E91 : Community Mental Health Alcohol and Other Drugs : Potential Biol

Co-occurring disorders describe the presence of both mental health and a substance use disorder (Ogloff, Talevski, Lemphers, Wood & Simmons, 2015). The commonly co-occurring disorders are alcohol addiction and Schizophrenia together with heroin addiction and depression. Schizophrenia is a mental disorder that is admitted to be as a result of chemical imbalance in the brain which affects how an individual perceives the world around them (Hing, Russell, Gainsbury & Nuske, 2016). That is, persons with this disorder will hear, smell and see things that are not there. Individuals with a mental health disorder are most likely to develop alcoholism due to the manner in which some diseases interact with alcohol.

Several risk factors lead to the development of an alcohol use disorder in patients after they had been diagnosed with schizophrenia disorder (Nielsen, Toftdahl, Nordentoft & Hjorthøj, 2017). Mental and socioenvironmental factors subscribe to the co-occurrence of schizophrenia and alcohol use disorder. Patients with this co-occurring disorder say that they take alcohol to attenuate the extensive dysphoria of psychological disorder, insufficient chances, boredom along with poverty (DeVylder et al., 2015). Also, they add that the use of alcohol facilitates the development of a social network and identity. Although these people live primarily in the community instead of living in the hospital, they have restricted entertainment, social and vocational opportunities due to their illness, segregation and stigma. Moreover, they have faced downward social drift into poor urban living settings in which they are profoundly and frequently susceptible to alcohol use substance abusing networks (DeVylder et al., 2015).

The other factor that leads to the development of schizophrenia and alcohol use disorder is biological factors (Hartz et al., 2017). Three potential biological factors facilitate the development of this disorder. The underlying neuropathological malformations of schizophrenia are thought to promote the reinforcing impacts of substance abuse. A regular neurological basis for schizophrenia and the reinforcing implications of alcohol use may incline individuals to both states. The standard base encompasses the dysregulation of the neurotransmitter dopamine, and that explains the reason behind preferring drugs like a class of antipsychotic medications and nicotine by individuals with schizophrenia that increases the transmission of dopamine in some of the brain regions (Hartz et al., 2017).

The other organic factor proposes that individuals with schizophrenia are susceptible to the adverse psychotic impacts of alcohol use since the syndrome of schizophrenia generates debilitated thinking and social judgment along with deficient management of impulse (Hartz et al., 2017). Therefore, even when taking comparatively minute quantities of psychoactive contents, these individuals are vulnerable to thrive valuable content associated with detectable issues that certify them for an alcohol use disorder diagnosis. Finally, researchers and clinicians have declared that persons with schizophrenia use alcohol to alleviate the side impacts of the antipsychotic drugs stipulated for schizophrenia or its symptoms (Moncrieff, 2018).

The reason behind the impacts of alcohol abuse is because it is a central nervous system depressant (Peacock et al., 2016). People with schizophrenia feel relieved once they use alcohol since it dulls their senses and they become unaware of everything that is happening around them. Using alcohol does not just relax most cases of schizophrenia, but it also gives a break from whatever they have seen the whole day although studies show that alcohol can have a greater euphoric impact on them compared to individuals who don’t have the illness (Peacock et al., 2016). The alcohol use disorder affects a person with schizophrenia in every way it would affect someone without the disease straining their health and relationships. Also, symptoms resulting from withdrawing can make their hallucinations worse adding additional pain to whatever they hear and see (Peacock et al., 2016).

Hospitalization, homelessness, suicide attempts and unemployment are the most common effects of schizophrenia and alcohol use disorder (Kalmakis & Chandler, 2015). Patients with schizophrenia and alcohol use disorders leave a safe place such as a hospital and stay on the streets making them be involved in medications rarely. When they don't take drugs, they end up trying alcohol to manage the symptoms of the disorder. Homelessness can be triggered by inadequate funding that creates a shortage of institutions to house patients with schizophrenia (Kalmakis & Chandler, 2015). Patients with schizophrenia and alcohol use disorder are socially isolated and stigmatized and can lead to suicide attempts. Also, hopelessness, hospitalization and health deterioration are vital risk factors that can contribute to suicide. These people fear further mental decline and they show either excessive treatment dependence or loss of faith in medication (Kalmakis & Chandler, 2015).

The co-occurring disorder of alcohol use and schizophrenia disorder can be managed by using multidisciplinary medical staff that delivers overextend, inclusive services along with stage-wise medications (Gannon & Eack, 2016). Overextend is required since victims are always demoralized and hesitant to be involved in medication. Full services are essential since improvement incorporates building expertise and support to seek for a life that is worthwhile instead of controlling illness and symptoms. Furthermore, stage-wise medication concludes that victims recuperate from two severe diseases in stages, over time and with assistance from those individuals who give medications (Gannon & Eack, 2016). To best manage this disorder, patients have to pass through treatment stages. Engagement phase incorporates building a trusting treatment association and persuasion phase that involves developing the stimulation to control both the diseases along with seeking for improvement. Moreover, the active treatment stage entails skill growth together with support required for the management and improvement of the disorder. Finally, the relapse prevention stage encompasses strategies to prevent and reduce the impacts of relapses (Gannon & Eack, 2016).

