It would be unconscionable to tell those with cancer that they can’t be treated because they don’t have a different disorder, and it should be considered equally unconscionable to not treat those with the other chronic, progressive, lethal disease.
The National Institute of Mental Health states, “Substance use disorder (SUD) is a treatable mental disorder that affects a person’s brain and behavior, leading to their inability to control their use of substances like legal or illegal drugs, alcohol, or medications. Symptoms can be moderate to severe, with addiction being the most severe form of SUD.” (NIMH)
Another way to determine if a SUD is a mental disorder is through the bible of mental disorders, the DSM…the Diagnostic and Statistical Manual of Mental Disorders. It’s right there in the title, and we know that substance use disorders are identified in the DSM. “The Diagnostic and Statistical Manual of Mental Disorders, Fifth Edition, Text Revision (DSM-5-TR) features the most current text updates based on scientific literature with contributions from more than 200 subject matter experts. […] The manual will help clinicians and researchers define and classify mental disorders, which can improve diagnoses, treatment, and research.” (Psychiatry)
So, yeah, SUDs are mental health disorders.
But wait: I recently had the occasion to look at the Social Security website, and, lo and behold, I found out that solely having the “mental disorder” of substance use disorder, even in the most severe form of addiction, doesn’t allow for a diagnosis of a disability under Social Security Disability Insurance. However, having a single mental disorder does in many cases. (SSA)
And try to get into treatment for a substance use disorder. Many providers – far too many providers – get to say that unless you have a co-occurring diagnosis of a mental disorder, you don’t qualify for treatment for your SUD.
However, in 2018, the National Institute on Drug Abuse said that of the 20.3 million adults with SUDs, 37.9% also have a mental illness (NIDA). More recent statistics indicate that about 17% of the population aged 12 and over suffered from a SUD in the last year (SAMHSA), so let’s say that nearly 38% of that population has a mental illness. Oh, boy, is a mental illness the same as a mental disorder? I really don’t know that answer, because I am a Wisconsin-certified Substance Abuse Counselor, and I have no capabilities of determining if someone has a mental illness or a mental disorder. Well, except that of SUD.
I have made no secret about my belief that substance use disorders (SUDs) should not be under the mental health umbrella. Sadly, the government has never asked me for input, so my complaints have fallen on deaf ears.
We complain about the stigma that our language causes, but what about the stigma that our diagnoses cause? “You’re sick, but you’re not sick enough to get help.” “You have to be sicker to get help from us.” “We recognize that you have a disease from which you may die, but we can’t help you because you don’t have the RIGHT disorder.” “You’re sick, but you have to get a different diagnosis for us to help you.”
Let’s review: addiction is a chronic, progressive, lethal disease. It’s like having cancer. Without treatment, you’ll die. Can you imagine if someone went to the doctor, received a diagnosis for breast cancer and then was told, “But we can’t help you because you need to also have a diagnosis for depression”?
It’s unconscionable for those with cancer, and it should be considered equally unconscionable for those with the other chronic, progressive, lethal disease.
We have got to do better.
References
https://www.nimh.nih.gov/health/topics/substance-use-and-mental-health#
https://www.psychiatry.org/psychiatrists/practice/dsm
https://www.samhsa.gov/newsroom/press-announcements/20231113/hhs-samhsa-release-2022-nsduh-data
https://www.ssa.gov/disability/professionals/bluebook/12.00-MentalDisorders-Adult.htm
Guided by Guida 
Leave a comment