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Co-Occurring Disorder Treatment

  • Reviewed by: Dr. Carl Williams, Ph.D., LCADC
  • Modified:
  • Reading Time: 9 minutes
  • Reviewed by: Dr. Carl Williams, Ph.D., LCADC
  • Last Update:
  • Reading Time: 9 minutes

Learn about treatment for co-occurring disorders, addressing addiction and mental health together.

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The Impact of Alcohol

Co-Occurring Disorders & Addiction

Many individuals suffer from mental health and substance use illnesses simultaneously, despite these disorders being fundamentally distinct. People who suffer from psychological issues such as stress or depression sometimes turn to drugs or alcohol to relieve their conditions. When individuals gather together, such as at a party, sure of these ailments are more likely to occur.

Table of Contents

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Levels of Care
Popular Topics
Families & Addiction

Navigating Dual Diagnosis

What are Co-Occurring Disorders?

We’ve all seen it somewhere, others even closer home, or perhaps have personally experienced it: substance use disorder, otherwise known as addiction. Though standard and many times recurrent, many have recovered from these disorders.

They are mental, emotional, or behavioral disorders clinically proven to interfere severely with at least one primary daily function of a person’s life. These usually occur within one year. This impairment can be caused by the regular use of alcohol, drugs, or both. On the other hand, co-occurring disorders refer to mental health challenges and substance use disorders.

The two are not the same and may not necessarily be triggered by the same things, but they co-exist and may sometimes be the cause or trigger of the other. The good news is that all these disorders can be treated, and many who have had them before have successfully overcome them.

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As established above, both mental health disorders and substance use disorders can coincide and may or may not be caused by the same triggers. Some common triggers include sex addiction and drugs or alcohol.

They can lead to mental health disorders, with the victim using them as (unhealthy) coping methods for painful symptoms of mental conditions they are going through. These can also be a result of self-sabotage (self-defeating behavior). Their effects often overlap with mental health disorders, including anxiety, personality disorders, and schizophrenia.

In 2018, records estimate that more than 9 million Americans had substance abuse and mental health disorders co-occurring, with 60% of young adults having these co-occurring disorders in mental health due to their stage of brain development, exposing them to alcoholism, drug addiction, and depression.

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Addressing the Intersection

Commonly Abused Drugs

Co-occurring disorders are usually severe when drug use is involved. The following are drugs and substances that victims of co-occurring diseases suffer from misuse:

• Heroin

• Benzodiazepines

• Stimulants

• Methamphetamine

• Cocaine and Crack

• Prescription Opioids

For people in Medical Assisted Treatment for substance abuse, co-occurring disorders occur more often. Alcohol substance use disorder patients who have been taking alcohol regularly should not stop its use, as this interferes with one’s system.

Common symptoms of co-occurring disorders include:

• Feelings of hopelessness and despair

• Fear of public situations 

• Nosy ideas

When drugs are involved, it becomes worse for the users. Studies released in 2016 show that 3.4% of adults had co-occurring disorders within the past year. When both mental health and substance use disorders co-occur, it is imperative to have both of them treated simultaneously. Many of the symptoms are similar and thus must be distinguished to treat them effectively.

Among the most commonly occurring disorders are emotional issues such as anger management problems, guilt, and low self-esteem. These strongly impact each individual’s addiction challenges and are considered symptoms of the disorder, not the disease itself. Conditions refer to the actual diagnosis that leads to these symptoms.

Mental Health affects one’s emotional, psychological, and social well-being. It refers to the state of one’s mind and its productive use. They tend to destabilize their victims and interfere with their normal functions in these areas. Once substance use disorder is established within such individuals, the condition is compounded, and treatment must be done for both mental health and substance use disorders.

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From ADHD to Schizophrenia

Addressing Dual Diagnoses

Several mental health disorders co-occur with substance use disorder that the National Institute of Mental Health recognizes. Among these are:

1. Attention Deficit Hyperactivity Disorder

Often diagnosed in children and young adults, attention deficit hyperactivity disorder (ADHD) is characterized by impulsiveness, inability to focus, and hyperactive behavior. Prescription medication for these includes stimulants. Sadly, young adults under this prescription often begin to use them more often than prescribed and use alcohol to self-medicate and suppress their symptoms.

2. Generalized Anxiety Disorder

Generalized anxiety disorder occurs in individuals who experience the following:

• Recurring, frequent anxiety or panic attacks 

• Symptoms such as sleep disturbances 

• Restlessness 

• Functional impairment

The victims may use alcohol and drugs in such cases to enhance social skills and ease the symptoms.

3. Bipolar Disorder

A chemical imbalance causes bipolar disorder in the brain that causes the victim to experience severe and uncontrollable episodes of mania and depression. This renders individuals with this disorder susceptible to drug and alcohol abuse and addiction. Self-medication is practiced by many individuals with bipolar disorder to ease the pain of these episodes, but this only aggravates the situation and leads to an increase in attacks and severe addiction.

