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Co-Occurring Disorders and Substance Abuse

What Are Co-Occurring Disorders?

Co-occurring disorders involve two or more existing substance use disorders (SUD) or mental health conditions. They can also include intellectual disabilities (ID). Understanding each of these disorders, conditions, and disabilities is key to understanding the difficulties many individuals experience because of co-occurring disorders.

The Mayo Clinic classifies substance use disorders as a disease that affects a person’s brain and behavior, resulting in an inability to control the use of licit or illicit medication or drugs despite negative consequences.

Mental health disorders are defined as, impaired psychological functioning that causes significant distress typically associated with an individual’s cognition, emotion regulation, or behavior that reflects a dysfunction in the psychological, biological, or developmental processes underlying mental functioning.

The DSM-5 highlights how mental health and substance abuse can overlap. Symptoms of mental health disorders increase an individual’s risk of substance abuse.  At the same time, having a substance use disorder also increases the risk of experiencing mental health issues such as post-traumatic stress disorder (PTSD), depression, anxiety, bipolar disorder, eating disorders, and personality disorders.

How Common Are Co-Occurring Disorders?

Research studies have shown that approximately 50% of people with a substance use disorder also have a mental health diagnosis and vice versa.
  Therefore, they are considered to have a dual diagnosis of substance abuse and mental illness.

According to the National Alliance of Mental Illness (NAMI), 10.2 million adults have co-occurring disorders.

What Are Common Risk Factors?

Why are some individuals at a greater risk of co-occurring disorders and substance abuse? Factors could include their biology, past traumas, environment, or other life experiences.

  • Biological – Having a family history of addiction and/or mental health disorders increases the risk.
  • Trauma – Someone who has experienced sexual, physical, verbal, or psychological abuse or has witnessed domestic violence has a greater likelihood of being at risk for addiction and mental illness.
  • Environment – A person who has grown up in a home with heavy alcohol or drug use is more likely at risk for developing a substance use disorder and for developing a mental health condition.
  • Life experience – Someone who may use substances recreationally or socially expose themselves for an increased chance of triggering mental health issues such as depression and anxiety.

Distraught young man talks with counselor

Treatment for Co-Occurring Disorders & Substance Abuse

When treating co-occurring disorders, it is important to get treatment that addresses both the person’s mental health and addiction issues. Many people who have a substance use disorder will need to begin detox in an inpatient therapy setting to start the process of safely monitoring withdrawal symptoms.

Following, an initial detox period, an individual should be assessed for the most appropriate level of care which could include:

  • Partial Hospitalization Program (PHP) This treatment incorporates elements of both inpatient and outpatient treatment, allowing the individual to continue to live at home while commuting to a treatment facility for treatment on their predetermined days.
  • Intensive Outpatient Program (IOP) These outpatient alcohol and drug addiction programs offer a curriculum that’s more intensive than a standard outpatient program. An individual who enters intensive outpatient treatment can expect to attend counseling, psychotherapy, and group sessions at a facility at least a few days a week.
  • General Outpatient Program (GOP) – These programs allow the person to continue living in their own homes while attending a facility for individualized treatments, typically one to two days per week.

Additionally, group and individual therapy are recommended to achieve the best results.

Another protective factor includes attending a support group in your community to meet others who are struggling with similar conditions. This can provide longer-term support both for substance use recovery and mental health recovery.


Ready to get help for yourself or someone you love? Contact Malvern Treatment Centers for more information, and to be admitted.

By: Cara DelMaestro, CAADC, LCSW

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