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Friday, October 24, 2014
Addiction and Substance Abuse
Mental health / Addiction
I work for a company called SparkPeople, a goal achievement company. A lot of our clients have weight loss goals. We have a message board for people to post their results and to offer support and motivation. We have a member who has posted for quite awhile and recently she`s started talking about how she drinks 10 shots of liquor daily. Members and SparkPeople Coaches have tried to explain that she probably has a drinking problem and that it`s best she get help, but her response is that her husband is an alcoholic and he doesn`t think she is an alcoholic. She has also mentioned she is paranoid schizophrenic, and that she`s visited a few different mental health doctors, and taken medications that haven`t worked. I asked her if she would be willing to talk with someone, and she said if I threw out a name that she would consider it. I`m wondering if you have any advice for me?
Thanks for any advice you can give me!
Hello, I got the question back today and hope that this helps.
First, the major symptom of addiction is denial. She will be the last person (except maybe her husband) to see that she is an alcoholic. She can see that he is and the fact that he supposedly says she is not one tells her what she wants to hear to continue justifying her drinking. She needs detox most likely if she is drinking that much. The recommended safe drinking amount is 1 drink per day (ie. one shot) She is drinking such a large quantity that she has shown tolerance now and will likely go into withdrawal if she were to stop or cut down too quickly. She would need to be admitted to an inpatient dual diagnosis unit that can detox her safely and evaluate whether or not she has paranoid schizophrenia. About 50% of patients with mental illness also have drug abuse or addiction diseases as well.
From what I understand of what you describe as your posting, she is asking for help. Assuming she is employed, many times the insurance company has preferred providers that they use for addiction and dual diagnosis. Sometimes a call to them by the employee is all that it takes to get someone headed to the right referral source.
Treatment centers for addiction may or may not be licensed to treat those with comorbid psychiatric disorders. Both of these diseases should be treated at the same time. Failing to do so will result in relapse into both diseases. It is hard to successfully treat a paranoid schizophrenic since they are so distrusting of everyone including doctors. It takes a physician and healthcare team that are experienced in both to do this well.
I would recommend contacting insurance first and then the next major chore will be convincing her to go. A close coworker might be able to help reach her. There is a national treatment center registry available at the link below. Thank you for your patience.
Edna M Jones, MD, MRO
Emeritus Clinical Assistant Professor of Family Medicine
College of Medicine
The Ohio State University