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Substance Abuse Disorder and Mental Illness

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Substance Abuse Disorder and Mental Illness
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The expression “chasing the dragon” refers to the positive reinforcement act of continual craving and seeking for the initial euphoric state especially among opiate or heroin users. The act of chasing begins after the user experiences the high for the first time and seeks to attain the same bliss and pleasure as the original feeling. However, an increased quantity of heroin is required by the user in the subsequent times in a conditioned effort to achieve it once more. Opiates strongly affect the brain’s reward system by stimulating the pleasure-sensing site in the nucleus accumbens CITATION Yan08 l 1033 (Yanes-Hoffman, 2008). The initial feeling becomes forever elusive as the user is building a tolerance after every use since the brain cells are now less receptive to opioid stimulus. The recurrent use of opiates prompts changes in neuropeptide and neurotransmitter systems that control stress-receptiveness and incentive, as a result, causes loss of control and encourages compulsive use CITATION Vri02 l 1033 (Vries & Shippenberg, 2002). Henceforth addiction develops as the body functions become extremely dependent on opiate use due to the recurrent pursuit of the elusive initial feeling.
The high prevalence of comorbidity between psychological and substance use disorders fosters multiple barriers in diagnosing and treating either of them. Establishing a prognosis of either disorder is complex as it is difficult to separate the overlying symptoms of both CITATION Nat18 l 1033 (NIDA, 2018).

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Also determining the causality and which of the two conditions influenced the other is challenging as it only depends on the patient’s recollections CITATION Wes08 l 1033 (West, et al., 2008). Users with both mental and substance use syndromes are more treatment-resistant and have higher treatment dropouts as compared to those with only one. Treating substance abuse becomes problematic as mental disorders alter brain activities, increasing the susceptibility to drug use by augmenting rewarding effects or lessening symptoms of the psychological disorder. For instance, through neuroimaging patients with ADHD exhibit alterations in brain circuits that prompt greater drug cravings CITATION Nat18 l 1033 (NIDA, 2018). Similarly combating mental disorder is difficult as substance abuse intensifies its symptoms in the long-run, for instance, extended cocaine usage exacerbates the bipolar disorder symptoms. Moreover, substance use often obstructs the effectiveness of psychotherapeutic treatments, as it creates an illusion that the treatment is not operative.
In patients with comorbid substance abuse and mental disorders, integrated treatment is preferable as opposed to serial treatment. In addition to short and long-term medications for either disorder, integrated approach for comorbidity involves behavioral therapy strategies to produce better long-term results (NIDA, 2018). Cognitive behavioral therapy can be used for a patient with PTSD and drug use disorder to lessen their anxiety and symptoms by modifying their harmful beliefs and behaviors. The therapy will foster coping and interpersonal skills that help the user to adhere to medications and avoid drug use triggers for functional recovery (Society for Neuroscience, 2018). Exposure therapy can also be simultaneously used which involves continual exposure to traumatic or dreaded scenarios and memories in a controlled environment. It aims at desensitizing the patient to the stimuli that prompt symptoms and compulsive drug use while helping them improve coping skills and reduce symptoms (NIDA, 2018). Furthermore, to combat the probability of relapsing back to drug use, incorporating motivational incentives in the first phase of quitting will encourage abstinence. In addition, pharmacotherapy medications that have no adverse psychotic symptoms such as bupropion for nicotine dependency.
References
BIBLIOGRAPHY NIDA. (2018). Common Comorbidities with Substance Use Disorders. National Institute on Drug Abuse. Retrieved November 05, 2018
Society for Neuroscience. (2018). Brain Facts: A Primer on the Brain and Nervous System (8th ed.). Washington, DC: Society for Neuroscience. Retrieved November 06, 2018
Vries, T. J., & Shippenberg, T. S. (2002, May 01). Neural Systems Underlying Opiate Addiction. The Journal of Neuroscience, 22(9), 3321–3325. Retrieved November 05, 2018
West, R., Benowitz, N., Hall, W., Peter, Liz, & Randall, D. J. (2008, May 10). Quitting the habit: neurobiology, addiction, and the insidious ciggie. (N. Mitchell, Interviewer) Retrieved November 05, 2018
Yanes-Hoffman, N. (2008). A Clue To Why Tobacco Is So Addictive. Brain Science Podcast. Retrieved November 05, 2018

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