Dual Diagnosis Disorder combat stress PTSD and the drug ultram dual diagnosis

DualDiagnosis Disorder: combat stress PTSD and the drug ultram dualdiagnosis


Thepurpose of this research paper is to find out information aboutposttraumatic stress disorder (PTSD) and drug ultram dual diagnosisfrom different sources, especially past researches from healthscience. The research paper identifies the symptoms, causes,diagnosis, treatment, management, prevention, support activities,society bias, history and complications associated with the dualdisorder. The most important finding of the research is that dualdiagnosis is characterized by two types of disorders – PTSDdisorder and ultram abuse disorder. This duality problem makes itsdiagnosis, treatment and interventions to become complicated. Aperson suffering from the disease has cravings for drug ultram, andtends to show withdrawal syndrome. Some of the most effectivetreatments include medications, psychotherapy, rehabilitation andself-help support groups.

Definitionof Dual Diagnosis Disorder

Dualdiagnosis disorder, also known as co-occurring disorder is acondition that involves both substance abuse and mental healthproblems (Drake and Mueser, 2000). The mental health problem thatthis paper focuses on is called combat posttraumatic stress disorderPTSD). This is a stress related disorder in which military personnelbecome stressed after facing traumatic situations in military combat(Reynolds et al, 2004). The substance abuse disorder is the drugultram disorder, which is the addiction of the drug known as ultram.This drug is prescribed to relieve severe pain, addiction to whichcauses disorder. In most cases, the mental problem takes place firstbecause the military experience stress through traumatic combat,leading them to take ultram so that they can relieve their paintemporarily. Drug ultram is highly addictive and causes addictiondisorder to those who take in large quantities. Statistics show that75% of the combat veterans who are diagnosed with PTSD also showdependence on drugs, including ultram.

Signsand Symptoms

Theprimary feature of dual diagnosis is that substance abuse and mentalhealth disorders occur at the same time. Because two disorders areinvolved in this dual diagnosis, its signs and symptoms are due toaddiction and PTSD (Lunsky et al, 2013). One of the symptoms of thistype of dual diagnosis disorder is that it causes withdrawal of theaffected person (Drake and Mueser, 2000). In this case, the patientsecludes himself or herself from family and friends. This ischaracteristic of PTSD as a result of the military trauma. Theindividual may also show a sudden behavioural change due to PTSDproblems. A person with dual diagnosis disorder may also use ultramdrugs in a dangerous manner. Furthermore, this dual diagnosis diseasemay show signs of drug ultram overdose through side effects such asnausea, constipation, dizziness, vomiting, drowsiness and headache.

Causesand Diagnosis

PTSDand drug ultram Dual diagnosis is caused by various factors thataffect the mental health and substance abuse of individuals.Sometimes the abuse of drug ultram may be caused by posttraumaticstress experienced by victims during military combats. For instance,a military person suffering from posttraumatic stress may developanxiety, depression and frustration. To overcome this, he or shetakes drug ultram to reduce the anxiety or depression temporarily(Lunsky et al, 2013). Generally, PTSD is caused by environmentalfactors including traumatic experiences in military combat whileultram addiction disorder is caused by an overdose of drug ultram asindividual victims attempt to relieve their pain. Ultram drugincreases a person’s focus and relaxation temporarily. It is alsoeasily accessed because it can be acquired over the counter.

Diagnosisof the disorder involves testing for the symptoms of posttraumaticdisorder and drug ultram disorder (Reynolds et al, 2004). Posttraumatic disorder is tested based on its signs and symptoms anda thorough psychological evaluation. A person diagnosed with PTSDshould meet the DSM-5developed by the American PsychiatricAssociation. This test looks for experience of an event that heldthreat to life, signs and symptoms of PTSD after the event, and thesymptoms lead to significant stress. On the other hand, ultramaddiction disorder is tested by looking for its signs and symptoms,and screening for the traces of ultram drug in the body of thepatient.

Treatment,Intervention and Management

Integratedintervention and management are the major methods of treatment forPTSD and drug ultram dual diagnosis. In this case, the patient isgiven comprehensive care on the two disorders at the same time. Oneof the ways of treating ultram dependence or addiction is throughdetoxification. This involves daily monitoring for about seven daysas the patient is given reducing amounts of the ultram daily to weanhim or her off and reduce withdrawal effects. The addiction disordermay also be managed through inpatient rehabilitation. At the sametime, PTSD is treated through the inpatient rehabilitation facilitywhere the patient is given specific care related to posttraumaticstress disorder (Lunsky et al, 2013). Rehabilitation centres providepatients with medication, therapy, health services and support inorder to eliminate ultram addiction and PTSD problems. Otherresidential treatment centres such as homes may also be provided forpatients who need to avoid relapse.

