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Dual-Diagnosis Treatment

Wha is a dual diagnosis?
Mental illness and drug abuse

What is a Dual-Diagnosis?

Many persons with substance use disorders (SUDs) also have mental or behavioral issues. A dual diagnosis is a term commonly used to describe this situation. Individuals with dual diagnoses need a treatment approach that treats both ailments simultaneously as interrelated issues.

The dual diagnosis problem in the US is alarming. Forty-five percent of persons with addiction have a co-occurring mental health issue, according to the National Survey on Drug Use and Health (NSDUH). This means that we all need to work together to combat this issue, as it affects most of us directly or indirectly. In reality, nowadays, it is difficult not to have a sister, brother, cousin, friend, or colleague facing one or both of these challenges at any point in their lives.

Mental Illness and Drug Abuse

The connections between mental illness and drug abuse are intricate. Persons with mental illnesses may use alcohol and other substances for the same reasons that other people do — to relax or feel good. 


Sometimes mental illness occurs first, and drug abuse develops as a mechanism to manage or self-medicate. In other instances, drug abuse and mental health problems co-occur and are caused by the same factor, such as trauma, stress, or heredity.


Substance abuse may alter the chemical equilibrium in the brain, resulting in mental health problems or exacerbating an existing mental disorder.


A mental condition, however, typically leads to drug misuse in a variety of ways, including:


  • Self-Medication

A person grappling with a mental illness may misuse the drugs to self-medicate and manage their symptoms. Someone suffering from depression, for example, may use euphoric narcotics such as heroin to feel better.


  • Untreated Mental Issues

Certain mental illnesses might increase a person's risk of being a drug addict. For example, the development of conduct disorders, ODDs (oppositional defiant diseases), and ADHDS (attention-deficit/hyperactivity disorders) in the kindergarten years, as continuous through the young peoples’ developmental phases, have been linked to eventual drug usage in adulthood.


  • Drug Experimentation

People with impulse control issues may be more prone to experimenting with various drugs.


  • Biological Issues

Addictive substances may alter the brain's chemical equilibrium, causing, exacerbating, or uncovering various mental problems over time. Cocaine usage, for example, may cause episodes of panic and anxiety.


  • Effects on the Environment

Substance addiction may raise stress levels and lead to a lack of emotional support, making it easier to develop a mental condition.

Medically Reviewed:


Rolling Hills Recovery Center

Expert Contributor

Dr. Williams presently serves on the board of Directors for two non-profit service organizations. He holds a Master’s degree in Human Services from Lincoln University, Philadelphia, Pa, and a Ph.D. with a concentration in Clinical Psychology from Union Institute and University. In Cincinnati, Ohio. He is licensed to practice addictions counseling in both New Jersey and Connecticut and has a pending application as a practicing Psychologist in New Jersey.

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Dual Diagnosis Signs and Symptoms

Dual diagnosis signs and symptoms

To be identified adequately with Dual Diagnosis, you need to see a psychiatrist or an addiction expert and get a proper analysis. Because many combinations of multiple illnesses might arise, symptoms can vary greatly. Some treatment centers use drug assessments, mental health, and alcohol screening methods to identify persons at risk for dual diagnosis.


Here are typical signs and symptoms of dual diagnoses:


  • The tendency to separate from others, including friends/family, and refusal to join other social groupings and activities.

  • Difficulty sustaining excellent grades or job performance.

  • Lying or stealing. 

  • Sleeping throughout the day (which is often preceded by a time of staying up late at night).

  • Trying to avoid drinking, doing drugs, or gambling yet relapsing regularly.

  • Recurring feelings of guilt about your illness.

  • Greater dosages of drugs or taking more potent liquor to get a more significant "high."


These symptoms may appear in psychologically troubled people:


  • They are isolating themselves from others skillfully, such as by tactfully rejecting offers of friendship and assistance from loved ones.

  • Delusions (occurring when you believe in things that are not true or have sensory experiences that others don't have, i.e., hallucinations).

  • You may experience despair, hopelessness, or uselessness as time goes on.

  • To cope with your anxiety, especially for anxious achievers, you may feel driven to accomplish complex physical and mental tasks while adhering to elaborate routines and trying to maintain high standards unnecessarily.

