A Non-Fatal Mirtazapine Overdose in a Suicide Attempt

Abstract

issue [1] and sadly I have to agree with most of what he had to say about the treatment of comorbidity or 'dual diagnosis' patients. In particular, MacQueen makes the pertinent point that most comorbidity in the substance abuse field is actually anxiety and depressive disorders and that the classic 'dual diagnosis' patient (e.g. a person suffering from schizophrenia who smokes marijuana), is only the tip of the iceberg. The incidences and prevalences of psychiatric disorder in those presenting with substance abuse are far higher than the incidence of substance abuse in those presenting with psychiatric disorders, so it turns out that it is much more relevant to train those in the drug and alcohol field in recognizing and treating psychiatric disorder, rather than the other way around [2].However, I do feel that MacQueen has basically missed the point in issuing his challenge to psychiatrists as individuals. In fact, psychiatrists have been put in an impossible position as the powers that be, for politically correct reasons, have artificially separated substance abuse and psychiatric services. They have, in fact, attempted to unscramble the egg and thus we now have this ludicrous situation with patients being bounced between the two services and never receiving adequate treatment.As Harvey Whiteford stated in this Journal,The high rates of comorbidity, especially with alcohol and illicit drugs confirms clinicians' experience. In the light of this I am even more certain that the administrative separation of mental health and substance abuse services makes little sense, especially to the consumer and their carers [3].