What is a co-occurring disorder? What does it have to do with dual diagnosis treatment? We hear these questions often. The terms are a little obscure, so it’s not surprising. This post will explain them, and answer the most common questions.
1. What do “co-occurring disorder” (COD) and “dual diagnosis” mean?
When someone has a substance use disorder (SUD) and a mental health disorder at the same time, we call that a “Co-Occurring Disorder.” The medical community used to use “Dual Diagnosis” for the same condition. They refer to the same thing.
In order to benefit from SUD treatment (e.g. drug addiction rehab), the substance use disorder must be more severe/disruptive than the mental health issue. If the mental issue is more severe, the individual should have mental health treatment first.
According to the Department of Health Care Services Co-Occurring Disorder Fact Sheet:
“…both disorders have to be diagnosed separately from each other and not be one set of symptoms described as two disorders. Co-occurring disorder is a condition best diagnosed by a doctor with training in both psychiatry and addiction medicine.”
2. How prevalent are co-occurring disorders today?
Growing. A large national survey conducted in 2014, published by the Substance Abuse and Mental Health Administration (SAMHSA), found that 7.9 million Americans experience both SUD and a mental disorder simultaneously.
3. Why is addressing co-occurring disorders important?
According to SAMHSA, “people with mental health disorders are more likely than people without mental health disorders to experience an alcohol or substance use disorder. Co-occurring disorders can be difficult to diagnose due to the complexity of symptoms, as both may vary in severity.”
Often, people receive treatment for one issue while the other remains undiagnosed…or known about, but untreated. More SUD programs incorporate treatment for those with co-occurring disorders today, but we can all do more to effectively support these individuals throughout and across systems. Efforts like:
- Training and educating treatment program staff
- Educating the public
- Educating those involved in community-based systems and organizations
- Screening for co-occurring disorders
- Ensuring treatment programs have protocols for addressing clients with co-occurring disorders, so that they stay in – and benefit from – treatment.
We agree with SAMHSA when they say, “The consequences of undiagnosed, untreated, or undertreated co-occurring disorders can lead to a higher likelihood of experiencing homelessness, incarceration, medical illnesses, suicide, or even early death.”
4. How is SUD treatment different for those with co-occurring disorders?
Treating those with co-occurring disorders is complicated. Treatment providers doing so must have experienced, well-trained staff, and access to key resources in order to provide comprehensive, integrated services for the co-occurring conditions. Not every treatment center can meet the need…even some formerly-labeled “dual diagnosis treatment centers” cannot.
If a co-occurring disorder is suspected, but not yet identified, treatment centers should link the client with a mental health professional for an assessment. Once they confirm the presence of a co-occurring disorder, providers such as ourselves will incorporate that information into the client’s individualized treatment plan. That way their counselors can deliver relevant treatment and case management throughout the program.
The client’s counselor may coordinate with mental health professionals. Both for the client’s care, and for their family’s education about co-occurring disorders (for example, how & when to give medication). Treatment center staff will also ensure medication protocol is followed, and monitor, document, and address how the client responds to treatment.
In addition to the treatment plan, the counselor works with the client to create a maintenance plan following treatment. The client will leave recovery with documentation of all the resources and support options they might need.
5. What can you do if you or someone you care needs substance abuse treatment, but may also have a mental health issue?
As you’re researching SUD treatment programs, find out if they do integrated assessments to identify potential co-occurring disorders. If they do, ask for their qualifications in treating such disorders.
These resources can show you what kinds of qualifications you should watch for:
- Co-Occurring Disorders (SAMHSA)
- Co-Occuring Disorders Fact Sheet (State of California Department of Health Care Services)
- Behavioral Health Trends in the United States: Results from the 2014 National Survey on Drug Use and Health (SAMHSA)
- National Alliance on Mental Illness (NAMI)
Experienced treatment providers help you or your loved one through the screening, assessment, and treatment processes effectively.
Not ready for SUD treatment yet? Just want a little insight into a loved one’s possible condition? You can always speak with a medical professional, therapist, or licensed psychiatrist. Many have existing relationships with SUD treatment providers, if they do recommend this course of action.
As a final note, we at Support Systems Homes offer tours of our co-occurring disorder treatment center (formerly a dual diagnosis treatment center!). During a tour you can speak with clinical staff, ask questions, and learn more about the programs offered.
Still uncertain about co-occurring disorders? Please leave your questions in the comments, and we’ll answer them as quickly as we can.