The Importance of Integrated Treatment for Dual Diagnosis and Addiction

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The Importance of Integrated Treatment for Dual Diagnosis and Addiction

Exploring the complications of co-occurring disorders and the benefits of an integrated treatment approach that offers better coping strategies for individuals with a dual diagnosis.

— by Carl Yazbek


Dual diagnosis or co-occurring disorders refer to when a person has both a mental health disorder and a substance use disorder. This complex condition requires specialized treatment that addresses both disorders simultaneously. Research shows that the two conditions are closely linked and can worsen each other’s symptoms, leading to a difficult cycle to break.

Dealing with both conditions at the same time can complicate recovery, leading to a less promising treatment outcome and an increased risk of negative health consequences if proper treatment is not received. To ensure effective treatment and successful recovery, it is crucial to understand the unique challenges presented by a dual diagnosis.


Why Are Co-Occurring Disorders More Complicated?

Co-occurring disorders are quite a common occurrence, such as alcohol addiction with anxiety disorder or cocaine addiction with major depression. Addictions to depressants may occur with symptoms that cause stress or other stimulating emotions, while addictions to stimulants may occur with symptoms that cause depression, lethargy, fatigue, or apathy. Multiple substance abuse is often caused by a broader range of symptoms that cannot be controlled with just one type of substance. The severity and degree of impairment vary greatly among co-occurring disorders, which can also change over time, causing fluctuating levels of severity and impairment in functioning and disability.


Heightened Risk for People With Co-Occurring Disorders

Individuals with co-occurring disorders face significant challenges, as they are more likely to experience chronic and severe emotional, medical, and social problems compared to those with only one disorder. Coping with multiple disorders also makes patients more susceptible to worsening psychiatric symptoms and addiction relapse. This can create a vicious cycle, where each relapse or symptom exacerbates the other, leaving patients in a challenging position.


Certain Mental Health Disorders Are More Common in Dual-Diagnoses

Substance abuse problems are often closely associated with certain mental health issues, including:

  • Depression
  • Anxiety disorders
  • Schizophrenia
  • Personality disorders
  • Posttraumatic stress disorder (PTSD)
  • Eating disorders (such as anorexia nervosa and bulimia nervosa)


Sometimes Substance Abuse Looks Like a Mental Disorder

It is important to note that substance use and abuse can lead to symptoms that may resemble those observed in organic mental disorders. However, these symptoms are distinct from those observed in independent mental disorders as they are a direct result of substance use. The good news is that these symptoms can be treated more quickly by discontinuing the substance.

Certain symptoms may be linked to a specific pattern of substance abuse, intoxication effects, or withdrawal syndrome. For instance, methamphetamine-induced psychosis or mania, severe anxiety triggered by discontinuing benzodiazepines, depression caused by stopping stimulants, and Korsakoff’s syndrome (which results in memory and cognitive problems) due to chronic alcohol abuse are some examples.


Dual Diagnosis Treatment is Complicated

After receiving an official diagnosis from a professional, treatment can commence. Patients who are grappling with both substance abuse and a mental health issue may experience symptoms that are more persistent, extreme, and resistant to treatment than if they were dealing with only one of these disorders.

Addressing a dual diagnosis can be challenging, as comorbid disorders often have a more chronic course of development. Additionally, individuals with a dual diagnosis are often exposed to more environmental risk factors. Furthermore, medication options may be limited due to the higher potential for abuse. These challenges can impact a dual-diagnosis patient’s approach to and response to treatment, making the recovery process more complex.


Why Co-Occurring Disorders Are Treated Differently

45% of Americans struggle with a dual diagnosis. Mental health patients are twice as likely to have an SUD. Likewise, those who abuse drugs or alcohol tend to have a co-occurring mental health issue. Researchers are uncovering the causes of these simultaneous conditions.

Several factors can worsen a mental health disorder or SUD:

  • Brain Responses: Drug abuse can mimic mental illness symptoms. For instance, too much marijuana can cause psychosis, which makes people lose touch with reality.
  • Genetics: A person’s genes can make them more prone to addiction or mental illness. Studies suggest that 40 to 60% of a person’s addiction susceptibility is genetic.
  • Environmental Triggers: Chronic stress, anxiety, or trauma can trigger addiction or mental illness.
  • Early Exposure: Young people who try drugs or alcohol may develop addiction or mental health problems later on. Adolescents and young adults are more vulnerable to brain damage from substance use than older adults.


Treating Co-Occurring Disorders

Treating co-occurring disorders requires an integrated approach that addresses both substance use and mental illness. Adequate treatment should integrate both disorders into the recovery process, considering that co-occurring disorders may be more persistent and severe than having only one disorder.

An integrated approach is critical because you cannot treat one disorder without assessing the risk factors for the co-occurring disorder. For example, you wouldn’t want to treat anxiety with a medication that may have abuse potential, nor would you want to treat a substance use disorder without understanding the circumstances and effects of the substance use. A lack of improvement in either disorder can lead to a relapse of both conditions.


What Is an Integrated Treatment Approach?

Integrated treatment simultaneously addresses mental health disorders and substance use disorders, recognizing their interconnectedness and the risk of relapse if only one is treated. Patients receive specialized care, including medication management, counseling, behavioral therapy, and support groups, leading to long-term recovery and improved quality of life.

Treatment targets common symptoms of both disorders, such as negative mood or impulse control problems, and inspires alternative incentives and rewards for recovery. Although a dual diagnosis presents challenges to the individual, their friends, and family, with better understanding and education, successful recovery is possible.


A Holistic Approach to Treatment

The holistic approach of integrated treatment addresses not only the symptoms but the entire person, including their emotional, social, and psychological well-being. Addiction and mental health disorders are complex issues that require a comprehensive approach. Cognitive-behavioral therapy is a key therapy that helps individuals identify and alter negative thought patterns, and family therapy is helpful in addressing the impact of these disorders on relationships.


Benefits of Integrated Treatment

Integrated treatment programs are highly effective. Studies have shown that they surpass traditional approaches. Patients in these programs are more likely to stay in substance abuse treatment, have fewer hospitalizations, and fewer relapses. Such programs also have a collaborative approach, where mental health services and addiction specialists work together to provide comprehensive care.

This approach helps patients manage their psychiatric disorders and substance use disorder, leading to long-term recovery. Integrated treatment programs also benefit society by reducing the burden on healthcare, criminal justice, and social welfare systems. These programs use evidence-based therapies and interventions customized to meet each patient’s specific needs.

Healthcare providers may recommend the following treatment approaches for a dual diagnosis:

  • Detoxification: The initial step involves stopping substance use and flushing them out of the system. Healthcare providers can monitor the patient and provide medica