What Is a Co-Occurring Disorders Treatment Program?

Read on to learn when substance use disorders and mental health disorders coincide.

What Are Co-Occurring Disorders?

The combination of a substance use disorder (SUD) and mental health disorder can be dangerous. Both problems exacerbate each other, making it difficult to function or reach out for help.

Fortunately, treatment of co-occurring disorders is readily available. If you are concerned that someone you know has co-occurring mental health disorders, don’t be afraid to talk to them about it. Finding support for that first step toward wellness is sometimes the most difficult part of recovery.

Co-occurring disorders are two health conditions that occur at the same time. The term also describes when one condition is caused or made worse by the other. According to the Substance Abuse and Mental Health Services Administration, approximately 9.2 million U.S. adults have co-occurring disorders.1 

Examples of Co-Occurring Disorders

Co-occurring disorders may include any combination of mental or substance disorders that have been identified as co-occurring disorders (DSM-5). That includes the following co-occurring disorder examples:
  • Mental health disorders, such as bipolar disease
  • Mood-related disorders like depression
  • Anxiety-related disorders, such as panic disorder or social anxiety disorder
  • Severe mental illness or psychotic disorders

Other common mental health disorders that occur along with SUD are schizophrenia, personality disorders, and ADHD.

Why SUDs and Other Mental Disorders May Occur Together

Co-occurring disorders
Co-occurring disorders are the result of several factors. For example, some people carry a higher genetic risk for both addiction and mental illness. The National Institute on Drug Abuse reports that genetics cause 40% to 60% of an individual’s risk for SUDs.2  In addition to biology, the two problems also share these common risk factors:
  • Experiencing trauma in childhood or early adulthood
  • Living with family members whose mental health (or SUD) impairs their ability to provide a safe, supportive home
  • Environmental factors, such as drug exposure or chronic stress
  • Brain circuitry

The treatment of co-occurring disorders is most successful when mental and addiction issues are seen as symbiotic. Just as one condition can make the other worse, improving one condition can also help improve the other.

How Mental Disorders Contribute to SUDs

It is common for individuals with mental health issues to use drugs or alcohol to self-medicate. This trend is alarming but understandable, especially when there is an average delay of eleven years between the time a person first exhibits symptoms of mental illness and the time they finally receive treatment.3 

While some drugs do temporarily bring relief to some mental illness symptoms such as depression and anxiety, drug and alcohol use worsen mental health in the long run. Changes in brain activity related to mental illness can intensify drug cravings, driving individuals to use more frequent and larger doses.

Because illicit drug use can magnify symptoms of mental illness, self-medicating leads to a vicious cycle that highlights the dangers of co-occurring conditions.

How SUDs Contribute to Mental Disorders

Substance use can cause changes in the brain where mental disorders occur. Put simply, drug use can jump-start a mental illness by changing brain structure.

Substance use can also mask mental illness symptoms. Erratic behavior, changes in sleeping patterns, or general confusion are all easily blamed on drug or alcohol use. Overlooking the possibility of mental illness can delay proper co-occurring treatment, ultimately allowing both problems to grow worse over time.

The relationship between substance use disorders and mental illness is complex. It can be difficult to diagnose which problem came first in some cases. Nonetheless, co-occurring disorders treatment can be highly effective even if delayed.

Common Co-Occurring Disorders Examples Seen with Substance Abuse

Identifying the signs of a mental health disorder early on can prevent the long delay in treatment that allows a SUD to develop. Below are some of the most common co-occurring mental health disorders and their symptoms.

Generalized Anxiety Disorder

Also known as GAD, generalized anxiety disorder is persistent, intense feelings of anxiety and worry. Some of the symptoms include overthinking, restlessness, and difficulty concentrating.4 

People with GAD do not necessarily feel anxious all the time, but their anxiety is severe enough to interfere with everyday activities.

Eating Disorders

Several types of eating disorders are considered co-occurring conditions, including bulimia nervosa and anorexia nervosa. Eating disorders are unhealthy preoccupations with food, exercise, eating, or body shape.

People with eating disorders may also withdraw from friends and family. This is because avoiding social situations makes it easier to control their food intake and prevents others from scrutinizing what they are or are not eating.

Bipolar Disorder

Bipolar disorder is marked by extreme swings of high and low moods. Everyone feels depressed or extra happy once in a while, but those with bipolar disorder experience periods of mania and depression that disrupt their life, sometimes in dangerous ways. There are at least three types of bipolar disorder, and certain drugs can induce symptoms.5 
Post-Traumatic Stress Disorder

The Anxiety & Depression Association of America reports that approximately eight million people are living with PTSD in the U.S. today. Trauma survivors are the ones who commonly experience PTSD. Sufferers may experience depression, anxiety, emotional numbness, and lapses in memory, especially memories associated with the traumatic event.6 

People who have directly experienced trauma and those who have witnessed it or heard traumatic events repeatedly are at risk for PTSD.

