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Dr. Paul Dulaney and Dr. Kerri Outlaw gave a “dual diagnosis” on Tuesday of the connection between addiction and mental health.

Dulaney an Outlaw were the featured speakers at what was the first of a new series quarterly luncheons  hosted by Troy Regional Medical Center on topics surrounding mental health and wellness.

“We’re here today to look at addiction a little bit differently,” Dulaney said. “Our goal is to destigmatize addiction a little bit.”

The duo started out the presentation describing a typical case: a 27-year-old woman who began using substance abuse at a party after being pressured by her boyfriend. An addict of six years, the patient had been suffering from depression even longer – since she was a teen. The drug use cost her everything – her job, her kids and her health.

Dulaney explained that illegal substances “hijack the pleasure-reward pathway” of the brain and train it to ignore its natural functions and now depend on the drug.

“It is no longer a natural process driving behavior, it has been replaced,” Dulaney said.

He explained that most commonly used illegal drugs stimulate the brain in the same way as food or sex. Except dopamine stimulates the brain nearly 150 percent that of sex and harder drugs like methamphetamines even stimulate at levels of 200 and 300 percent.

But that’s just the start, Dulaney said. Once chasing the high wears off, it becomes not about seeking pleasure, but avoiding the pain of withdrawals.

Dulaney demonstrated with a game, asking how many people would take a guaranteed $250 rather than take a 75 percent risk of losing everything for a 25 percent chance at $750. Almost everyone took the guaranteed money. Then he asked whether people would rather lose $750 guaranteed or take a 25 percent chance of losing nothing against a 75 percent chance of losing $1,000. Almost everybody took the risk.

“People tend to avoid risk to ensure gain, and take risk to avoid loss,” Dulaney said.

Outlaw said 57.8 million people in the US have either a mental illness or substance abuse disorder – and 9.2 million have both.

“Many of us know there is a connection between addiction and substance abuse, but I don’t know how many of us understand it as such a huge connection that it truly is,” Outlaw said.

Whichever comes first doesn’t matter, Outlaw said. “We still have the same problem.”

Some people suffering from mental health issues use drugs to self-medicate, Outlaw said. Other substance abusers develop mental illness from the drug use. Often, it is a combination of both.

Outlaw said treating people who suffer from both a substance abuse disorder and mental illness becomes a real challenge, as each works against the other. The only solution, Outlaw said, is addressing them together, a dual diagnosis.