4. Eating Disorders

Anorexia and bulimia commonly occur in individuals with addiction problems. The use of drugs, stimulants/diet pills, and alcohol to increase confidence is evident in such individuals, causing them to have low self-esteem caused to high expectations of how their body should look. It is most commonly seen in young adults but occurs at any age.

5. Post-Traumatic Stress Disorder

When a person experiences events that cause excessive stress or goes through life-threatening events, they may develop post-traumatic stress disorder (PTSD). Extreme violence, ghastly accidents, or war may trigger this condition, causing nightmares and flashbacks that torment them. Because of this, they may resort to alcohol and drug abuse to relieve their symptoms. This, however, only leads them further downhill emotionally, and they may experience sleeplessness.

6. Personality Disorders and Mood Disorders

Obsessive-compulsive disorder (OCD) and borderline personality disorder (BPD) can be symptomized by: severe mood swings, impulsive behavior, and extreme emotional imbalance. For these people, it is tough to maintain normal relations, and coping mechanisms may be the use of more alcohol and drugs, which further complicates the condition.

7. Schizophrenia

Schizophrenia is characterized by psychosis, delusions, hallucinations, and disorganized thinking. For many with this disorder, the fantasy world and real life are undistinguished, and they have difficulty being normal. Because of this, reliance on alcohol and drugs to cope with their condition is high. This, however, introduces other conditions that worsen the problem they already have.

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Optimizing Recovery

Diagnosing and Providing Integrated Treatments

Compared to co-occurring disorders, having an individual disorder alone (either mental health or substance use disorder) lessens the probability of being hospitalized. Integrated treatment coordinates mental and substance and links people to providers who offer curated services to individuals for medicine to treat the physical and emotional aspects of mental health and substance use disorders.

Three models for treatment for co-occurring disorders are:

1. Coordinated.

2. Co-located.

3. Fully integrated.

Fully integrated care achieves a complete recovery for patients.

Better Outcomes from Integrated Treatment

Early detection coupled with integrated treatment can significantly improve outcomes and the quality of life for people with co-occurring disorders. The following can be achieved:

• Improved quality of life.

• Improvement in psychiatric symptoms and functioning.

• Reduced or discontinued substance use.

• Increased housing stability.

• Decreased hospitalization.

• Reduced medication interactions.

• Fewer arrests.

• Increased chance for successful treatment and recovery for both disorders.

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SAMHSA’s “no wrong door” policy emphasizes that effective systems identify and assess persons needing treatment and ensure that they receive that treatment, regardless of where they seek it.

Routine screening for both disorders is done on individuals who present themselves for either condition, thus offering more accurate information on each of their statuses when they present themselves.

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Guiding Treatment

The SAMHSA Treatment Improvement Protocol (TIP)

A Treatment Improvement Protocol (TIP Series, No. 42) from SAMHSA offers newly updated, best practice guidelines for preventing and treating substance use and mental disorders that help clinicians to screen, assess, diagnose, and manage co-occurring diseases, empowering them to apply coherent, stepwise approaches in developing and using treatment protocols.

Studies have shown that treating co-occurring mental health disorders and substance use disorders together is a perfect recovery tool.

Among the methods used to treat mental health disorders are:

1. Therapeutic Communities. 

2. Cognitive and Dialectical Behavioral Therapy

For younger patients, behavioral therapy is conducted to help remove family interactions that adversely affect the children. Medication is also used to treat abuse like opium, alcohol, and drugs. More treatment options can be found on the Drug Facts and Treatment pages of the National Institute of Mental Health’s website.

HIV, AIDS, and Hepatitis B testing are done on people with substance use disorder. This, together with risk- counseling, has been proven to reduce drug use and risky behavior among users.

Understanding the Balance Between Enjoyment and Risk

Finding Help at Rolling Hills Recovery Center

Anyone suffering from co-occurring disorders in the United States can get help at Rolling Hills Recovery Center. We offer a variety of options for treatment as well as helpful information on how to start the journey out of co-occurring disorders.


In conclusion, there are many working solutions to co-occurring disorders, many of which involve medication and therapy. Applying individualized and personalized integrated medicine to victims has improved patients’ lives significantly and, in many cases, led them to full recovery.

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Written By:

Geoffrey Andaria

Geoffrey Andaria mental health writer at rolling hills recovery center
Rolling Hills Recovery Center

Mental Health Writer

About Author:

Geoffrey Andaria is an experienced mental health content writer and editor. With a B.A. in English and Journalism, Geoffrey is highly educated in freelance articles and research. Having taken courses on social work, Geoffrey is adamant about providing valuable and educational information to individuals affected by mental health and the disease of addiction.

Medically Reviewed By:

Dr. Carl Williams Ph.D., LCADC

Carl Williams, medical content reviewer at rolling hills recovery center
Rolling Hills Recovery Center

Expert Contributor

About Reviewer:

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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