The other common co-occurring disorder is heroin addiction and depression. Heroin is an artificial opiate obtained from the naturally occurring opioid morphine, and it’s highly addictive and very dangerous opiate which reduces agony, persuades exhilaration and comfort together with causing sleepiness (Bergen-Cico, Scholl, Ivanashvili & Cico, 2016). Depression is an antecedent psychological disease associated with psychotic aggravation related to heroin dependence or generated by heroin termination. Those individuals who are dependent to opiates have a higher likelihood of establishing the tenacious disease of depression and in few cases great disorders of depression (Saha et al., 2016).

Heroin strains its impacts through binding with receptor cells in the brain that retaliate to sedatives (Günther et al., 2018). When heroin is smoked or injected it transforms to morphine in the brain where it abates the neurological actions inducing a taste of soothing. People with depression, heroin may seem to be an antidote to guilt, hopelessness and sadness but it may worsen symptoms of depression. The worsened symptoms may include low energy, social isolation, negative mood, suicidal thought and anxiety (Günther et al., 2018). Depression can arise from genetic factors, physical disability, drug abuse, psychological trauma and imbalances in brain chemistry. People with family members who struggle with heroin addiction have a high susceptibility to addiction. Moreover, some people inherit personality characters which can place them at an increased risk of becoming dependent on a substance such as heroin (Günther et al., 2018).

Addiction and abuse of heroin physically result to long-term adjustments in the brain operation and structure (DiClemente, 2018). However, when these changes occur they affect self-control and the ability of an individual to make the correct decisions as they start craving the drug. Also, people who have been raised in homes in which addiction is regular get used that drug abuse is a way of coping with adverse life circumstances (DiClemente, 2018). Individuals who tend to experiment with drugs at young ages are at a higher risk of developing an addiction later in their lives.

The effects of heroin addiction and depression vary as the illness progresses (Volkow, Koob & McLellan, 2016). Depression is common among users of illicit opioids. In that case, more extensive opioid illegal use is related to more severe depression. Rates of depression decrease when people get involved in opioid dependence treatment, in particular, maintaining pharmacotherapies. Consequently, use of illicit opioid continually affects adherence to depression treatment in opioid-dependent individuals. This co-occurring disorder has effects such as stigma and isolation, job loss, legal troubles and financial problems along with relationship conflicts (Volkow, Koob & McLellan, 2016).

Due to heroin use and depression users lose their jobs because they cannot be contained in the workplace and as a result, they face financial challenges (Milner, Maheen, Currier & LaMontagne, 2017). Furthermore, since heroin users are not aware of the strength of the heroin bought on the streets, they are at risk of overdose or death. Addiction affects the person who is using the drug by diminishing their life quality, destroying their mental and physical health and leaving them in a situation where they have no job or no effective remaining relationships in their life (Milner, Maheen, Currier & LaMontagne, 2017).

The abuse of heroin is accountable for several divorces since it is challenging to retain amorous marriages with heroin users for they keep the drug as their priority. Spouses of addicts always feel that they live in a toxic environment and that they cater for duties of the household (Milner, Maheen, Currier & LaMontagne, 2017). Heroin use also affects parents of the young addicts leaving them emotionally drained and depressed. When they use heroin, they are likely to engage in criminal activities or be sexually involved, and their parents are forced to bail them from problems. The adverse repercussions of heroin use affect how people will react to the addicts. For instance, people will discover some signs of heroin use and even how the users will feel about themselves. Relationship conflicts will contribute to depression and makes it difficult to stop addiction (Milner, Maheen, Currier & LaMontagne, 2017).

Other effects of heroin addiction and depression include coma, cardiac complications, and infection by bloodborne pathogens resulting in chronic conditions like hepatitis and HIV/AIDS (Volkow, Koob & McLellan, 2016). Furthermore, respiratory issues including pneumonia, other pulmonary infections and depressed breathing, infection at the injection site and necrotizing fasciitis which is a rapid- moving and fatal infection that kills tissue it experiences (Volkow, Koob & McLellan, 2016).

The heroin addiction and depression disorder can be managed through treatments, counseling and peer support (Sokol, LaVertu, Morrill, Albanese & Schuman-Olivier, 2018). As with other co-occurring disorders, heroin abuse and depression can complicate each other. If heroin addiction is treated alone, it is possible that relapse to substance abuse will happen when depression rears its head. Likewise, if depression is treated alone substance abuse will have the potential of leading to deterioration in depressive symptoms. To recover effectively, people should seek treatment for both problems (Sokol, LaVertu, Morrill, Albanese & Schuman-Olivier, 2018).

Antidepressants do a great deal in minimizing the symptoms of depression, and some medications are available for treatment of heroin use (Cipriani et al., 2018). The serendipitous discovery of antidepressants has revolutionized both depression management and understanding. However, their efficiency in depression treatment has been discussed and brought into the public limelight in which the responsibility of placebo response in antidepressant efficiency trials is highlighted. These antidepressants are also believed to level mood and slow down or block out harmful thoughts (Cipriani et al., 2018). Also, regular medication is more effective when a person seeks counseling behavioral support. Several individuals have noticed that to curb addiction intensive inpatient or outpatient is necessary. When trying for heroin addiction and depression treatment one needs to seek immediate medical attention first to address the withdrawal symptoms of heroin (Sokol, LaVertu, Morrill, Albanese & Schuman-Olivier, 2018). Duration of abstinence may be necessary before a clinician can conduct an accurate diagnostic evaluation.

References:

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