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Co-Occurring Disorders and Substance Abuse Treatment Near Me

Co-occurring disorders involve having at least one substance use disorder in addition to at least one mental health disorder, at the same time. For example, an individual can be diagnosed with depression while also having a diagnosis of opioid use disorder. 1 According to the 2019 National Survey on Drug Use and Health (NSDUH), 9.5 million people aged 18 or older reported having a co-occurring disorder.2

In order to address the complex nature of co-occurring disorders, many treatment programs offer a full range of integrated services to simultaneously manage both the substance use disorder and any concurrent mental health issues.1 It is important to treat both disorders at the same time, so one doesn’t go left untreated leaving the individual with a higher relapse potential. Through professional treatment, the successful management of both substance use disorders and any co-occurring mental health disorders can help promote your recovery.

What is Addiction?

Addictions, which are diagnosed as substance use disorders (SUDs), are characterized by problematic patterns of substance seeking and compulsive use that can interfere with multiple aspects of an individual’s daily life. When an individual has a substance use disorder, their brain undergoes long-lasting changes and as a result they are unable to quit or cut down despite the negative consequences such as significant social, occupational, legal, or interpersonal problems in their life. 4

What is a Co-Occurring Disorder?

A co-occurring disorder is marked by the coexistence of an SUD and mental health disorder. Historically, these disorders have also be called comorbidities or dual diagnoses. In those with co-occurring disorders, 2 or more conditions exist at the same time or in succession, potentially exacerbating their progression.7

Though SUDs can occur together with mental illnesses, it is important to note that this does not always mean that one causes the other.7(Why do these disorders often co-occur? 1st paragraph, 1st sentence) Genetic and environmental factors can contribute to the development of a substance use disorder, mental health disorder, or the co-occurrence of both. Sometimes, a mental health disorder such as depression can lead to the development of a substance use disorder or vice versa. For example, one theoretical explanation for such co-occurrences involves an individual beginning to use drugs or alcohol to cope with their signs and symptoms of depression. This misuse of drugs or alcohol can develop into a co-occurring substance use disorder. 7

SUDs and co-occurring mental health disorders may also be more prevalent among certain populations. For instance, 60% of adolescents in community-based treatment centers for SUDs have also been diagnosed with a co-occurring mental health disorder.9(1st paragraph, last sentence toward the end) Additionally, among people who experience mental illness at some point in their lives, nearly half will also experience an SUD.9

Depression, Anxiety, and Co-Occurring Substance Use Disorders

Depression is a type of mood disorder that can impact your emotions, behaviors, and daily routines.10 Though depression varies widely, a persistent sad, irritable, and empty mood are common features of depressive disorders.5

Anxiety disorders are a spectrum of disorders characterized by excessive worry about a diverse range of events or things.6 A person with an anxiety disorder may find it difficult to control their worry and stress, to the point that it interferes in their work, school, relationships, or daily functioning.6

The co-occurrence of mood disorders and anxiety disorders with substance use disorders have been well-established. Clinical studies indicate that an individual with a mood disorder such as depression  or with an anxiety disorder is 2-5 times more likely to have a SUD, or vice versa.12

Post-traumatic Stress Disorder (PTSD)

PTSD is a type of trauma-and stressor-related disorder that can develop after a person experiences or witnesses a traumatic event, such as near-death, a major injury, or sexual violence.13, 6 Research suggests that among the 90% of people that experience trauma at some point in their lives, about 10% develop PTSD.14 However, the prevalence of PTSD is higher among populations that are repeatedly exposed to traumatic events, such as veterans and first responders.14, 15 The link between SUD and PTSD is of particular concern in that nearly 1 in 5 veterans with PTSD also has a co-occurring SUD.16 Additionally, people with PTSD are 2-4 times more likely to meet the criteria for an SUD than people without PTSD and individuals seeking treatment for PTSD are up to 14 times more likely to develop a substance use disorder compared to individuals without PTSD. Additionally, individuals who are seeking treatment for SUDs, have lifetime PTSD rates between 30% and 60%.13

Treatment Options and Programs for Co-occurring Disorders

According to The National Institute on Drug Abuse (NIDA) treating both substance use disorders and co-occurring mental health disorders at the same time is more effective than treating them separately.19 The simultaneous management of both substance use and mental health issues has historically been called dual diagnosis treatment, though it is now more commonly referred to as integrated treatment for co-occurring disorders.

