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The Complex Challenge of Co-Occurring Disorders

Co-occurring Disorders (COD), also frequently referred to as dual diagnosis or dual pathology, is when an individual is suffering from both a mental illness and some form of substance abuse. This term includes a wide range of conditions that vary in intensity. For example, it could refer to someone with a mild generalized anxiety disorder and drug dependency, or to someone with severe mental illness like schizophrenia and full blown substance use disorder.

Individuals who struggle with co-occurring disorders often face a number of unique and complex challenges. Some of these adversities become even more noticeable during recovery. Compared to those who struggle with only one condition, individuals with co-occurring disorders experience increased rates of:

  • Hospitalization
  • Homelessness
  • HIV and Hepatitis C infections
  • Relapse

Furthermore, cases of co-occurring disorders are extremely prevalent. According to the Substance Abuse and Mental Health Services Administration (SAMHSA), approximately 7.9 million adults in America were living with co-occurring disorders in 2014. In fact, experts indicate that people with mental health disorders are more likely to experience alcohol or substance abuse disorder.

The Importance of a Proper Dual Diagnosis

One of the biggest issues that occur often with dual diagnosis treatment is that clinicians will approach treatment as if there is only one primary diagnosis, with a secondary diagnosis as a footnote. However, the reality is that there isn’t one main issue and another side-effect. Instead, there are two co-occurring primary conditions.

If someone is properly diagnosed as having an addiction, it is acknowledged as a substance use disorder. Experts say addiction is a disease/brain disorder, and recent research affirms that there is a genetic component to addiction. So while mental illness may act as a catalyst that leads to alcohol and/or drug use, the act of using these substances is only a symptom of a specific condition. So if a clinician only treats the mental health disorder, believing the addiction will fix itself as a result, the risk of relapse is extremely high.

In contrast, treating symptoms of mental illness as a byproduct of addiction is also an ineffective approach to treatment. Some clinicians may act as if the symptoms of a mental illness are being caused by drug use, and assume that by treating the addiction that those symptoms will leave. However, an untreated mental health disorder will persist despite the absence of drugs, and can even undermine treatment and cause relapse. While the effects of certain substances may exacerbate the symptoms of mental illness, that does not mean they are the cause.

It is vital that in the presence of a mental illness and a substance use disorder that clinicians address the patient as someone suffering from two primary conditions. This is why they are co-occurring disorders. They exist independently, even if they have the capacity to influence one another. Therefore, they need to be treated in a way that is both simultaneous and integrated to ensure for more comprehensive results.

Top 5 Co-Occurring Disorders

According to some researchers, some types of mental health disorders are more common to co-occur with specific drug addictions. In no particular order, here are 5 of the most common co-occurring disorders.

  1. Schizophrenia and Marijuana Addiction

The American Journal of Psychiatry released a study that suggests approximately half of all people with schizophrenia also have a substance abuse disorder. In particular, marijuana addiction was most common for those with schizophrenia.

  1. Anti-Social Personality Disorder and Alcoholism

Alcoholism quite often co-occurs with many mental health disorders. However, according to the National Institute on Alcohol Abuse and Alcoholism (NIAAA), anti-social personality disorder (ASPD) is the most common for those with alcoholism. In fact, people who drink to excess on a regular basis are 21 times more likely to deal with ASPD.

  1. Anxiety Disorders and Cocaine Addiction

Not only do the symptoms of anxiety mirror those experienced with cocaine abuse, but statistics suggest there is a very high risk of anxiety and cocaine abuse occurring together. For those who already have an anxiety disorder, the risk becomes even higher that you will develop a severe emotional problem when using a drug like cocaine, due to its stimulant properties.

  1. Post-Traumatic Stress Disorder and Prescription Opioid Addiction

Prescription opioids are often abused in order to boost feelings of pleasure and calm inside the brain. Those struggling with post-traumatic stress disorder (PTSD) often end up abusing these medications in order to both experience that feeling of euphoria and to numb themselves to physical pain and/or emotional trauma.

  1. Depression and Heroin Addiction

Advances in Psychiatric Treatment estimates that approximately 48% of opioid users have experienced depression at some point in their lives. In fact, extended use of heroin and other opioids can alter brain chemistry and demoralize portions of the brain responsible for producing pleasure sensors and mood changes.

This does not mean that these disorders and addictions are only found in these combinations. It is also common for people with depression to abuse alcohol, or people with anxiety disorders to abuse marijuana. Regardless of the mental illness or the substance, both conditions should be treated as co-occurring primary disorders.

Dual Diagnosis Treatment

Sadly, only a small percentage of those with co-occurring disorders actually receive proper care that addresses both disorders. Back in 2011, data suggested that approximately only 12.4% of adult Americans with co-occurring disorders were able to get access to both mental health and addiction treatment resources. While there are different approaches to addressing dual diagnosis care, it is still important that individuals get treatment for both conditions.

Palm Partners Recovery Center believes in integrated treatment, which combines multiple methodologies into a single coherent treatment plan. Each treatment plan is developed with a consistent philosophy and approach, and personalized for a patient’s individual needs. In this respect, both disorders are considered primary instead of focusing on one and minimizing the other. Integrated and holistic treatment can improve many aspects of care, such as:

  • Accessibility
  • Personalization of services
  • Engagement in treatment
  • Compliance with treatment
  • Mental health symptoms

In the end, integrated treatment for co-occurring disorders frequently experiences improvement in overall outcomes. The Substance Abuse and Mental Health Services Administration in the United States describes the integrated approach to dual diagnosis treatment as being in the best interests of not only the clients, but also the healthcare providers.

Palm Partners Recovery Center understands the important elements of dual diagnosis treatment and co-occurring disorders. Part of our mission is to provide safe and effective holistic addiction treatment. This means having a variety of resources and specialists to help those suffering with co-occurring disorders.

https://www.dualdiagnosis.org/

https://en.wikipedia.org/wiki/Dual_diagnosis

https://www.samhsa.gov/disorders/co-occurring

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