Substance abuse does not exist in a vacuum. People who become addicted to drugs or alcohol often have other significant challenges. Sometimes these other challenges contribute to the decision to use psychoactive substances and sometimes they are a result of that use. When people suffer from both substance addiction and a mental health condition, such as depression, anxiety, post-traumatic stress disorder or bi-polar illness, they are said to have a “dual diagnosis” or co-occurring disorders. It was once thought that treating one part of the equation would automatically improve the other, but now it is understood that best treatment outcomes arise from treating all identified problems, in a coordinated and integrated way.
The Co-Occurrence of Addiction and Mental Health Disorders
It is very common for addiction and mental health disorders to co-exist. The National Alliance on Mental Illness (NAMI) notes the following about the co-occurrence of mental illness and substance abuse:
- About half of people who suffer from severe mental illness are also affected by substance abuse issues.
- Slightly more than half of those who abuse drugs also suffer from at least one mental illness.
- About 37 percent of people who abuse alcohol have a co-occurring mental health disorder.
- People with co-occurring disorders are less likely to respond to standard treatment.
- People with co-occurring disorders have a greater chance of relapse.
The Center for Evidence-Based Practices at Case Western Reserve University notes that, in addition to relapse, people suffering from co-occurring substance abuse and mental health conditions are more likely to experience a wide range of negative life circumstances. These include experiences in the physical, emotional and social domains. People suffering from co-occurring disorders have higher rates of hospitalizations, emergency room visits, violence, homelessness, arrests, incarcerations, relationship difficulties, poverty and unemployment.
Types of Treatment for Co-Occurring Disorders
A publication entitled Integrated Treatment for Dual Disorders: A Guide to Effective Practice notes that a variety of models are possible for treating patients with co-occurring conditions, including sequential, parallel and integrated. In the sequential treatment model, people are not eligible for treatment services addressing one part of the equation (mental illness or substance abuse) until the other is addressed. In parallel treatment, people receive treatment for both substance abuse issues and mental health conditions concurrently, but needs are addressed by different professionals who do not generally collaborate or coordinate care. When patients receive integrated treatment, services for all conditions are provided by the same team of providers, and clinicians work collaboratively.
Although the specifics of integrated treatment may vary slightly among treatment facilities, there are commonalities in the approach. The Center for Evidence-Based Practices describes Integrated Dual Disorder Treatment (IDDT) as an evidence-based treatment model that helps people address mental illness and substance use disorders at the same time in the same program and by the same team of care providers. Key features include the following:
- The treatment is individualized and addresses each patient’s personal needs.
- It utilizes a stages-of-change approach in which big changes are achieved by a series of small, overlapping, incremental ones.
- It is a multidisciplinary approach utilizing, as necessary, medical, psychological, social and educational interventions.
- Family members may be involved.
- Needs for stable housing and employment are addressed.
- Treatment may involve motivational interventions, individual and group treatments and counseling, family education, medication and support group involvement.
NAMI notes other key components of integrated treatment. These include establishing trust between caregivers and patients, assertive outreach and intensive case management. They note that a patient’s social support system is vital to address, as is stress management. Optimism and hope are said to be the foundation of the treatment approach.
Finding Integrated Treatment for Co-Occurring Disorders
Integrated treatment has been shown to increase positive treatment outcomes in a wide variety of areas. Patients have lower rates of relapse (in both substance abuse and mental illness domains). They also have lower levels of hospitalizations, arrests, and incarcerations. NAMI notes, however, that integrated treatment is still not widely available and that a service gap exists for people with dual diagnosis.
If you or someone you love is suffering from both a substance abuse and mental health disorder, we can help you find integrated treatment. The compassionate and knowledgeable phone counselors who staff our toll-free helpline understand the issues and can answer your questions. They can help you identify your treatment options and can even check your insurance coverage for you if you wish, at no cost or obligation. The helpline is available 24 hours a day, so there is never a wrong time to call. There is a treatment program right for you, so call now and begin your journey of recovery.