Treating Co-Occurring Disorders
What is a Co-occurring Disorder?
Co-occurring disorders, also referred to as a dual diagnosis or comorbidity, is often used to describe a circumstance where an individual is diagnosed with more than one disorder at the same time.1 Individuals who simultaneously struggle with both a mental health and substance use disorder are said to have co-occurring disorders—also referred to as a dual diagnosis.2
People often ask, what is the difference between a dual diagnosis and co-occurring disorder? A person with co-occurring disorders can actually have two or more disorders at once; dual diagnosis is the same concept.
Common Co-Occurring Disorders
According to the 2018 National Survey of Drug Use and Health conducted by the Substance Abuse and Mental Health Services Administration, nearly 9.2 million people had both a substance use disorder and mental disorder in the U.S.3 In 2020, that number rose to 17 million individuals living with co-occurring disorders. More than half of those with co-occurring disorders are men.
Several mental health conditions may co-occur with substance use disorders, including:
- Depressive disorders (e.g., depression)4
- Bipolar disorders
- Anxiety disorders (e.g., panic disorder, phobias, etc.)5
- Personality disorders.
- Psychotic disorders (e.g., schizophrenia)
Some common co-occurring disorders include:
- Major depression and alcohol use disorder6
- Borderline personality disorder and polydrug addiction.7
- Schizophrenia and alcohol use disorder8
Because substance use and mental health issues are prevalently encountered in connection with each other, screening for either a mental health disorder or for a substance use disorder will commonly include a thorough assessment for the other as well.
Frequently co-occurring with other mental health disorders are alcohol use disorder and tobacco use disorder: This is because alcohol and tobacco can be easily and legally obtained by adults, and relatively easily, albeit illegally, obtained by minors. Additionally, benzodiazepines and narcotic pain medications are also becoming increasingly more prevalent forms of substance use disorders in dual-diagnoses.
Which Comes First: Mental Health Disorders or Substance Use Disorder?
It is not always easy to answer the question: “Did the substance abuse problem or the mental health disorder occur first?” In some cases, it appears that the substance abuse issue predated the mental illness; in other cases, it appears that the mental illness predated the substance use disorder. In many cases, it can’t be determined.
Some drugs are thought to potentially elicit or mimic symptoms of certain mental illnesses. In some cases with chronic substance use this can lead to the development of more lasting mental conditions. For example, research into cannabis and cannabis-related psychosis has indicated that heavy users of marijuana are at a significantly higher risk to later develop psychosis. This has been used to support the idea that substance use itself may predate the arrival of mental health issues.9
On the other hand, there is some evidence that unmanaged mental health issues might drive to start using certain substances, which can turn into compulsive use. In lay circles, and even in some clinical circles, this is the very popular notion of self-medication, where an individual who has symptoms of a mental health disorder begins to use drugs or alcohol to cope with the stress of those symptoms.
A third perspective notes that substance use disorders and other mental health disorders share many similar risk factors, and are often associated with specific environmental events, such as physical or emotional abuse.11 Thus, the development of both a mental health disorder and a substance use disorder simply reflects a shared vulnerability to developing a co-occurring disorder.
Risk Factors for Co-Occurring Disorders
There are several risk factors that increase the probability you will develop a substance use disorder and a co-occurring mental health issue, including:12
- Gender: Males are more likely to develop substance use disorders than females.
- Family history: Having a first-degree relative (e.g., parent or sibling) who has a substance use disorder will increase a person’s risk to develop a substance use disorder.
- Lack of social support: Having a lack of family support or perceiving that one does not have a supportive environment increases the risk of developing a substance use disorder.
- Peer associations: Peer pressure is often a significant factor in drug abuse, particularly in adolescents and young adults.
- A history of trauma or abuse: Having a childhood history of emotional trauma or abuse of any type is a risk factor for the development of a substance use disorder.
- Having a diagnosis of a mental health disorder: Individuals diagnosed with any mental health disorder have a higher risk of developing a substance use disorder.
What Are the Symptoms of Co-occurring Disorders?
