Preliminary data and clinical experience suggests that the symptoms initially produced by drugs may, in particularly vulnerable individuals, actually go on to produce persistent psychiatric disorders. Such disorders may only partially clear when drug or alcohol use has ceased. The special vulnerability of persons who have already developed or are at risk of developing psychiatric disorders is such that even very small amounts of alcohol or drugs may produce severe psychiatric symptom reactions.
Dual disorders is a new field to American psychiatry.
Because most seriously mentally ill persons spent long years in state hospitals they had little opportunity to become addicts or alcoholics. Before the 1970's alcoholics tended to despise drug addicts and viewed them as socially deviant because they used an illegal' substance. Both alcoholics and substance abusers tended to look down on those who suffered from a serious psychiatric disorder. By the late 1960's the United States was changing in many ways, not the least of which was a dramatic change in our social attitude towards illicit drug abuse. This discord between social law and statute law had gone so far by the late 1980's that a conservative republican president nominated a marijuana user to the Supreme Court.