What Is Dual Diagnosis Treatment?

Dual diagnosis, also called co-occurring disorders, is having a mental health condition and a substance use disorder (SUD). These conditions can make each other worse.

For example, depression can make someone more likely to abuse substances, and substance misuse can worsen symptoms of depression. If left untreated, this can be a vicious cycle that can lead to serious problems.

In this article, we’ll take a look at what dual diagnosis is, the importance of integrated treatment, and how to find effective treatment programs for co-occurring disorders.

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What is the Role of Dual Diagnosis Treatment in Addiction Rehab?

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What Is Dual Diagnosis?

Dual diagnosis is a complex issue, and the reasons behind it can be different for people who are struggling with it.

Sometimes, mental health struggles can lead to substance abuse as a way to numb the pain. Other times, substance use can trigger or worsen mental health symptoms.

How Common Is Dual Diagnosis?

The co-occurrence of mental health disorders and substance use disorders is common. Approximately 7.9 to 8.9 million adults in the U.S. experience both a mental health disorder and a substance use disorder.

Among people with substance use disorders, 37.9% also have mental illnesses, and 18.2% of those with mental illnesses have substance use disorders. This high prevalence emphasizes the need for integrated treatment approaches.

How Does Dual Diagnoses Impact People?

Having a mental health problem and a drug or alcohol addiction at the same time can be really difficult for people and their families.

If you struggle with this, you are more likely to get sick often, need more medical care, and even die younger. You also have a higher chance of losing your home, going to jail, and dying early.

This can be really hard on families, who are often the first ones to help. The situation can be emotionally and physically draining.

What Are the Common Dual Diagnosis Disorders?

Let’s take a look at the common concerns when it comes to dual diagnosis. Take note that not all of these conditions are sure to have dual diagnosis.

If you’re worried about your or a loved one’s condition, we strongly recommend consulting your doctor about your concerns.

Common mental health disorders associated with dual diagnosis include:

• Depression
• Anxiety disorders, including generalized anxiety disorder (GAD), panic disorder, and post-traumatic stress disorder (PTSD)
• Bipolar disorder
• Attention-Deficit Hyperactivity Disorder (ADHD)
• Schizophrenia
• Personality disorders, such as borderline personality disorder and antisocial personality disorder
• Eating disorders, such as anorexia nervosa and bulimia nervosa

Common substances involved in dual diagnosis include:

• Alcohol
• Opioids (e.g. heroin, prescription painkillers)
• Cocaine
• Marijuana
• Methamphetamine
• Benzodiazepines
• Nicotine/tobacco

It’s important to note that either a mental health disorder or a substance use disorder can develop first. In some cases, people may use substances to self-medicate symptoms of mental illness, while in other cases, substance use may trigger or worsen mental health symptoms.

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What Is Integrated Treatment for Dual Diagnosis?

Integrated treatment for dual diagnosis is crucial due to the complex relationship between mental health disorders and substance use disorders. Treating mental health and substance use disorders separately can be ineffective for several reasons:

• Fragmented care: Separate treatment approaches often lead to disjointed care, where providers may not communicate effectively about your overall condition.
• Conflicting treatment plans: Mental health and substance abuse treatments may sometimes contradict each other when not coordinated.
• Increased risk of relapse: Failing to address both issues simultaneously can lead to higher relapse rates, as one untreated condition can worsen the other.
• Incomplete recovery: Focusing on only one aspect of dual diagnosis may result in partial improvement but fail to address the full scope of your needs.

What are the Benefits of Integrated Treatment?

Integrated treatment provides a holistic approach that considers the interrelated nature of mental health and substance use disorders. It leads to better overall outcomes, including reduced substance use, improved mental health symptoms, and enhanced quality of life.

This type of treatment allows healthcare providers to collaborate toward common treatment goals. They can then provide people with personalized strategies that address their unique needs.

By treating both conditions together, it helps normalize the co-occurrence of mental health and substance use disorders.

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Components of a Dual Diagnosis Integrated Treatment

Here are the key components of dual diagnosis treatment:

1. Assessment and Diagnosis

Getting a proper diagnosis for dual diagnosis can feel tedious and overwhelming, but it’s an important step towards recovery.

Doctors take a comprehensive look at your situation, including your mental health history, substance use patterns, and how these issues affect your daily life. They might use specific tests and talk to family members to get a complete picture of your health.

