By Kristian Foden-Vencil
Forest Grove, OR March 14, 2008 6:04 a.m.
Two of the most difficult problems a person
can face are mental illness and drug abuse.
Now imagine -- suffering from both. It's
known as a dual diagnoses.
Doctors estimate that about half of the
people who struggle with mental illness also
suffer some form of addiction. They may have
had psychological problems first and then
chose to self-medicate with alcohol or
drugs. Or their excessive use of drugs may
have altered their brain chemistry or
otherwise triggered a mental illness.
Doctors and therapists have been trying to
address the special needs of those with a
dual diagnoses for years. But as Kristian
Foden-Vencil reports in this next
installment of "On Our Minds," getting
government, treatment centers and colleges
on board has been a slow process.
Kate Oldfield is a 25-year-old mother.
Petite, with rich auburn hair and hazel
eyes, she lives with her parents and her
four-month-old in Forest Grove.
Today, Oldfield is dressing her bundle of
joy in the living room of the small ranch
home. It's an idyllic scene. But life wasn't
always like this for Oldfield.
Her teenage years started off okay -- she
got a job with a local fitness company. But
then she met a man, 11-years her senior, who
after an initial romance, began to beat her.
Kate Oldfield: "I started to work more
hours, so I wouldn't have to go home. I got
promoted. I moved up the ladder and a lot of
people there did cocaine."
She says cocaine helped her work longer
hours and feel good about her life. But
gradually the drug use -- and her
relationship -- spiraled out of control.
Kate Oldfield: "He broke my nose three
times. Broke 13 ribs and I'd become a person
I didn't even recognize. I never thought I'd
be that type of person who'd be in that kind
of relationship. And that's where I wound
up. And I couldn't even look myself in the
She says, the cocaine did something
important: it numbed that feeling.
Kate Oldfield: "There were no lows. I didn't
have to confront the choices that I had made
and where I was and toward the end, part of
it was, I didn't have the guts to put a
bullet in my head."
She's out of the relationship now and on
probation for various drug charges.
She's also about to reach her one-year
sobriety mark -- an important milestone. But
there have been costs.
She's on Zoloft for depression and
anti-anxiety medication for Post Traumatic
Stress. The flashbacks, she says, are
Kate Oldfield: "If I would say no to sex, he
would rape me. And to this day, I can't have
someone, if someone comes up and puts their
hand within five inches of my face, I freak
out. I scream. It's not fight or fright
mode, it's straight fight mode."
Oldfield attends Narcotics Anonymous four
times a week. She also goes to group
sessions with mental health therapist, Tina
Bialas says Oldfield's case is typical -- in
that her drug use and her mental illness are
so intertwined that it would be all but
pointless to treat one problem without
addressing the other.
Tina Bialas: "In some programs, almost 100
percent of the women who are in treatment
for addiction are reporting histories of
sexual abuse. So it's very clear that this
linkage exists between the mental and
emotional pain that's caused from having
mental illness and that human drive to not
want to feel that pain. And I always tell my
clients that that's one thing that drugs and
alcohol are really good at -- help me not
feel this right now."
Bialas says there's a national movement to
change public perceptions around drug
addiction: from that of a 'moral failing'
to that of a 'brain disease' or mental
illness. Indeed, a bill in Congress last
year would have classified addiction as a
disease. It didn't pass.
Bialas says many people stubbornly cling to
the "moral failing" point of view because
there is an element of choice involved.
On Our Minds
OPB's series on mental
health care in Oregon
The health system in Oregon, as in
the rest of the United States is in
Costs are skyrocketing, millions of
children and adults remain uninsured
and even working people are going
without health care. Presidential
candidates are promising plans that
will come to the rescue.
Here at OPB, we're focusing on one
aspect of the health care system in
Oregon: mental health.
Our new series, "On Our Minds,"
examines who's getting and giving
mental health care.
Tina Bialis: " I have yet to meet one
addict, that when they first started
drinking or using had the goal to become
addicted. They're looking for many other
things, but they're not looking to become an
addict, live on the fringe of society and
suffer all these horrible consequences."
As a progressive state, Oregon has been on
the forefront of treating addiction as a
In fact, Bob Nikkel recently chanced the
name of the state health department to
recognize the problem of dual diagnoses, or
co-occurring disorders. He now heads what's
called 'The Addiction and Mental Health
Bob Nikkel: "I just think helping educate
people about how common people with
co-occurring disorders are, and that we have
to stop ping-ponging them between the
systems. And both systems, I think the
public sphere, are working hard to grapple
with this issue. Do we have a way to go,
yes. But I think we're clearly enlightened
about this in Oregon."
That's true, says Vietnam vet and former
self-described "dope fiend," Corbett Monica.
He founded Dual Diagnosis Anonymous of
Oregon, and holds group sessions where
patients follow a 12-step process -- plus
five extra steps that deal specifically with
Corbett Monica: "We used to talk about what
was called the ping-pong approach to
treatment. Which meant that for my addiction
problems I was sent to an alcohol and drug
treatment program, and for my mental health
problems I was sent to a mental health
service provider. Back and forth, back and
forth. So that nowhere did the train come
together so there was a concerted, what's
called these days 'integrated treatment'."
He says that things are changing, but it's
taking a long time. People are still turning
up at mental health treatment centers and
being told to come back when they're clean
But a bigger problem, he says, is access.
Corbett Monica: "I can tell you this, almost
every residential program that I know of
that treats dual diagnosis has a waiting
list and the time for that waiting list will
vary, sometimes into the several months, but
at least a couple of weeks usually."
Mental health therapist, Tina Bialas, says
it's not uncommon for her to have the
friends and relatives of her clients begging
to tag along with them for treatment.
The solution, she says, isn't a surprise --
Tina Bialas: "An increase in the beer tax is
long overdue. Oregon has one of the lowest
beer and wine taxes in the nation. We could
fund significantly more treatment and it's
desperately needed. Folks don't understand
how hard it is to get treatment. One in ten
people, who need inpatient treatment for
their addiction are able to get it. The
other nine, even though they want it, have
no way to get it."
Back in Forest Grove, at the small home of
Kate Oldfield, the 25-year-old mother
prepares a bottle of milk. She knows she's
lucky to be in treatment. And, she sees this
as her big chance.
Kate Oldfield: "Yeah. I made a decision. I
made a decision to turn to a substance to
deal with my pain. It wasn't the best
decision I made in my life. But I am working
my butt off to fix that. And there are a lot
of people out there who are suffering still.
So the people who say, well they made that
choice, they don't know the back-story. They
don't know what someone's gone through. That
it was so horrible they had to turn to that.
They didn't feel they didn't have any other
We're getting help reporting the "On Our
Minds" series from our
Public Insight Network.
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