Schizophrenia
Schizophrenia is usually diagnosed in the late teens to early thirties, and the disorder tends to emerge slightly earlier in males. A diagnosis for this disorder is typically made after an initial psychotic episode. Some common symptoms include hallucinations, delusions, and disorder thoughts or speech.
Co-Occurring Disorders Treatment Programs
Co-Occurring Disorders Treatment Programs

Co-occurring disorders treatment programs may include a variety of therapies. Once a co-occurring diagnosis is identified, a medical team consisting of mental health and addiction specialists may recommend one or more medications to help manage symptoms. Other treatments include:

  • One-on-one counseling
  • Behavioral therapies
  • Cognitive-behavioral therapy (CBT)
  • Dialectical behavior therapy (DBT)
  • Assertive community treatment (ACT)
  • Therapeutic communities (TC)
  • Contingency management (CM)

The successful treatment of co-occurring disorders is possible when both (or all) disorders are properly diagnosed and prioritized equally. All clients with co-occurring conditions will benefit from simultaneous mental illness and substance abuse treatment. 

Behavioral Therapies for Children and Adolescents
Children and adolescents are also at risk for substance and mental health disorders. Treatment of co-occurring disorders for this age group may include:
  • Brief strategic family therapy (BSFT)
  • Multidimensional family therapy (MDFT)
  • Multisystemic therapy (MST)
  • Integrated treatment
  • Medications
Symptoms of mental health disorders can present differently in children than in adults. If your child exhibits changes that concern you, don’t assume it’s a “phase.” Ask your pediatrician for more information and request a mental health evaluation.
Aftercare and Support Groups

Following through with aftercare programs and support groups after completing formal treatment of co-occurring disorders is crucial to long-term wellness. Aftercare may include sober living, attending outpatient care, and participating in appropriate support groups.

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What is an Intervention?

In a situation involving substance use disorder, planning an intervention may be the best, and safest, option to help someone who is living with an addiction. So, what does intervention mean? An intervention is a strategically planned process of confronting the person who is living with addiction about the consequences of their actions while simultaneously encouraging them to accept help and treatment for their addiction.1

The key feature of an intercession is that while it can be an immensely helpful option in convincing a person that they should seek treatment, it should not be done solely by friends and family members. Without the aid of a specialist, or someone who is equally trained in the process of interventions, an intervention may do more harm than good.

An intervention specialist is someone that has been professionally trained in helping people break free from their addictions. They can help a person without judgment, emotions, or blame to understand how their actions are negatively impacting themselves and those that they care about.

When performed properly, without judgment or pressure, and with the aid of a qualified intercession specialist, 80-90% of substance use interventions are successful in convincing the patient to seek help.

Early Intervention

Treatment is more effective the earlier that it begins for an alcohol or drug abuse disorder. As with any other health condition, early intervention and treatment can prevent more significant problems further on in life.

Unfortunately, in many cases, an alcohol addiction intervention or a drug abuse intercession does not take place until most other options have been exhausted. It can be difficult for those struggling with a substance use disorder to realize or admit that they need help.

It often takes a life-altering event, such as a divorce, loss of employment, or a housing crisis for a person to be willing to seek treatment. Because early
alcohol and drug intercession can be so beneficial, first responders must be able to recognize the symptoms of substance abuse.3

What is a Nursing Intervention?

Nursing interventions are often the first time a patient will experience care for their disorder. It takes place when someone enters a care facility such as a clinic or hospital for a condition that may or may not be caused or exacerbated by their substance use disorder.

After initial evaluation and stabilization, a nurse will take action to help their patient by suggesting healthy physical or emotional coping mechanisms for a patient that wants to quit using the substance that they are addicted to. The nurse will also be able to offer education and information to the patient about other treatment facilities or care providers that can help them on their road to recovery.

Alcohol Intervention

A Further Look at Interventions

Nearly 50% of adults in America regularly drink alcohol, and it is believed that as many as 25% of those Americans have an alcohol addiction, most commonly in the form of binge drinking. In many situations, once a person with an alcohol use disorder realizes the way that alcohol is negatively impacting their life, they can reduce the amount that they drink, or even quit entirely, without outside assistance.

However, some people that have an alcohol use disorder are unable to see how their addiction is negatively affecting them. In this situation, an alcohol use intercession can be extremely beneficial. Some of the benefits of interventions include:

  • Showing the person with the addiction the consequences of their actions to this point as well as the potential consequences that may happen if they do not seek treatment.
  • Showing them the available treatment options, and helping them understand that people are willing to help them with their addiction.
  • Showing them how their alcohol addiction has impacted their friends and family members.
  • Showing them that things are not hopeless, that they can recover, and that they can take charge of their life once more.

Drug Intervention

A Further Look at Interventions

Over nineteen million adults struggle with a drug abuse disorder and of those, nearly 74% also struggle with a co-existing alcohol abuse disorder. Drug abuse and addiction can be a much harder disorder to recover from than alcohol addiction, particularly due to the high rate of co-use that most people with a substance use disorder experience.

In many cases, suddenly stopping the use of an illicit substance can be just as harmful, if not more so than using the substance itself. The side effects and withdrawal symptoms that a person may experience when they decide to stop using a substance can be severe and at times life-threatening.

Luckily, substance use is a highly treatable disorder and several medications can help a person wean off of illicit substances in a safe, sustained, and monitored manner. A drug abuse intervention can help someone realize that they have options and that they can recover safely and healthily.

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