Since both mental health and addiction can change over time, regular check-ins are important. This allows doctors to adjust your treatment plan as needed on your journey to recovery.

2. Therapeutic Interventions

The different therapy approaches for dual diagnosis include:

• Cognitive Behavioral Therapy (CBT): It is effective in treating a range of substance use and mental health disorders by focusing on changing negative thought patterns and behaviors.
• Dialectical Behavior Therapy (DBT): DBT is a form of CBT that combines standard cognitive-behavioral techniques with concepts of distress tolerance, acceptance, and mindful awareness. It is particularly effective for treating borderline personality disorder and has been adapted for substance abuse treatment.
• Motivational Interviewing (MI): This counseling approach can help you resolve ambivalent feelings to find the internal motivation to change your behavior. It is often used in substance abuse treatment.
• Integrated Group Therapy (IGT): IGT is designed for people with bipolar disorder and substance dependence, addressing both issues simultaneously in a group setting.
• Contingency Management (CM): CM provides tangible rewards for positive behaviors such as abstinence. This approach has been shown to be effective in substance use disorder treatment.

3. Medication Management

In dual diagnosis treatment, medication has a big role in managing both the mental health condition and the substance use disorder.

Doctors may prescribe medications to address symptoms of mental illness or to help with a person’s substance use disorder. These include:

• Antidepressants
• Mood stabilizers
• Antipsychotics
• Naltrexone
• Acamprosate

Doctors must carefully consider any potential interactions between these medications and substances of abuse. Through ongoing monitoring and adjustments, they can find the best medication combination that effectively manages both disorders while keeping side effects and risks to a minimum.

4. Support Systems

Building a strong support network helps maintain long-term recovery and prevents relapse for both disorders. These include:

• Family therapy: Improves family dynamics, communication, and support for the individual in treatment
• Support groups: Provide peer support and shared experiences (e.g. Dual Recovery Anonymous)
• Peer support specialists: Offer guidance from those with lived experience of dual diagnosis recovery
• Case management: Coordinates various treatment components and community resources
• Vocational/educational support: Assists with reintegration into work or school

How to Find the Right Dual Diagnosis Treatment

When seeking dual diagnosis treatment, it’s important to carefully evaluate your options to find the right fit.

When selecting a dual-diagnosis treatment program, ensure the facility is properly accredited and licensed to provide dual diagnosis treatment. Look for programs that address both mental health and substance use disorders simultaneously.

The treatment team should include professionals from various disciplines, such as psychiatrists, psychologists, and addiction specialists.

Other factors you should consider include:

• Evidence-based therapies: Effective programs use proven treatment methods like cognitive-behavioral therapy, dialectical behavior therapy, and motivational interviewing.
• Individualized treatment plans: The program should tailor treatment to each person’s specific needs.
• Comprehensive services: Look for a range of services including detox, therapy, medication management, and aftercare planning.
• Family involvement: Programs that include family therapy and support can be beneficial.

Important Questions to Ask Treatment Centers

When contacting potential treatment centers, consider asking the following questions:

• How do you assess and diagnose dual diagnosis conditions?
• What specific therapies and treatments do you offer for co-occurring disorders?
• How do you integrate treatment for mental health and substance use disorders?
• What is the typical length of your treatment program?
• Do you offer medication management for both mental health and addiction?
• What types of aftercare and ongoing support do you provide?
• How do you involve family members in the treatment process?
• What is your staff-to-patient ratio?
• Are your treatment methods evidence-based?
• How do you handle relapse prevention?

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Resources for Finding Treatment

To find treatment centers and get help, you can use the following resources:

• SAMHSA’s National Helpline: Call 1-800-662-HELP (4357) for free, confidential 24/7 treatment referral and information.
• FindTreatment.gov: A comprehensive online treatment locator provided by SAMHSA.
• NAMI Helpline: Call 1-800-950-6264 for support and referrals from the National Alliance on Mental Illness.
• Local mental health or substance abuse treatment authority: Many states and counties have local agencies that can provide referrals to treatment programs.

Finding the right dual-diagnosis treatment can have a major impact on your long-term recovery. Take the time to research and ask questions so you can find a program that meets your specific needs. We encourage contacting multiple facilities and compare their offerings before making a decision.

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