National Overview: carers of people with substance misuse
There are now more than 180,000 people receiving structured drug treatment in the UK. There are likely to be many more than this number providing some form of care to those with substance misuse problems. These carers may not be included in current estimates of carers nationally.
There are also estimated to be "between 250,000 and 350,000 dependent children living with parental drug misuse and 920,000 living with parental alcohol misuse."1 Many of these parents will not be known to any services, which conceals young carers in this situation.
Substance misuse is a problem which presents challenges in its own right, both for users and the people around them. However, it is estimated that a third of patients in UK mental health services also have a substance misuse problem. At the same time, around half of patients in drug and alcohol services have a mental health problem (most commonly depression or personality disorder).2
There is no single definition of dual diagnosis, but this can be understood as "the co-existence of mental health and substance misuse problems".2 So when talking about dual diagnosis in a mental health context, this means that a person has two (or probably more) diagnoses; one of a mental health problem and the other of a substance misuse problem. For example, a patient may have a dual diagnosis of schizophrenia and heroin addiction.
Additional physical health problems are also common among patients with a dual diagnosis, such as hepatitis, malnutrition and related conditions.
In this sense, treating substance misuse problems and combining this with treatment for mental illness are big issues in the UK. More importantly, these problems can and do cause serious harm to children and young carers.3
1 The effect of parental substance abuse on young people by The Joseph Rowntree Foundation, 2004 - Ref 064. Taken from the full report: Parental drug and alcohol misuse: Resilience and transition among young people
2 Dual Diagnosis Toolkit, p.6, produced by Turning Point
3 Hidden Harm: Responding to the needs of children of problem drug users Executive Summary, p.3, produced by Advisory Council on the Misuse of Drugs, 2003.