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Treatment for Dual-Diagnosis or Co-Occurring Disorders

What is a Dual-Diagnosis?

The term dual diagnosis, or co-occurring disorder, is when an individual suffers from two conditions: mental illness, such as anxiety, depression, or bipolar disorder, and substance abuse use disorder (drug or alcohol addiction). Both issues make the other more severe, and the patient faces difficulty dealing with both stressful scenarios.


In the 1980s, it was termed “Dual Diagnosis,” but later in the 2000s, the Substance Abuse and Mental Health Services Administration (SAMHSA) used the term “Co-occurring Disorder.” The patient faces difficulty treating them both simultaneously, which worsens the rehabilitation process. It could get worse if not treated properly. A dual diagnosis needs proper care and attention; sometimes, it takes a long time to recover fully. Almost half of the patients with mental illnesses suffer from substance abuse once in their lives and vice versa. Both disorders, i.e., Substance abuse disorder (SUD) and mental health disorder, can co-occur one after another.

What is The Prevalence of Dual-Diagnosis?

The correlation between the two disorders can cause many adverse effects on health, resulting in poor intervention. Several studies show the prevalence of dual diagnosis or co-occurring disorders among the population.

  • To examine the prevalence of co-occurring mood and anxiety disorders and substance use disorders (SUD), National Epidemiologic Survey on Alcohol and Related Conditions (NESARC) conducted a study that concluded that 20% of the general population with a substance use disorder also had one or more mood disorders, and 18% had an anxiety disorder.

  • A study conducted in 2018 suggested that 48% of the population in the United States diagnosed with substance use disorder (SUD) also suffered from at least one psychiatric disorder.

The Journal of the American Medical Association reports that 53% of drug abusers and 37% of alcohol abusers have at least one serious mental illness; fifty percent of the participants with severe mental disorders are also drug abusers.

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Treatment of Dual-Diagnosis

Co-occurring disorders have two types of issues that need to be treated simultaneously. Focusing the treatment on one disruption like substance use disorder (SUD) can increase symptoms of mental illnesses like anxiety, depression, bipolar disorder, obsessive-compulsive disorder (OCD) and schizophrenia, etc.


Some substance abusers can get symptoms of mental illness by using a substance or drugs too often. In addition, they start self-medication without professional supervision; this practice can also worsen the symptoms of mental illness and addiction. It is tricky to diagnose a person with a co-occurring disorder, but as soon as it has been diagnosed, the treatment outcomes are much better and more responsive for the patient. In this scenario, the integrated treatment plan is beneficial and has positive outcomes for patients with dual diagnoses.

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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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What Is the Integrated Treatment Plan?

Substance Abuse and Mental Health Services Administration (SAMHSA) suggested the integrated treatment plan as a standard for treating dual diagnosis or co-occurring disorders. This plan provides care by achieving sobriety from drug or alcohol addiction and treating the symptoms of mental illnesses too.


The treatment protocols include various strategies like counseling, effective behavioral therapy, and medications. These multiple therapeutic techniques have proven beneficial in treating substance use disorder (SUD) and mental disorders. Treating a patient through integrated care needs determination and acceptance to accomplish the desired outcomes.


“Substance misuse can often be stigmatized in other psychiatric treatment settings, and other mental health concerns can be pushed to the back burner in addiction treatment settings. Getting integrated care for one person is a huge challenge.”  R. Kathryn McHugh, Ph.D.

Treatment at Rolling Hills Recovery Center

Cognitive Behavioral Therapy (CBT)

Cognitive behavioral therapy is a type of psychotherapy that deals with the patient’s feelings and thoughts. CBT aims to expose the patient to the desired feelings or sensations, build belief systems, and focus on positive thoughts and behaviors. The behavior and opinions of an individual play a vital role in building the belief system. Sometimes factors like negligence, ignorance, and feeling unworthy can develop severe issues like depression, anxiety, or addiction.

The cycle of actions and reactions is based on an individual’s assumption, perception, and concentration. CBT works by focusing and visualizing positive and rational thinking and avoiding any imaginary scenarios, which contributes to getting more anxious and ending up having an addiction to any substance. The cognitive and emotional functioning changes during CBT help the patient deal with problems effectively and develop healthier relationships.

Group Therapy

Studies have shown that group therapy supports and encourages patients with any mental disorder or co-occurring disorder. Sometimes the therapist introduces the individual to support groups where the people seeking help for co-occurring disorders meet each other. Enrolling in a 12-step support program is also beneficial in coping with the illness. These programs, facilitated by peers, use group support and guiding principles to help them obtain sobriety and peace.

Alternative Treatments

Relaxation methods like mindfulness, meditation, exercise, and yoga have plenty of benefits in treating a patient with a dual diagnosis or co-occurring disorder. Sometimes medications are also prescribed for a short time to reduce the symptoms. This practice diverts the focus from negative thoughts to structured, rational thinking, resulting in maintaining sobriety and mindful healing.


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Many behavioral therapies and lifestyle interventions are helping patients with co-occurring disorders or dual diagnoses and mental illnesses. Personalized care and long-term intervention can treat both conditions effectively. Some inpatient and outpatient facilities provide therapy, support, medication, and health services to treat substance use disorders and their underlying causes. Some sober homes and residential houses also help the individual maintain sobriety and healthy living after rehab, reducing relapse chances.

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What is a dual-diagnosis?
What is the prevalence of dual-diagnosis?
Treatment of dual-diagnosis
What is the integrated treatment plan?
Cognitive behavioral therapy (CBT)
Group therapy
Alternative treatments
Getting help
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