If you or someone you love are suffering from a mental health and substance abuse issues at the same time, a dual diagnosis rehab center can help you overcome or manage your substance use and mental illness at the same time. According to the National Alliance on Mental Illness (NAMI), 6.7% of U.S. adults (17 million people) suffered co-occurring mental illness and substance use disorder (SUD), a medical condition defined by uncontrollable use of substances despite negative consequences, in 2020.1
More than 25% of people who experience SUDs also struggle with mental health disorders.2 There are a variety of reasons for this. Sometimes, certain drugs trigger mental health symptoms as dependency develops.2 Others with mental health problems may turn to substances as a maladaptive way of coping with symptoms, or self-medicating.2 And yet others with mental health disorders and SUDs may find the same root cause for both diagnoses—including neurobiological, genetic, or trauma-related factors.2
What Does Dual Diagnosis Mean?
A dual diagnosis occurs when someone meets the criteria for a substance use disorder and they are diagnosed with one or more mental health disorders.3 Dual diagnosis is frequently known as a co-occurring disorder as well. Although these terms may refer to any number of simultaneously occurring mental health conditions, the terms most frequently refer to individuals experiencing mental health and SUDs.3 In this case, each condition could be described as comorbid, though the term comorbidity is also used outside of the mental health field to describe the coexistence of multiple medical issues.4
Dual Diagnosis Tests and Assessments
Dual diagnosis is common. Thus, individuals being screened for SUDs should also be screened for psychiatric issues; and consequently, individuals being treated for mental illnesses should be screened for substance abuse.10Assessment may be conducted via lab screening, self-reporting, and screening questionnaires or tools that sometimes consider information from family and friends.10
Signs You May Need Dual Diagnosis Treatment
Assessing co-occurring mental disorder and addiction can be complicated because of the significant overlap between the symptoms of each.5,13,14 Some drug withdrawal symptoms appear similarly to the signs associated with some mental illnesses, for instance.11 To avoid confusion—and a potential misdiagnosis—a mental health diagnosis is ideally made after a period of abstinence when there are no drugs present in the individual’s system.5
Signs of Mental Health Disorder
Symptoms and signs can vary according to diagnosis and severity, but some common signs of mental health illness may include:13
- Frequently feeling worried or afraid.
- Dropping hobbies or activities that were once important.
- Experiencing extreme mood changes or highs and lows.
- Having issues focusing, paying attention, and concentrating.
- Strong feelings of anger or irritability.
- Isolating or avoiding social activities and friends.
- Changes in sleeping and eating habits.
- Increased or decreased libido.
- Loss of touch with reality, such as experiencing hallucinations or delusions.
- Lacking insight to recognize changes in one’s feelings or behaviors.
- Suffering from physical complaints, such as headache, stomachache, aches, and pains with no cause.
- Suicidal thoughts, statements, or attempts.
- Inability to handle daily tasks, like personal hygiene.
Signs of Substance Use Disorder
The symptoms of SUDs can also differ depending on the substance used, but common signs that indicate an individual may have an issue with substances include:14
- Isolating from family and friends or spending time with different friends.
- Frequently late or absent from work or school.
- Neglecting responsibilities at home, school, or work due to substance use.
- Participating in risky behaviors, including getting into fights, having unprotected sex, or driving while intoxicated
- Increased alcohol or drug tolerance, meaning having to take more of a drug or drinking more alcohol to feel its effects.
- Loss of control related to substance use—using more than planned or feeling unable to stop, for instance.
- Experiencing withdrawal when substance use is stopped.
- Having difficulty functioning or coping with stress without alcohol or drugs.
- Inability to stop using even after substance misuse caused or worsened physical or mental health conditions or interpersonal relationships.
- Spending a lot of time getting, using, or recovering from the effects of the substance.
Ways to Get in Contact With Us
If you believe you or someone you love may be struggling with addiction, let us hear your story and help you determine a path to treatment.
There are a variety of confidential, free, and no obligation ways to get in contact with us to learn more about treatment.
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- Verify Your Insurance Coverage for Treatment
Dual Diagnosis Treatment Programs
Dual diagnosis treatment addresses both the SUD and the mental health disorder concurrently. These integrated treatment programs screen, assess, and treat both disorders at the same time using medical and therapeutic interventions.14 Comprehensive integrated treatment can occur along the continuum of care, including: 14
- Detoxification: The initial step for those with chemical dependency, usually conducted in a medically managed setting with around-the-clock medical supervision, where physicians may prescribe medications as needed to ensure safety and comfort while an individual clears their body of drugs and alcohol.
