Dual Recovery

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There are two meanings for the phrase “dual recovery.” The first is someone who is addicted to more than one (unrelated) substance or behavior. Sometimes it’s one substance and an activity, either of which is addictive by themselves. So, for instance, someone who is both an alcoholic and a compulsive gambler. Recovery would have to address each of the addictions.

The second meaning is a medical diagnosis. It means someone who is a substance abuser (usually addicted) with a mental illness – depression, bipolar disorder, schizophrenia, psychosis. Dual recovery here would be treatment for the addiction while also dealing with the mental illness.

It is those with two addictions I will talk about here. Their problem is finding a group that “speaks to them.” Currently, while the medical community has a category for a kind of addictive personality, the treatment community at large tends to process people in categories. Someone seeking help with both a cocaine addiction and a sex addiction will be hard pressed to find a facility that specializes in both.

Certainly, there are parallels that define all addictions – the compulsion element, cravings, sacrifice of other parts of one’s life… but how we approach them differs. The combinations aren’t strictly additive either. Someone who gets high and then shops to excess or spends hours playing online games may be having a different experience that someone who just does one of the activities alone.

The usual rule is to deal with one thing at a time. But dual recovery, when available, can address multiple behaviors that are linked. This wasn’t always so. Alcoholics would enter a facility and be allowed to smoke, for example. Stopping both addictions at once was considered too hard. The ideas are changing however, at least for inpatient care. Current best practices are to treat the whole patient – in whatever condition they arrive.

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