Co-Occurring Disorders and Dual-Diagnosis Treatment
A Better Today Recovery Services can connect you with patient-focused care from qualified professionals. Having qualified professionals allows addiction treatment centers to provide a more complete diagnosis for patients with co-occurring disorders. Effective treatment centers focus on healing the person as a whole, not just the addiction or just the mental disorder. Focusing on the whole person results in a greater chance for continued recovery after the individual leaves treatment.
Alcohol and drug addiction can fill a person’s mind with negative self-images and destructive thoughts. Patients struggling with addiction tend to think it is impossible for them to be happy in recovery; they believe they will be miserable for the rest of their lives and that the only way to deaden their pain is with alcohol or drugs. Having a co-occurring disorder only serves to reinforce these thoughts.
Imagine trying to cross a raging river, the water beating against you, your own self-doubts troubling you, uncertain if you will be swept away at any moment. This is what it feels like trying to overcome a substance use disorder. Now imagine that your pockets are filled with heavy rocks as you try to cross that raging river, every step weighing you down with the overwhelming feeling that the journey is impossible and out of your reach. This is what it feels like trying to recover from a substance use disorder when you also suffer from a co-occurring disorder.
A Better Today Recovery Services understands the difficulty for someone struggling with both a mental health disorder, like major depression, PTSD or bipolar disorder, and suffers from a substance use disorder, such as heroin or alcohol addiction. Any treatment that does not address both the mental health disorder and substance use disorder handicaps an individual’s long-term recovery.
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Check out this video about patient-focused care in an individualized treatment plan and how that affects those who struggle with a co-occurring disorder when they enter drug and alcohol treatment.
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What are Co-Occurring Disorders & What Does It Look Like in Drug and Alcohol Treatment?
A co-occurring disorder is defined as a patient having both a mental health disorder and a substance use disorder. Once referred to as a “dual diagnosis,” co-occurring disorders were given their own label to refer specifically to a substance use disorder and a mental health disorder.
A Better Today understands that individuals suffering from an undiagnosed mental health disorder often develop a dependency to Heroin, Alcohol, Marijuana, or other substances to cope with the symptoms of their mental health disorders, like depression, anxiety or PTSD.
This destructive behavior of self-medicating with drugs and Alcohol may appear to allow the individual to feel normal or cope with life’s hardships. What appears at first like a cure to his or her problems, turns into a trap that enslaves the person to addiction.
ABTRS can connect you to alcohol and drug treatment that offer quality levels of care. Receiving high-quality treatment can result in long-term sobriety by offering co-occurring treatment that addresses the mental health disorder and substance use disorder simultaneously. Effective treatment centers focus on healing not just the addiction, but also the co-occurring disorders that heavily impact their lives.
The Medical Definition of Co-occurring Disorders or Dual Diagnosis
A co-occurring disorder means having a mental health disorder along with a substance use disorder. The symptoms from mental health disorders can often lead a person to self-medicate with drugs and alcohol.
The problem is that once an individual develops a substance use disorder on top of a mental health disorder, it can severely complicate and difficult to properly diagnose the mental health disorder. When it comes to a Substance Use Disorder, the DSM 5 is constantly evaluating the criteria to better treat patients with a dual diagnosis.
In the United States there were 7.9 million individuals who suffered from co-occurring mental health and substance use disorders in 2014. Unfortunately, those who suffer from mental health disorders are more likely to develop a substance use disorder. In order to truly get the people who have co-occurring disorders help, treatment is needed to properly diagnose and treat both disorders.
Treating the substance use disorder without the mental health disorder creates a high likelihood of relapse and those who have co-occurring disorders are more likely to find themselves in psychiatric hospitals, jail, or even homeless.
This table depicts the evaluation of DSM-IV and DSM-5 Criteria for Substance Use Disorders. Table acquired by the National Center for Biotechnology Information: https://www.ncbi.nlm.nih.gov/pmc/articles/PMC3767415/.
In the past, treatment usually existed for one disorder or the other, but not both disorders together. Now, no matter how complicated things are, there are highly trained mental health professionals who can diagnose and treat both disorders in a person.
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The Challenges Associated with Properly Treating Co-occurring Disorders and Substance Abuse Disorders
One challenge with having co-occurring disorders is finding a qualified therapist who knows how to treat both disorders. There are mental health professionals and there are addiction professionals, and rarely do they talk to each other when providing care for the patient. Currently, there is a split between the mental health and addiction fields, and professionals who practice co-occurring therapy are stuck somewhere in between, seeing the need for treating both disorders.