Medicationmay also play an important role in the treatment of ultram and PTSDdual diagnosis. Medication provided by doctors and nurses can helppatients to overcome cravings for drug ultram. Another form oftreatment is psychotherapy. For example, cognitive behaviouraltherapy may be used to help people with posttraumatic disorders tocope and change their patterns of thinking. Stress anger managementcan also be provided alongside psychotherapy in order to managestress related to posttraumatic stress disorder (Reynolds et al,2004). Lastly, patients of posttraumatic stress disorder and drugultram dual diagnosis may join self-help groups where members supporteach other and share their successes, frustrations, and experiences,and refer specialists to each other. Family support, counseling andtherapy can also be used to manage posttraumatic stress disorder andultram drug addiction.


Posttraumaticand drug ultram dual diagnosis is complicated because it involves twotypes of disorders which require different types of interventions andtreatments (Reynolds et al, 2004). It is difficult to get staff withknowledge and skills related to the two types of diseases. Peoplesuffering from the dual disorder have complicated psychiatric andmedical needs they may go from service to service without gettingsufficient assistance because the service providers do not understandhow to help them. People with the disorder also face fundingcomplications due to the complex nature of their conditions.

Preventionand support

Preventionof posttraumatic stress disorder and ultram addiction dual diagnosisinvolves those activities that reduce dependence on drug ultram, andmental problems such as stress, depression and anxiety. One of theways to prevent mental problems from reaching serious levels is tospeak positively about oneself, e.g. I am going to overcome this, Ican do it, I am okay, etc. Another prevention mechanism is to avoidproblematic thoughts which may bring back the memories ofposttraumatic events experienced in the past (Reynolds et al, 2004).People may also talk openly and honestly in order to avoid stressfulor problematic issues. These preventive measures enable people toavoid mood changes that cause dual diagnosis.

Supportcan also help people with posttraumatic and drug ultram dualdiagnosis. In this case, community and self-help groups can play acrucial role in providing support to people with the dual diagnosis(Todd et al, 2004). These groups provide them with counseling andhelp them to discuss topics that will enable them to overcome theirproblems (Lunsky et al, 2013). The community and supportorganisations may also help them by providing homes and money to helpthem run their lives normally and overcome their frustrations slowly.

Historyof the Dual Diagnosis

Mentaland drug abuse disorders have existed since time immemorial, but theywere not considered to co-occur in the past. Traditionally, theseconditions were treated using parallel programs whereby each disorderwas treated by different clinicians. In 1980s, mental health care andsubstance abuse treatment were integrated so that the two conditionswere treated simultaneously using the same support or treatmentprograms (Drake and Mueser, 2000). This shifted the focus on dualdiagnosis from a confrontational to a supportive one. This has beenexperienced in the military combat where the military suffering fromPTSD have been recently treated for drug addiction. Ultram overdoseis a new issue that has influenced dual diagnosis interventions inthe past few decades.

Societyand Cultural Bias

Accordingto Lunsky et al (2013), the society has excluded some people withdual diagnosis from normal social activities. Some of them are notgiven houses due to their posttraumatic stress disorders and ultramdrug dependence. Some people also believe that addiction is aweakness, and veterans should be able to overcome them consideringtheir nature of work. However, acceptance of combat veterans in thesociety is boosted by their role to bring peace in the society.


Drake,R.E., Mueser, K.T. (2000). Psychosocial Approaches to Dual Diagnosis.Schizophrenia Bulletin,26 (1), 105–118.

Lunsky,Y., Weiss, J., O’Grady, C. and Skinner, W. (2013). AFamily Guide to Dual Diagnosis.Toronto: Centre for Addiction and Mental Health.

Reynolds,M., Mezey, G., Chapman, M., Wheeler, M., Drummond, C., &ampBaldacchino, A., (2005). Co-morbid post-traumatic stress disorder ina substance misusing clinical population. Drugand Alcohol Dependence,77,251-258.

Todd,J. Green, G., Harrison, M., Ikuesan., B.A., Self, C. And Baldacchino,A. &amp Sherwood, S. (2004). Defining dual diagnosis of mentalillness and substance misuse: some methodological issues. Journalof Psychiatric and Mental Health Nursing, 11,48–54.