Dual Diagnosis is becoming a fashionable term to describe and demarcat
e groups of service users who have severe and enduring mental health p
roblems and concurrently use substances. To date, the term has been us
ed loosely creating problems of definition and targeting of services.
It is argued that the problems with dual diagnosis do not end at this
point with important philosophical considerations arising from the pow
er of such terminology to construct versions of social reality. In thi
s sense the adoption of the discourse of dual diagnosis can be seen as
a feature of an increasing medicalisation of aspects of social activi
ty. The evaluative framework provided by postmodern notions of medical
dominance and the psychological complex are relied on to suggest that
services aiming to meet the needs of such people operate, ultimately,
in the arena of social control.