The new boundaries: drug addiction or mental illness

  • Tamara Boccia Pedagogist, educator and operator of deviance on child marginality (Rome, Italy)
Keywords: adolescent discomfort, psychiatric comorbidity, drug addiction, adolescent groups, family values


The article aims to act as a heartfelt cry of denunciation towards the lack of attention of the current socio-health system towards an alarming condition faced by thousands of young people and adolescents: being affected by double diagnosis. It is a psycho-socio-pathological phenomenon in which the drug addiction dimension is combined with the psychiatric one. The devastating effects produced by the intake of chemicals, often corroborated by large doses of alcohol, determines a real short circuit of the cerebral cortex. The comorbidity between psychiatric disorders and substance use disorders is commonly referred to as Double Diagnosis (1992, First and Gladis) which concerns in particular three types of patients: patients with primary psychiatric disorder and secondary abuse / dependence; patients with primary abuse / addiction disorder and secondary psychiatric disorders; patients with psychiatric disorders and abuse / addiction disorders both primary.

In addition to reporting the lack of policies to prevent the phenomenon, the author associates a more general analysis of the juvenile reality in which the tendency to implement antinomic and deviant behaviors is increasingly evident. This form of "generational suicide" is opposed by a request for the activation of "network" policies that encourage young people to assume a higher degree of responsibility towards a process of social integration based on the determination of a solidarity structural identity. Socially and therapeutically, it is essential to highlight the importance of that operating discipline which is defined as "integrated treatment", not meaning, by this term, the parallel treatment of both ailments. As the author points out, the current approaches of the doctrine consider the need to work on both and therefore, together with the primary disturbances. In this sense, it is still to be remembered that an authentically integrated treatment allows to modify the prognosis of the double diagnosis, bringing it closer to that of the single disorders. The integration of knowledge, psychiatric and drug addiction must, however, tend overall to support a psychotherapeutic path and to the simultaneous involvement of families in this evolutionary process, in particular intended for adolescents.