Co-occurring disorders (COD), also known as dual diagnosis, refers to the coexistence of substance abuse and mental health disorders. Unfortunately, the co-occurrence of these two types of disorders can be difficult to diagnose. In fact, completely different therapeutic approaches were used in the past to treat each of these two types of disorders with different facilities delivering the necessary care. As a result, many of those suffering from COD received treatment for one of the existing disorders while the other remained unattended.

According to a study conducted by SAMHSA in 2014, approximately 7.9 million adults had COD in the United States alone. Today, however, the treatment of COD is viewed as a unique field, one that calls for special consideration.

Symptoms of co-occurring disorders

Dual diagnosis symptoms include those associated with any of the existing mental illnesses and substance use disorders. But because of the complexity of these symptoms, COD is a lot harder to diagnose. For starters, the symptoms of a psychiatric disorder can easily mask those of a substance abuse disorder and vice versa. Secondly, both types of disorders can have psychological, biological and social components. Other reasons can include the need to prioritize other health issues and inadequate training or screening.

Undiagnosed, untreated, or under-treated COD can increase your chances of experiencing additional problems like symptomatic relapses, homelessness, incarceration, social isolation, severe medical conditions, suicide and early death. Unfortunately, any one of these issues can complicate the treatment of COD. Dual disorders can also vary in severity, chronicity, degree of functional impairment and level of disability. For instance, one of the existing disorders might be comparatively more severe or all of them can be either mild or severe. The levels of severity, functional impairment and disability can also change over time.

As such, co-existing disorders can often mean more crises, slower progress and longer treatment periods than a single disorder.

Causes of co-occurring disorders

The occurrence of substance use disorders and mental health issues is often linked to environmental and biological factors. Each of these two types of disorders is a dynamic process that can involve varying symptom manifestations, progression rates and levels of severity. Additionally, each type can be impacted by pharmacological influences, the environment, and genetic susceptibility.

In other words, some individuals will have a higher risk for mental health or drug and alcohol addiction problems than others while some medications are more likely to cause the same disorders than others. Some situations can also induce or help sustain these disorders.

People suffering from mental illness are more likely to experience a substance use disorder than those who don’t have a psychiatric disorder and vice versa. On the one hand, substance use disorders can lead to or trigger severe mental and emotional distress. On the other, people with mental health issues can easily turn to drug or alcohol use for temporary relief.

Dual diagnosis treatment

Because they have two different types of disorders, dual diagnosis patients are vulnerable to aggravated psychiatric disorders and relapses. Addiction relapses can result in further mental distress while the worsening of a mental issue can lead to an addiction relapse.

Relapse prevention is, therefore, a vital part of dual diagnosis treatment and must be designed to meet the needs of those suffering from COD.

According to recent research on the effectiveness of the rehabilitation programs employed in treating co-existing disorders, integrated care is the most effective approach. Integrated treatment occurs when a patient receives a combination of substance use therapy and psychiatric interventions from the same professional health care provider or staff.

Integrated treatment involves the coordination of substance use therapies and psychotherapy. In the past, each disorder was treated separately and with no consideration for the other. However, combining alcohol and drug addiction treatment strategies and psychiatric interventions can lower the rate of relapse among rehab graduates and foster long-term abstinence. Treating the existing disorders simultaneously is important for the following reasons:

• Integrated recovery programs are designed to help patients overcome the undesirable side effects of mental illness, including fear of socializing, reduced attention spans and low levels of motivation.
• In the treatment of COD, integrated treatment eliminates the reluctance to prescribe psychotherapeutic medications.
• Medication therapy offers better results when pharmacological treatments address both types of disorders.
• People with COD can reap significant benefits from the stronger support network offered by group therapy. Group meetings and therapy sessions can be structured to accommodate the needs of those with mental health issues.
• Patients can better address their unique relapse triggers, from mood swings to depression and panic attacks.

Tailoring these programs to the needs of the patient helps keep symptoms like compulsive behavior, hopelessness and social anxiety from becoming obstacles. Here are a few treatment strategies to consider:

• Intensive residential treatment programs: These programs offer structured, supervised support to those going through rehabilitation. The absence of triggers makes it easier to focus on recovery.
• Outpatient treatment options: Clients who don’t require 24-hour supervision can consider outpatient alternatives.
• Individual therapy: Centered on tasks like the identification of self-defeating thoughts, building motivation and learning new, positive behaviors.
• Psychoeducational classes: These classes are vital since they can help increase awareness in a safer, more positive context. They will often focus on the signs of mental illness, the effects of psychiatric disorders on substance use problems, relapse-prevention education and medication.
• Medication therapy: Many clients with co-occurring disorders need medication to manage their psychiatric traits. Anti-addiction drugs can be prescribed to reduce cravings and withdrawal symptoms. Pharmacological advances have led to the production of more effective antipsychotic, anticonvulsant, and antidepressant medications that have fewer side effects.
• Dual recovery self-help groups: Clients can be referred to groups that are tailored to their unique needs. These groups exist in various communities and offer a safe forum for the discussion of mental health issues, substance abuse and medication in a safe and supportive environment. Coping skills can be shared in such groups as well.
• Ongoing support after rehabilitation: The completion of a rehabilitation program is just part of your recovery journey. As such, comprehensive aftercare services are just as important as integrated care. Once you’ve been discharged from treatment, having access to recovery resources can minimize your chances of a relapse.

MD Home Detox

At MD Home Detox, we offer the specialized care required to treat co-occurring disorders (COD) and rely on the most effective rehabilitation strategies to give you the best chance of success. If you need any kind of help with COD or want to begin the process of recovery, please contact us to find out more.