse, and hospitalization. Access to comprehensive treatment is a goal that will define much of our work as a care system in the near future. Last year the Substance Abuse & Mental Health Services Administration issued the Report to Congress on the Prevention & Treatment of Co-occurring Disorders. Included in the report is the statement, “Research has suggested that the vast majority of people with co-occurring substance abuse disorders and mental disorders do not receive care for a broad range of reasons.” What barriers make access to treatment difficult?

The stigma associated with each type of disorder makes seeking help when both are present very difficult. To appreciate the impact of stigmatization, take a moment to think of as many names for people with chemical dependence and/or psychiatric disorders as you can, then list some of the attributions our culture makes about these individuals. Reviewing the list, can you see why it might be hard for someone to validate the presence of these conditions in his or her life? We all have the challenge of telling the truth about both mental health and substance use disorders, separating the facts from popular fictions, and creating an environment where there is a wellspring of support and respect for the prospect of a person seeking help.

Another barrier to accessing comprehensive treatment is the traditional divide between the mental health system and the alcohol and drug treatment system. Both systems evolved very differently, staffed with different professionals, highlighting different goals for their clients, and regulated by separate agencies. In 1998 the New York State Office of Mental Health and the Office of Alcoholism and Substance Abuse Services signed an agreement to partner together integrating care for individuals with co-occurring disorders. There have been many results so far from that cooperation, including twelve Dual Recovery Coordinators being installed throughout the state. Tompkins County is one of the selected areas and I serve as the Dual Recovery Coordinator here.

The Tompkins County Mental Health Department is organizing a presentation by Kenneth Minkoff, M.D. to be held September 22 on the topic of integrating services for individuals with co-occurring disorders. Dr. Minkoff is a national expert on the subject of co-occurring disorders and service integration. For more information contact Shane Jaynes at the Mental Health Department, 274-6300.

Sober Talk is a monthly column by the Alcohol & Drug Council of Tompkins County, Inc. and runs in the Journal on the first Thursday of each month.