Substance dependence is one of the biggest challenges in psychiatry. There are millions of patients with alcoholism. In Japan, methamphetamine psychosis is so common that some leading Japanese researchers are the top of this academic region. In the UK, cannabis misuse are frequently seen not only in psychiatric situation but in the community.
Furthermore, there are other diagnoses of dependence upon other than psychotropic drugs. Gambling disorder is categorized as dependence in DSM-5. Internet gaming will be classified as a mental illness according to coming ICD-11. Purchase, internet use, sexual relationship, and any other bbehaviors are subject to be a cause of dependence.
There are few specialists of dependence in Japan. Very limited opportunities are given for people with crept-mania. Almost all physicians, as well as many psychiatrists are opposing to include people who tend to commit criminal acts such as theft and peeping as patients with mental disorder.
In my opinion, patients with psychopathology of dependence should be properly treated for their rehabilitation. Some of them can overcome their undesirable tendency. But most are struggling to mitigate their symptoms. They need help of a specialist.
However, Japanese specialists of dependence have not gained approval of public mental health. They are often discriminated. One of the reasons is social prejudice of dependence.
On the other hand, I think specialists have not provided proper explanation for the need of appropriate treatment. Instead, they tend to blame other practitioners who hesitate to be involved in this issue. As a result, many psychiatrists are not willing to be collaborative with specialists.
Dependence is a basic psychological alignment. Co-dependence often occurs in the relationship between a patient and his supporter. Specialists, as well as general supporters, should not be in such malfunction as relationship.
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