- Inpatient rehabilitation: Individuals learn to manage their substance use and the symptoms of any co-occurring disorders at inpatient rehabilitation centers, where therapy, psychiatric care, education, medication and social services, and health monitoring can be supported 24/7 by a staff of medical and mental health specialists.
- Outpatient care. Services, therapies, and treatment looks similar—if not identical—in outpatient settings as they do in inpatient care. However, individuals live at home or off site in a sober living facility or other similar housing situation while receiving treatment for co-occurring disorders.
- Aftercare, or continuing care. Ongoing support, such as mutual-help groups for both SUDs and co-occurring disorders, individual therapy, alumni reunions, and more help individuals in recovery long term.
The goal of integrated treatment is to help individuals maintain sobriety or significantly reduce their substance use as well as mange the symptoms of their mental illness.5 The process includes counseling, behavioral therapies, and sometimes medication.4,5 Integrated treatment may utilize several therapeutic techniques that have proven effective in the treatment of mental health disorders and SUDs, which may include:12,14
- Cognitive behavioral therapy (CBT). This research-based talk therapy improves an individual’s coping skills by exploring their beliefs and patterns of thinking and changing their behaviors. CBT is also often used to help reduce the risk of relapse.
- Dialectical behavior therapy (DBT). DBT uses mindfulness and self-awareness to improve an individual’s emotional state and reduce negative behaviors, such as self-harm, substance use, and suicidal tendencies.
- Contingency management. Encouraging healthy behaviors, this therapy offers vouchers and other small rewards for desired outcomes, like passing a drug test.
- Self-help and support groups. Peer support or mutual-help groups tailored to populations with substance use or co-occurring disorders, such as Dual Diagnosis Anonymous (DDA) and other 12-step, skills-based, or psychoeducational groups may be offered as part of a dual diagnosis treatment program in order to mitigate feelings of isolation and support healthy coping skill-building.
Is Dual Diagnosis Treatment Effective?
Integrated, comprehensive, individualized treatment that addresses both mental health and substance use issues is considered the standard of care for most individuals with co-occurring SUDs and other mental health problems.15 With early detection, integrated treatment can reduce or stop an individual from misusing substances, improve their psychiatric symptoms and functioning, increase chances for successful recovery for both disorders, reduce their medication interactions, ease their legal issues, improve their overall health, and give them a better quality of life.15
Studies indicate that integrated or coordinated treatment for co-occurring disorders is far more effective than unintegrated treatment that lacks coordination amongst both mental health and other medical providers. Thus, attention to substance abuse as well as mental illness is integrated into all aspects of effective treatment, which typically includes motivational interventions, intensive case management, education, support, counseling, involvement from family and friends, and long-term support and programming.16
How Much Does Dual Diagnosis Treatment Cost?
Dual diagnosis treatment costs vary depending by state and type of program. Private health insurance typically covers at least part of dual diagnosis treatment. As a result of the Affordable Care Act (ACA) and the Mental Health Parity and Addiction Equity Act (MHPAEA), mental health care coverage has improved, requiring health insurance plans to offer coverage for mental health disorders and SUDs similar to what they offer for physical health disorders.17 Additionally, this federal law ensures that restrictions for mental and behavioral health conditions aren’t more restrictive than they would be for physical health conditions, meaning deductibles and other out-of-pocket costs have to be similar as do limits on the number of days or visits covered.18
While all health insurance plans must cover behavioral health treatments like psychotherapy and counseling, mental and behavioral health inpatient care, and SUD treatment, it’s important to check with your provider to better understand the details of your individual health plan.
For those without insurance, many treatment facilities offer sliding-scale payment options, which means cost is determined by income.19
Finding Dual Diagnosis Treatment Centers Near Me
In 2019, only 12.7% of people with co-occurring mental illness and SUDs received treatment for both conditions.20 In most states, only about half of the drug or alcohol rehab centers have a specialty treatment program for individuals with co-occurring mental illness and SUDs.20
For assistance in finding a facility that offers integrated treatment for co-occurring disorders, the Substance Abuse and Mental Health Services Administration (SAMHSA) offers a behavioral health treatment service locator that can be found here.You can search by location, then filter by treatment setting, special programs, or payment type.
American Addiction Centers is the country’s top provider of addiction treatment, and many of our facilities offer an integrated treatment approach for co-occurring disorders, where individuals can get the help they need to manage their mental health conditions, achieve their goals to reduce or eliminate their substance use to go on to live happy and healthy lives.