The second challenge with having co-occurring disorders is the stigma associated with mental illness. Although acceptance of addiction as a treatable disease has come a long way, many people still have a negative opinion of mental health disorders. This may cause a patient with a co-occurring disorder to fail to receive the necessary treatment from their rehabilitation center he or she needs to successfully maintain sobriety.
The biggest challenge for A Better Today Recovery Services is the knowledge that individuals with co-occurring disorders are more likely to relapse than someone who only suffers from a substance use disorder. This is why we believe it is essential that a patient with co-occurring disorders receive treatment for both the substance use disorder and the mental health disorder. This maximizes the chances for the patient to successfully maintain their sobriety in recovery.
Co-occurring Disorders and Substance Use Disorder Treatment
There is no all-encompassing manual or proper dosage for the right type of treatment for drug and Alcohol abuse. Substance abuse and addiction affects each client differently, attesting the need for individualized treatment programs. This individualized care, provided by a drug and alcohol treatment facility, must consider the mental health of the client and the addiction as well. Adopting a patient-focused treatment program that is tailored to the patient’s needs will encourage long term recovery.
This approach requires a qualified therapist to properly diagnosis each patient for co-occurring disorders to properly evaluate the root of their addiction. This is where the first challenge is prevalent across other treatment centers. Having a separation of mental health and addiction therapists does the patient a disservice.
A Better Today Recovery Services can help you find a licensed co-occurring facility with master’s level therapists to offer the treatment that co-occurring disorders patient’s need. Treatment can heal the whole person, not just their addiction. Effective treatment centers care about the person’s quality of life from the moment they walk through our door.
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The Science Behind Co-Occurring Disorders & the Addicted Brain
Co-occurring disorders are far more common than most people realize. Many mental health disorders are the result of deficiencies of chemicals in the brain. Important chemicals for proper brain function, like serotonin and dopamine, are disrupted causing an unhealthy expression, ultimately effecting their perceptions of their own quality of life.
For examples, serotonin is responsible for the individual’s overall well-being and mood regulation, while dopamine is responsible for the pleasure and happiness a person would feel through-out their day to day life. A disruption in those chemicals affect the quality of life and how they cope with these symptoms.
Addictive substances, such as Alcohol, Heroin and Cocaine, produce either one or both of these brain chemicals. It is common for someone with a mental health disorder to self-medicate by using addictive substances because these drugs lessen the symptoms brought on by the imbalance associated with the mental health disorder.
Many addictive substances can also lead to a variety of mental health conditions. Sometimes these conditions are temporary, and other times, they become permanent. The most common co-occurring mental health issues among addicts and alcoholics are mood disorders, anxiety disorders and psychotic disorders.
Common Anxiety and Mood Disorders Associated with Substance Abuse Addictions and Co-Occurring Disorders
Mood disorders are caused by a deficiency of serotonin in the brain. Common mood disorders include major depressive disorder, bipolar disorders, persistent depressive disorder and seasonal affective disorder. Someone struggling with this type of mood disorder have trouble feeling right about themselves, the direction of their life and their ability to handle stressful life situations.
Ironically, Alcohol, opiates, Marijuana, and Benzodiazepines all cause the brain to create more serotonin. When someone with a mood disorder uses one of these drugs, they start to feel normal and their brain quickly makes the link that the individual needs this to function and be normal. Again, this behavior, unbeknownst to the individual, encourages self-medicating and later, a destructive addiction that could rob them of their goals and aspirations.
Common anxiety disorders like PTSD, obsessive-compulsive disorder and generalized anxiety disorder can be diagnosed with a co-occurring disorder therapist. Anxiety disorders are all caused by a deficiency of dopamine in the brain. Someone with an anxiety disorder feels an impending sense of urgency or fear that something bad is going to happen causing a restless and uneasily feeling through-out their day to day.
Alcohol, Opiates, Marijuana, Benzodiazepines, Cocaine and Methamphetamines all cause the brain to create more dopamine. When someone with an anxiety disorder self-medicates with one of these drugs, they begin to feel a sense of relaxation, relief and contentment with their current direction in life.
Psychotic disorders like schizophrenia and schizoaffective disorder are less common, but still present in co-occurring disorders and substance abuse disorders. These types of disorders are caused by excessive amounts of dopamine in the brain. Since most drugs produce dopamine, an excessive amount can produce psychotic symptoms such as hallucinations, delusions and paranoia.
The more dopamine the drug produces, the more likely it is to produce those symptoms pf psychosis. Flooding the brain with chemicals like dopamine and serotonin can have long lasting negative effects on the way the body functions.
