Co-Occurring Disorders

Previously referred to as “Dual Diagnosis,” a co-occurring disorder is the coexistence of both a substance use disorder and a mental health disorder. According to Substance Abuse and Mental Health Services Administration’s (SAMHSA) 2014 National Survey on Drug Use and Health (NSDUH), 7.9 million adults had co-occurring disorders in 2014, with 35.3% of these adults falling within the 18- to 25-year-old age range.

Addressing both the substance use disorder and the mental health disorder is not an easy process. The traditional 12-step treatment facilities often lack the resources and skills needed to address these types of issues; thereby lowering the chances of a successful treatment experience for many who truly desire an end to their use of drugs and alcohol.

Unfortunately, the prevalence of co-occurring disorders has not resulted in better screening efforts, nor has it motivated many providers to adequately train their staff in the appropriate therapeutic modalities which have been shown have superior outcomes when compared to the traditional model treatment.

Many persons with a substance use disorder experience anxiety, yet it is difficult for many of those people to accurately reflect which problem triggered the other problem. It is the classic “Chicken or the Egg” paradox. The drug or alcohol use causes anxiety, and then the substance is used to lower that anxiety. Maybe you or someone you know has been prescribed Valium or Xanax to help control your anxiety and the entire 30-day supply is used in one week resulting in such a heightened state of anxiety where all other responsibilities are neglected.

In these paradoxical situations, the separation of, and treatment of, the two or more disorders have traditionally been addressed through a one-size-fits-all treatment model. There was little attention given to the severity of each disorder as legitimate problems. The focus was either on the anxiety or the substance use, resulting in countless people leaving residential treatment grossly undertreated and left to face the consequences that lie ahead.

The consequences of a misdiagnosed, under-treated or undiagnosed co-occurring disorder is cause for great alarm. Studies show that the result is often incarceration, homelessness, suicide and early death. There are critical components that go into constructing a treatment which is evidence-based (meaning scientific data demonstrates a level of effectiveness, or efficacy, of a therapeutic modality, or therapy “style”). One study provided preliminary evidence that a Cognitive-Behavioral approach is more effective than the 12-step model when treating co-occurring disorders. When incorporated into a comprehensive treatment program, we see a significant increase in positive outcomes when a comprehensive program is developed around the unique needs of each individual.

In our offices, treatment begins with a comprehensive multidisciplinary diagnostic evaluation, during which time we evaluate every dimension of a person’s functioning. This includes: medical assessment and addiction medicine evaluation from a Board Certified Addiction Medicine Physician; Psychosocial Assessment; Psychiatric Evaluation; Neuropsychological Assessment and psychometric testing; biological testing; and a gathering and review of collateral information from family and friends. With these tasks completed, patients are provided with an individual treatment plan that is continuously undergoing revision as you progress through the various stages of treatment. There are several evidence-based treatment designs, consisting of a combination of therapeutic modalities which provides significantly improved outcome potential, and it is our mission to find the best fit for every patient we serve.

Some co-occurring diagnoses we treat:

• Major Depressive Disorder (MDD)
• Anxiety Disorders
• Personality Disorders
• Intimacy Disorders
• Trauma-related Disorders (PTSD)

If you or someone you know is struggling with a drug or alcohol problem with a comorbid mental health diagnosis, call us today, we can help.