Treatment for co-occurring disorders can take place in various settings depending on the severity of a person’s condition and the level of care they need.1 Treatment usually includes a combination of medication and behavioral therapies. Examples of behavioral therapeutic approaches used to treat co-occurring disorders include :19

  • Cognitive-behavioral therapy (CBT).
  • Assertive community treatment (ACT).
  • Dialectical Behavior Therapy (DBT).
  • Contingency management (CM) or Motivational incentives (MI).

Residential Treatment for Co-occurring Disorders

Residential treatment for co-occurring disorders provides 24-hour, structured living support in a safe, comfortable, and intimate setting.20 This allows staff to monitor the client around the clock and respond in real time to the appearance of symptoms, whether related to the SUD or the co-occurring mental health disorder. It also allows the individual and the treatment team to work together to develop a personalized treatment plan that can continue to help them stay in recovery even after the treatment program ends.22, 1

Co-occurring Disorders Treatment Near Me

If you or your loved one has decided to seek treatment and are looking for treatment centers that specialize in co-occurring disorders treatment, there are a few considerations to keep in mind. First, it’s important to determine your treatment needs. For example, will you need inpatient treatment for co-occurring disorders? Or will you be able to stick with outpatient programs? Speaking with a medical professional is one of the best ways to determine this. Once you have a general idea of the treatment you’ll need, you should begin searching for specialized co-occurring disorders treatment tracks.

Other considerations may include whether traveling out of state for treatment is a viable option. For some people, leaving home for treatment may remove them from triggers or negative influences that may be contributing to their problems. Seeking treatment options out-of-state opens more possibilities to find specialized treatment for co-occurring disorders. To determine the best option for you, you may consider factors such as access to social and emotional support systems, treatment needs and goals, and rehab costs. Numerous online resources can assist you in finding treatment for co-occurring disorders near you, a few include:25

  • Rehabs.com Treatment Directory.
  • Substance Abuse and Mental Health Services Administration (SAMHSA).
  • National Alliance on Mental Illness (NAMI).
  • National Institute on Alcohol Abuse and Alcoholism (NIAAA)

Which Rehab Type is Best for Me?

To find the rehab that is best for you, it is helpful to keep in mind that everyone is different and as a result will have unique medical needs and treatment goals. In addition, other factors might have impact your choice, including:

  • Cost: You may want to research components such as affordability of treatment, insurance coverage and methods of payment. Some programs offer financial support, such as payment plans, healthcare loans, or scholarships.
  • Insurance coverage: Though insurance generally covers rehab, the level of coverage varies. Check with your insurance provider to get a better understanding of your coverage.
  • Location: Deciding whether you would like to find treatment locally or out of state may depend on the cost of treatment as well as your medical needs, program goals, and access to care.
  • Types of programs: Different programs offer varying levels of care. Determining which program type is the best fit for you may depend on factors like the severity of your co-occurring disorder.

Does Insurance Cover Co-occurring Disorders Rehab?

Insurance may be able to cover some or all of your co-occurring disorders treatment. The Affordable Care Act (ACA) mandates coverage for mental health conditions.27 However, coverage may vary depending on your needs and insurance plan. To find out if your policy covers co-occurring disorders, you can check your coverage online or by phone.