A diagnosis of co-occurring disorders is generally made if you meet the criteria for both a mental health and substance use disorder. There are some overlapping symptoms of many mental health disorders and substance use disorder which can make it difficult to determine which disorder came first.
How to Treat Co-Occurring Disorders
Interestingly, a large percentage of people who have co-occurring disorders are not thoroughly assessed or diagnosed properly. Often, many individuals are only diagnosed with only one of their co-occurring disorders. This can result in a number of difficulties with treatment.
Having both depression and alcohol use disorder, for example, and only treating depression might not significantly affect the alcohol use disorder. Therefore, individuals who have co-occurring diagnoses should have both issues treated concurrently. The suggested approach to treating co-occurring diagnoses is known as an integrated approach.
The goal of an integrated treatment program is to help the individual manage their mental health issues, become abstinent from substances of misuse, and reach their highest possible level of independence. An integrated treatment program uses a multidimensional team approach in 4 stages to address a person’s diagnosed co-occurring disorders. These stages include:13
- Engagement: Develop a relationship between the client and the treatment team. It’s crucial that the client fully trusts the team.
- Persuasion: Motivate the client to become as involved in treatment as possible.
- Active treatment: Teach skills that the client lacks, which will help the client better manage both disorders.
- Relapse prevention: Help the client develop long-term strategies to maintain improvements, reach future goals, and avoid relapse.
Because there are so many different combinations of co-occurring disorders, and because every person is different when it comes to recovery, treatment for co-occurring disorders can vary drastically from person to person. This is why tailoring the treatment program to the individual’s needs along the way is so important.
Co-Occurring Disorder Treatment at Oxford Treatment Center
Oxford Treatment Center can take an integrated treatment approach with co-occurring disorders and has a team of experienced addiction treatment professionals to customize the correct treatment plan depending on the person and the co-occurring diagnosis.
An integrated treatment program for co-occurring conditions might involve:14
- A multidisciplinary team that will address your diagnoses from a number of different angles. Typically, this will include a psychiatrist and/or addiction medicine physician, a psychologist, social worker, case managers, and support from family and other individuals with similar diagnoses.
- A comprehensive treatment program that will address your needs. This can include medical detox, residential treatment, outpatient treatment, support group treatment, etc.
- Individual and/or group therapy/counseling
- Specific treatment for the mental health disorder.
- Specific treatment for the substance use disorder.
- Medically assisted treatment for the mental health disorder, substance use disorder, and any other medical issues.
- Lifestyle counseling to help you make healthy lifestyle changes.
- Assistance with placement if you need housing.
- Family support.
- Specialized supports and treatments for specific situations.
Integrated treatment is designed to be as comprehensive and supportive as possible. Your treatment team will set realistic goals for your program and adjust them accordingly as you progress in care.
You don’t have to do it alone; help is just a call away. Call us at and we can help you find the right rehab program for you or your loved one. Whether you choose to attend our addiction treatment program in Mississippi at Oxford Treatment Center or at one of American Addiction Centers’ other rehab facilities across the United States, we will be there with you at every step of the way.
Does Insurance Cover Co-Occurring Disorder Treatment?
In most cases, health insurance covers substance abuse treatment in some capacity, but the amount that will be covered for your treatment is going to depend on the insurance plan you have, as well as other factors such as what facility you choose and how long you stay in treatment. You can verify your insurance by using our or learn about other ways to pay for rehab that are available to you.
Our Dual-Diagnosis Treatment Facility in Mississippi
Living with co-occurring disorders can take a heavy toll on your quality of life. Fortunately, there are different levels of addiction treatment available at our inpatient rehab facility in Mississippi. Oxford Treatment Center offers evidence-based co-occurring disorder treatment programs that address your needs in a real and impactful way.
You can find out more information about us, the rehab facility amenities our center offers, and the rehab admission process by contacting our team of compassionate and knowledgeable admissions navigators at .
Do not wait to get the help that you deserve. Recovery is possible and we’ll help you get there.