Dual Diagnosis Drug And Alcohol Programs

Medically reviewed by

Isaac Alexis, M.D., AAMA, AMP-BC

June 5, 2019

Dual diagnosis is a term used to describe two mental health conditions that occur in the same individual. Also called co-occurring disorders or comorbidity, these concepts usually indicate a person has both a substance use and a mental health disorder.

Common Co-Occurring Disorders

Although there are no specific combinations of mental health and substance use disorders, several conditions are often at-risk of co-occurrence. Common mental health conditions seen in patients suffering from addiction include:

• anxiety and mood disorders
• attention-deficit/hyperactivity disorder (ADHD)
• bipolar disorder
• conduct disorders
• major depressive disorder
• post-traumatic stress disorder
• schizophrenia

Alternatively, many patients treated for mental health disorders also tend to struggle with certain substances of abuse. These often include:

• alcohol
• hallucinogens
• marijuana
• opioids
• prescription drugs
• stimulants (cocaine; methamphetamine)

Some co-occurring disorders, like alcohol use disorder and major depressive disorder, are more common than others. Regardless of the specific combination, the earlier a person receives treatment for dual diagnosis, the better.

How Is Dual Diagnosis Treated?

Dual diagnosis complicates treatment because of how each condition interacts with the other. This interaction can be dangerous and requires a comprehensive approach.

Due to the complex nature of dual diagnosis, both conditions must be treated at the same time. While this was once a rare practice, integrated treatment is becoming more accessible for those suffering from mental illness and addiction.

What Is Integrated Treatment?

Integrated treatment means the program combines substance abuse and mental health interventions into a seamless rehab schedule that is tailored to the individual’s needs.

Integrated approaches that identify, evaluate, and treat both disorders better serve the client than separately treating each condition. The best dual diagnosis programs involve a collaboration between clinical providers and substance abuse professionals at the same facility.

Behavioral Therapies For Dual Diagnosis

Behavioral therapy is a critical component to addiction and mental health treatment. While the particular therapies may differ from program to program and person to person, there are several evidence-based therapies that are helpful for co-occurring disorders. Some examples include:

Cognitive Behavioral Therapy (CBT)

Effective for mood and anxiety disorders, as well as substance abuse issues, CBT is designed to change harmful behaviors and beliefs. As a thought-focused therapy, CBT helps the person develop coping skills and better understand what is happening in the here and now.

Dialectical Behavior Therapy (DBT)

DBT was first designed to prevent self-harm among those with borderline personality disorder. For dual diagnosis, DBT focuses on reducing self-harming behaviors like drug or alcohol use. This therapy is grounded in the contradictory concepts of acceptance and change.

Assertive Community Treatment (ACT)

ACT is used for severe mental health and substance use disorders, like schizophrenia and co-occurring opioid addiction. Especially useful for those reluctant to stay in treatment, ACT is determined to maintain a healthy relationship between the client and the team of professionals involved in their care.

Contingency Management (CM)/Motivational Interviewing (MI)

CM/MI uses a prized-based system to reward individuals who show healthy changes in behavior. This incentive-based therapy is useful for reducing substance use and improving treatment participation in other behavioral health programs.

What Should A Dual Diagnosis Program Include?

Treatment planning for dual diagnosis is likely to be different for each person. In order to be effective, the person and the treatment provider must work together to establish the best ways to address each diagnosis.

However, there are common, evidence-based methods that are used throughout the course of treatment. A well-rounded, comprehensive program that provides a full-spectrum of care may include:

Detoxification

To begin a treatment, a person will need to safely withdrawal from drugs or alcohol. This can occur on an inpatient or outpatient basis, and may include 24/7 supervision and the use of FDA-approved medications. Typically, the detox phase lasts around seven days.

Inpatient Rehabilitation

During inpatient rehab, the person will receive 24-hour medical supervision and attention. This phase of treatment usually involves behavioral therapy, peer and professional support, wellness activities, medication-assisted treatment, and other services that address substance abuse and the underlying mental health condition.

Supportive Housing

Following a stay at an inpatient rehab center, individuals with co-occurring disorders may benefit from sober-living homes or transitional programs. This type of housing provides continued support and residential care, but also fosters skills for independent living.

Aftercare/Ongoing Support

A crucial part of learning how to manage persistent mental health and substance abuse issues is ongoing support. Aftercare may include weekly outpatient counseling sessions, support group meetings, referrals to specialists, access to community resources, and forming nourishing friendships that reinforce recovery.

Finding A Dual Diagnosis Program

When searching for dual diagnosis programs, make sure the facility is staffed with a multidisciplinary team of professionals. Ideally, the same team should address both conditions in one setting, and coordinate with each other to provide a united and coherent treatment package.

For help finding an integrated treatment program that can address both disorders, contact RehabCenter.net to connect with a treatment specialist today.