Articles Related to Co-Occurring Disorders Treatment

Sources:

  1. Substance Abuse and Mental Health Services Administration. (2020). Substance Use Disorder Treatment for People With Co-Occurring Disorders. Treatment Improvement Protocol (TIP) Series, No. 42. SAMHSA Publication No. PEP20-02-01-004. Rockville, MD: Substance Abuse and Mental Health Services Administration.
  2. Substance Abuse and Mental Health Services Administration. (2020). Key substance use and mental health indicators in the United States: Results from the 2019 National Survey on Drug Use and Health (HHS Publication No. PEP20-07-01-001, NSDUH Series H-55). Rockville, MD: Center for Behavioral Health Statistics and Quality, Substance Abuse and Mental Health Services Administration.
  3. National Institute on Drug Abuse. (2020, June 25). The Science of Drug Use and Addiction: The Basics.
  4. Daley D.C. (2013). Family and social aspects of substance use disorders and treatment. Journal of Food and Drug Analysis, 21(4), S73–S76.
  5. American Psychiatric Association. (2013). Diagnostic and Statistical Manual of Mental Disorders (DSM-5®). American Psychiatric Publishing.
  6. Substance Abuse and Mental Health Services Administration. (2020, April 20) Mental health and substance use disorders.
  7. National Institute on Drug Abuse. (2018, August 1). Comorbidity: Substance Use Disorders and Other Mental Illnesses DrugFacts.
  8. National Institute on Drug Abuse. (n.d.) Health Topics.
  9. (2021, April 13). Part 1: The Connection Between Substance Use Disorders and Mental Illness.
  10. National Institute on Drug Abuse. (2018, February).
  11. Rappeneau, V. & Berod, A. (2017). Reconsidering depression as a risk factor for substance use disorder: Insights from rodent models. Neuroscience and Biobehavioral Reviews, 77, 303-316.
  12. Turner, S., Mota, N., Bolton, J., & Sareen, J. (2018). Self-medication with alcohol or drugs for mood and anxiety disorders: A narrative review of the epidemiological literature. Depression and Anxiety, 35(9), 851–860.
  13. McCauley, J. L., Killeen, T., Gros, D. F., Brady, K. T., & Back, S. E. (2012). Posttraumatic Stress Disorder and Co-Occurring Substance Use Disorders: Advances in Assessment and Treatment. Clinical Psychology, 19(3), 10.1111/cpsp.12006.
  14. María-Ríos, C. E., & Morrow, J. D. (2020). Mechanisms of Shared Vulnerability to Post-traumatic Stress Disorder and Substance Use Disorders. Frontiers in Behavioral Neuroscience, 14, 6.
  15. Lewis-Schroeder, N. F., Kieran, K., Murphy, B. L., Wolff, J. D., Robinson, M. A., & Kaufman, M. L. (2018). Conceptualization, Assessment, and Treatment of Traumatic Stress in First Responders: A Review of Critical Issues. Harvard Review of Psychiatry, 26(4), 216–227.
  16. National Institute on Drug Abuse. (2021, April 13). Why is there comorbidity between substance use disorders and mental illnesses?
  17. National Institute on Drug Abuse. (2020, January). Bipolar disorder.
  18. Gold, A. K., Otto, M. W., Deckersbach, T., Sylvia, L. G., Nierenberg, A. A., & Kinrys, G. (2018). Substance use comorbidity in bipolar disorder: A qualitative review of treatment strategies and outcomes. The American Journal on Addictions, 27(3), 188–201.
  19. National Institute on Drug Abuse. (2021, April 13). What are the treatments for comorbid substance use disorder and mental health conditions?
  20. American Society of Addiction Medicine. (2020). Opioid addiction treatment: A guide for patients, families and friends.
  21. American Society of Addiction Medicine. (2015, May 13). What are the ASAM levels of care?
  22. Center for Substance Abuse Treatment. (2006). Detoxification and substance abuse treatment. Treatment improvement protocol (TIP) series, No. 45. HHS Publication No. (SMA) 15-4131. Rockville, MD: Center for Substance Abuse Treatment.
  23. National Institute on Drug Abuse. (2019, January 17). Treatment approaches for drug addiction drugfacts.
  24. National Institute on Drug Abuse. (2020, June 3). Types of treatment programs.
  25. National Institute on Drug Abuse. (2021, February 18). Where can family members go for information on treatment options?
  26. U.S. Department of Health and Human Services. (2020, September 1). Does insurance cover treatment for opioid addiction?
  27. Helathcare.gov. (n.d.) Mental health and substance abuse coverage.

 

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