Congratulations on your in depth article on Baltimore Behavioral Health and the over diagnosis of mental health problems among the addicted entering recovery ("Hooked on treatment," Nov. 7 and "Sheltered addicts, strained recovery," Nov. 8). I am a practicing clinical psychologist in private practice and in a transitional housing facility for homeless recovering addicts in Baltimore. Yes, affective disorders are over diagnosed among the recovering population and yes, any differential diagnosis between addictive behavior and mental health problems is nearly impossible until the addict has had a few weeks of sobriety.
But your article leaves the impression that recovering addicts are largely free of mental health problems. It failed to even mention perhaps the most important problem that is under diagnosed in recovering addicts, especially among women and which is a real sobriety killer: post-traumatic stress.
I see formerly homeless addicts here at the Lanvale Transitional Housing program who enter after 3-4 months of documented sobriety. The vast majority suffer post traumatic stress from early abuse. These poor people tell me heartbreaking histories of being taken to crack houses by their mothers as children, forgotten physical abuse at the hands of addicted caretakers, and multiple sexual molestations from parents boyfriends, step-parents and other caretakers. Untreated, the result is post-traumatic stress (an anxiety, not an affective disorder) which results in overwhelming emotions as adults, isolation and the utter inability to trust others, all roadblocks to a smooth recovery from drugs.
Jerry T. Lawler, Baltimore