When treating alcohol and substance use disorders (SUDs), or mental health conditions, it’s important for medical professionals to recognize if co-occurring disorders are present. A co-occurring disorder, also called comorbidity, or dual diagnosis, is a medical issue that occurs either simultaneously, or successively after another disease. These conditions may be mental, physical, or a combination of the two. 

According to the National Survey on Drug Use and Health, 9.5 million U.S. adults between the ages of 18 and 25 experienced both mental illness and a substance use disorder in 2019. Among this group, only 7.8% received treatment for both a substance use disorder and mental health disorder simultaneously. Although substance use disorders commonly occur with other mental illnesses, this does not mean that one caused the other, even if one appeared first. Nevertheless, co-occurring disorders can still worsen the level of severity in each disorder present.

Factors that influence co-occurring disorders 

The National Institute on Drug Abuse identifies three main considerations that can contribute to the presence of co-occurring disorders: 

1. Common/overlapping risk factors can contribute to both mental illness and substance use disorders. These can include, but are not limited to:

Genetics: A person’s genes can play a major role in the presence of co-occurring disorders. According to the National Institute on Drug Abuse, 40 to 60 percent of an individual’s vulnerability to substance use disorders is attributable to genetics. Research also suggests that there are many genes that may contribute to the risk for both mental disorders and addiction, including those that influence the action of neurotransmitters (such as dopamine and serotonin). 

Environmental: Environmental factors such as chronic stress, trauma, adverse childhood experiences, or drug exposure can induce changes in gene expression, which can alter functioning in the brain and impact behavior, making it more likely for a person to develop co-occurring disorders.

2. Self-medicating to treat mental illness.

Mental illness can lead to substance use as a way to cope with symptoms, resulting in substance use disorders. Even though some drugs may temporarily reduce symptoms, they can also exacerbate symptoms, both acutely and in the long term. 

3. Drug-induced changes of the brain, which lead to mental illness. 

Substance use can cause changes in areas of the brain that are disrupted by mental health disorders, including schizophrenia, anxiety, mood, or impulse-control disorders. Drug use that precedes the first symptoms of a mental illness, may produce changes in brain structure and function that spark an underlying predisposition to develop the specific mental illness.

Integrated treatment approach

When treating co-occurring disorders, an integrated treatment approach has been found to be superior compared with separate treatment of each diagnosis. Integrated treatment of co-occurring disorders typically involves using cognitive behavioral therapy strategies to help with interpersonal and coping skills, while using approaches that support motivation and functional recovery as well.

Integrated treatment programs will assess patients for substance use disorders, along with mental health conditions. These treatment programs may also provide additional support services, in order to address other areas of need (housing, employment, etc). Comprehensive care that begins with intervention and detox, continuing through aftercare treatment and support, can help those struggling to build a new life while in recovery.

When people are able to receive a higher level of care that is integrated and comprehensive, they are more likely to stay engaged and participate in treatment. Research has revealed that people participating in integrated treatment are more likely to stay sober, see a significant reduction of their symptoms, live independently, have less frequent hospital visits, maintain a steady job, and report feeling happier with their lives.

At Feinberg Consulting, our team of highly trained Clinical Managers, Case Managers, and Coaches are here to help you, or your loved ones, find an integrated treatment approach tailored to meet your individual needs. Through our case management and coaching services, your personal recovery team will help you learn how to maintain sobriety, while simultaneously managing your mental health conditions. Contact us today to learn more at 877.538.5425.