Co-occurring Disorders and Integrated Treatment

People who have one or more substance use disorders (SUDs) in addition to a mental health disorder are known to have a co-occurring disorder, or dual diagnosis.² In the United States, 7.7 million adults have a co-occurring disorder each year.³ Research shows a strong link between SUDs and mental health disorders. Of the 20.9 million adults diagnosed with an SUD in 2020, 17 million also had a co-occurring mental health disorder.³

The purpose of this article is to show how addiction and mental health disorders can be related and offer treatment options for co-occurring disorders.

What Is a Co-Occurring Disorder?

The term “co-occurring disorders” refers to people who have one or more substance use disorders (SUDs) in the presence of one or more mental health disorders.¹¹ SUDs and mental health disorders are bidirectional, meaning that a mental health disorder may lead to or worsen an SUD, and an SUD may lead to or worsen a mental health disorder.³

But in many cases, it is hard to know which disorder came first.¹¹ And no matter what the relationship between mental health disorders and SUDs, both need to be taken seriously as they can lead to poor outcomes when not effectively managed.^{3, 11}

Studies show that:^{3, 11}

• People with co-occurring disorders are more likely to be hospitalized.
• Co-occurring disorders can be a barrier to addiction recovery.
• People who use more than one substance (polysubstance use) are more likely to have co-occurring disorders.. People with multiple mental disorders are 9 times more likely to have multiple SUDs in the past year.
• Co-occurring disorders increase the risk of suicide, unemployment, being unhoused, and going to prison.

Common Co-Occurring Disorders

Examples of common co-occurring mental health disorders include:²

• Anxiety disorder.
• Bipolar disorder.
• Post-traumatic stress disorder (PTSD).
• Major depressive disorder.
• Schizophrenia.
• Attention deficit hyperactive disorder (ADHD).

Signs and Symptoms of Co-Occurring Disorders

Co-occurring disorders affect all groups of people, regardless of age, income, gender, or ethnicity.⁶ Symptoms of each co-occurring disorder can vary—and they can often mimic each other—so it’s important to talk to a doctor or mental health professional to get the right assessments and treatment.¹¹

In general, you or your loved one may have an SUD if substance use is uncontrolled and is causing:⁶

• Health problems.
• Disability.
• Failure to meet major responsibilities at work, school, or home.

Signs you may be dealing with a mental health disorder may include:⁸

• Feeling very sad or low.
• Excessive worry or fear.
• Extreme mood changes, including uncontrolled highs or euphoria.
• Changes in sleeping habits.
• Changes in eating habits.
• Avoiding friends and social activities.
• Confused thinking or being unable to concentrate.

Many mental health disorders affect how people think, behave, feel, and respond to situations, themselves, others, and daily responsibilities.⁶ SUDs and mental health disorders are common, recurrent, and can be serious. But the good news is that these conditions are treatable.⁶

How to Treat Co-Occurring Disorders

The preferred treatment model for co-occurring disorders is treating both substance use and mental disorders together at the same time.^{9, 10} This is called integrated treatment and studies show it leads to better outcomes than other treatment models.^{9, 10}

Ideally, co-occurring disorders are both treated at the same treatment center. Since everyone has different health and recovery needs, treatment should be tailored to each person. And if needed, clinical staff (doctors, nurses, counselors) works together with community agencies to offer support services for people who are unhoused or who face poor health, unemployment, and legal problems.⁹

Despite effective treatments for co-occurring disorders, in 2020 only 5.7% of people with co-occurring disorders were treated for both their SUD and their mental health disorder.³ The most common reasons people with co-occurring disorders didn’t get the care they needed were cost and not knowing where to get treatment.³

As of 2020, 44 substance abuse treatment centers in Nevada offered integrated treatment.⁴

What to Expect from an Integrated Treatment Plan

In integrated treatment, addiction and mental health specialists work together with you to improve your long-term health. The process often begins with a complete health assessment to gather information about your physical and mental health, employment, family and social groups, support network, and more. Your care team will use this information to outline the treatment options that will best meet your recovery needs.

For many people with co-occurring disorders, supervised medical detox may be the first step. Medical detox helps safely manage your withdrawal symptoms as you clear any substances from your body. After detox, you may continue treatment with inpatient or outpatient rehab, depending on your recovery needs and goals.

No matter which treatment setting you choose, most integrated treatment plans will include some form of behavioral therapy and may also use prescription medicines as part of treatment.^{9, 10}

How to Get Help for Addiction and Co-Occurring Disorders

If you or a loved one is ready to get help for an addiction and other mental health conditions, American Addiction Centers (AAC) is here for you. AAC is a leading treatment provider offering integrated treatment for addiction and co-occurring (dual diagnosis) disorders in Nevada and nationwide.

Our admission navigators are ready to hear your story without judgment and will answer any questions you have about addiction treatment. Our 24/7 helpline is free and confidential. When you’re ready, call and we will be there for you.

Does Insurance Pay for Integrated Treatment?

The Affordable Care Act (ACA) states that insurance plans must cover addiction and mental health treatment as an essential benefit.¹¹ The ACA, along with Mental Health Parity and Addiction Equity Act (MHPAEA), have improved care and coverage for many Americans seeking integrated treatment.¹¹ Today, roughly 300 million Americans are covered by some form of health insurance.¹¹

American Addiction Centers works with many common insurance companies to help give people access to addiction treatment. Many treatment centers also offer payment plans and sliding scale fees for people without insurance.