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Recognizing and Diagnosing Co-occurring Disorders
Which came first, the chicken or the egg? In the case of co-occurring disorders and substance abuse disorders, either can be true. Because the two are so closely intertwined, it is hard to determine if the mental disorders came first, like childhood trauma, or the tragic events commonly associated with drug and alcohol abuse sparked the mental disorder to manifest, i.e. prostitution for dope.
Sometimes the addiction just looks like a mental health problem, further pushing the need for qualified therapists. One of the first things a co-occurring disorder therapist tries to do is determine whether any mental health symptoms are drug-induced. Several drugs, such as Alcohol, Cocaine, THC, Methamphetamines and LSD, can cause depression, anxiety and psychosis. The only way to determine if these symptoms are drug-induced is for the individual to remain clean long enough to see if the symptoms subside.
A qualified therapist needs to be familiar with both substance use disorders and mental health disorders to be competent in making a co-occurring diagnosis that benefits the client long term. When a co-occurring diagnosis is made, the therapist must include a course of treatment that addresses both mental health and substance abuse tailoring their treatment plan and education to promote long lasting recovery.
Effectively Treating Co-occurring Disorders
Drug and Alcohol addiction treatment is typically individualized and addresses the patient’s reasons for using. When a patient is struggling with co-occurring disorders and addiction, often, the mental health disorder convinces the individual that their drug abuse is necessary for managing the symptoms associated with mental health disorder.
Only by simultaneously treating both, can the person’s perceived need for using be removed, giving the individual a fair chance at long lasting recovery. To further explain the situation, if the individual’s mental health disorder is not addressed, the person is more likely to relapse on his or her drug of choice in the future.
When someone enters drug and Alcohol rehab, they are provided with a treatment plan as a tool to address the individual’s concerns. When those concerns include mental health issues, the person’s treatment plan must reflect how those issues will also be addressed. Our network’s concept of successful treatment is that the quality of our patient’s life improves due to their path in recovery. The addiction treatment centers offer individualized treatment plans at centers that address both co-occurring disorders and substance abuse addictions to provide patients with long-lasting recovery and an improvement to their quality of life.
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Aftercare for Co-Occurring Disorders and Addictions
When a patient with co-occurring disorders completes a drug and alcohol treatment program, that person’s road to recovery doesn’t end. Substance abuse and mental health disorders cannot be cured with a pill; the individual will have to overcome triggers to use and abuse every day of their life. An effective drug and Alcohol treatment will provide the patient with tools or healthy coping mechanisms that they can use through-out their life in recovery. Strong support systems for aftercare is a great example.
Self-help groups such as Alcoholics Anonymous, Narcotics Anonymous, and Celebrate Recovery are available to anyone with a substance use disorder and co-occurring disorders. Additionally, groups such as Double Trouble Recovery and Dual Diagnosis Anonymous offer additional support specifically for someone with co-occurring disorders.
The individual should also seek professional help from a psychologist, psychiatrist, or mental health therapist to ensure that their mental disorder is managed and the patient has confidence in themselves to manage both their addiction and co-occurring disorders. This professional should have experience working with co-occurring disorders, so don’t be afraid to ask questions about the professional’s experience and credentials.
A psychiatrist can prescribe medication, whereas a psychologist cannot. Psychologists deal more with psychotherapy. A mental health therapist can do neither, however, they can offer counseling for daily and emotional problems. Supporting someone with co-occurring disorders means being aware of both problems and how they relate to each other.
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Reliable Sources Matter to ABTRS, Especially When it Comes to Getting the Care You Need
Substance Abuse and Mental Health Services Administration. Substance Abuse Treatment for Persons With Co-occurring Disorders. Treatment Improvement Protocol (TIP) Series, No. 42. HHS Publication No. (SMA) 133992. Rockville, MD: Substance Abuse and Mental Health Services Administration, 2005.
Substance Abuse and Mental Health Services Administration. (2016). Chronic Substance Use and Cognitive Effects on the Brain: An Introduction. In Brief, Volume 9, Issue 1.
NIDA. (2018, February 27). Common Comorbidities with Substance Use Disorders. Retrieved from https://www.drugabuse.gov/publications/research-reports/common-comorbidities-substance-use-disorders on 2019, February 13
Hasin, D. S., O’Brien, C. P., Auriacombe, M., Borges, G., Bucholz, K., Budney, A., Compton, W. M., Crowley, T., Ling, W., Petry, N. M., Schuckit, M., … Grant, B. F. (2013). DSM-5 criteria for substance use disorders: recommendations and rationale. The American journal of psychiatry, 170(8), 834-51