HOW ADDICTS ARE FALLING THROUGH GAPS IN THE SYSTEM

TREATING patients with drug or alcohol problems combined with other mental health difficulties is notoriously tricky.

Drugs and alcohol directly affect the brain and may mimic or cover up important symptoms, making an accurate diagnosis practically impossible. For example, alcohol is a depressant, meaning it triggers low mood.

On the other hand, many people with drug and alcohol problems start using precisely because of an underlying mental health problem. In such cases, it can be very frustrating for patients and their loved ones to be denied direct treatment for depression or other mental health issues.

Yet the evidence is clear that trying to treat the depression is futile because the person is still taking a substance that will keep triggering it.

And what’s more, the two main treatments for depression are medication and talking therapy, neither of which will work well when someone is abusing alcohol or other substances.

But none of this means people like Naomi’s father should be left without support.

Instead, the way around this problem is to offer such patients a specialist talking treatment that aims to strengthen their motivation to give up a substance. Once that is achieved, underlying issues, such as depression, can be treated.

This can be time-consuming, however, and requires considerable skill and expertise. Unfortunately, the number of addiction specialists in drugs and alcohol services — which these days are often run by private contractors, rather than the NHS itself — have been cut in recent years.

The Royal College of Psychiatrists, for example, has seen a reduction of 60 per cent in training posts in addiction psychiatry since 2006.

At the drug and alcohol service where I once worked as one of six specialist psychiatrists, there is now just one GP.

For those who fall off the wagon, this lack of specialist care can result in a cycle of desperately trying to stop using so they can get treatment for the mental health problems that triggered them to use drugs or alcohol in the first place.