  • Due to behavioral disorders or mood swings, you may have difficulty keeping a job, managing a house, or sustaining friendships.

  • Emotional states and energy levels are often rapidly shifting.

  • You may use a drink, drugs, or obsessive behaviors to deal with stress or regulate your mood.


All of these symptoms describe someone who has a dual diagnosis. An addiction treatment facility (rehab) or a practicing medical professional with psychiatric training is the proper place to visit for a dual diagnosis. In a dual diagnosis rehabilitation facility, intake counselors and assessment experts assess your mental health and drug use problems before providing a tailored treatment program to meet your needs.

Treatment Options for Dual Diagnosis

Treatment options for dual diagnosis
  • Will insurance cover drug and alcohol rehab?
    Private insurance is the most common and effective payment method for addiction treatment. It can pay for a significant number, if not all, of your rehabilitation appointments. Thanks to the efforts by private lobbyists and the government, rehabilitation for drug and alcohol addiction is now a mandatory benefit under insurance after the passage of the Affordable Care Act (ACA).
  • Paying for addiction treatment
    Ways to Pay for Addiction Treatment Here are the five points for financing that might be helpful for your treatment: ​ 1. Insurance 2. Self-Pay or Payment plan 3. Loan or second mortgage 4. Funding or Scholarships 5. Family Insurance ​ If a person has some benefits, they can use them for treatment and take advantage of insurance. If you use health insurance providers so that you can recover yourself from addiction because they collect payment regularly or they have scheduled their income as well. Self-Pay ​ The second method is self-pay, and in this method, you can pay for treatment in lump sums or months and create a payment plan so that you can pay weekly, monthly, or whatever you choose the way to treat. Loan ​ The third method to pay is a loan. You can take a loan or a second mortgage from those homeowners. Funding or Scholarships ​ If you do some research, then you can find a lot of funding or scholarships for you that are available to you there. Family The last method to pay is family. Your family can help you financially with your treatment. There are many options available for you as a key for financial assistance so that you can choose one of these methods for addiction treatment.
  • Will I lose my job if I go to rehab?
    Employees who get treatment for addiction while still at work are protected by the ADA and other laws like the MHPAEA, the ACA, and the Family Medical Leave Act, which all work together to make them eligible to return to work after the treatment.
  • How much does addiction treatment cost?
    Depending on your needs, treatment options for addiction vary from extensive medical detox to inpatient (or residential) care plans to less intensive outpatient ones. If your addiction is chronic or you are also grappling with a dual diagnosis, then long-term care at a residential facility is often the best option; but it is more costly. It's even more expensive when your situation necessitates the consultation of many specialists and the administration of costly drugs.
  • When is it time to go to rehab?
    Many believe that a person does not need to go to rehab, even if they struggle with the most severe addiction withdrawal symptoms. Still, studies show that last year almost 100,000 people died in the United States due to substance use disorder or overdoses. As 22 million people are suffering from addiction to either drugs or alcohol, there is a need to talk about this subject more casually. Many people don’t go to rehab because they feel ashamed of being addicted. There is a need to make them realize that no one can judge them if they see any symptoms; they should decide to visit a rehab as soon as possible.

If you (or a person you care about) have a co-occurring problem, such as depression and opiate addiction, you'll need a treatment regimen that can address both issues simultaneously. You're more prone to relapse if you solely treat one problem.

Here are some standard dual diagnosis treatment methods which may be used for managing both SUD and mental health issues that co-occur:

Getting help for the family

Getting Help for Everyone in the Family

Maintaining sobriety means you need people in your life to keep you on your toes and help you avoid triggers. These people should make you feel at ease.


In family therapies, you, your family, and other loved ones you live with participate in counseling together. Its goal is to help mend broken relationships and equip everyone in the family with the right skills to help you fight your illnesses.

Other components of a solid dual-diagnosis therapy are:


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The Bottom Line

Bottom line

Treatment for co-occurring problems is most successful when substance addiction and mental health concerns are addressed together in an integrated manner. It is ideal for getting therapy for all your cognitive difficulties at the same institution, as long as all you require is accessible.


Medication, individual, family, or group therapy, self-help techniques, dietary adjustments, and social support may all be part of your psychiatric care plan.


Detoxification, withdrawal management, psychosocial interventions, and support networks may be part of your treatment for drug addiction.


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