Substance Abuse and Co-Occurring Disorders

Addiction is a chronic illness with many onsetting factors. Individuals who misuse the drug intentionally are most commonly at risk for developing a dependence on drugs, and experiencing negative, long-lasting effects of their misuse. But, individuals who use prescription medications to treat either chronic pain or mental illness are also at risk for developing an addiction.

Addiction and mental illness are both chronic conditions that can make living a healthy, normal life near impossible on their own. But, mental illness and addiction can also coexist, resulting in co-occurring disorders. Co-occurring disorders can vary widely, often with different conditions or frequencies of conditions, occurring at a given time. When mental illness and addiction coexist, the diagnosis is usually defined as “dual diagnosis.”

Each condition can affect the other, magnifying adverse effects and making treatment for all of the co-occurring conditions more challenging. At St John’s Recovery Place (SJRP) your recovery is our number one priority, and that means digging deep to get to the root of your addiction and treating any co-occurring, dual diagnosis that presents alongside your substance use disorder.

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What Is A Co-Occuring Disorder?

The coexistence of both a mental illness and a substance abuse disorder simultaneously, is referred to as a co-occuring disorder. Co-occurring disorders are tricky chronic conditions that can often overlap, and magnify the existing symptoms of both disorders that are occurring, making diagnosis and treatment rather difficult. 

Oftentimes, medically professionals will pick up on one disorder, and fail to recognize the other because of this overlap and magnification of symptoms. Yet, it is not impossible for a correct diagnosis to be made. When co-occurring disorders are found and diagnosed, the client is said to have a dual diagnosis.

What Is A Dual Diagnosis?

The term dual diagnosis refers to when an individual suffers from both a mental illness and a substance use disorder at the same time. Even though a dual diagnosis can often be hard to assign to a client, due to the magnifying nature of co-occurring symptoms, the co-occurence of these conditions is actually quite frequent, and well known in medical and rehab communities. 

In fact, over 8% of the U.S. population suffers from some type of co-occurring disorder and has a dual diagnosis. Even though the condition can be rather common, that does not make its treatment any easier. In fact, it is imperative for individuals who suffer from co-occurring disorders to receive a dual diagnosis so that their rehab practitioners know to treat them for all occurring conditions simultaneously. 

If you or your loved one suffers from co-occurring disorders, it is important that you and your treatment facility both know that your recovery treatment should focus on treating all present conditions at once. Treatment for a dual diagnosis has to be carefully coordinated and managed to ensure the best, most holistic form of recovery treatment and mental health management. A dual diagnosis can be tricky to work with and treat, but is it not impossible to do. 

Definition of Co-occurring Mental Health and Substance Use Disorders

A co-occurring disorder, also known as a dual diagnosis, is a condition where at least one mental illness and one substance use disorder coexist within an individual at the same time. A person who suffers from a dual diagnosis can have a mental disorder paired with a drug use issue, an alcohol use issue, or all three at the same time. Individuals who suffer from mental health issues are at high risk for developing a co-occurring disorder, as they seek to manage their mental disorders with alcohol or drug use.

Whether an individual is being professionally medicated or using drugs illicitly does not really play a part in whether they develop this condition, they can still onset a dual-diagnosis if not careful with their medication use. Co-occurring disorders can refer to a multitude of different mental health and substance use conditions, the term is not assigned exclusively to any one type of dual diagnosis. Individuals who suffer from mental illness are more likely to be diagnosed with co-occurring disorders than individuals who do not suffer from mental health issues, but it is possible to develop a mental health disorder as a result of substance abuse as well.

The presence of multiple disorders in an individual can amplify the side effects of each disorder they are suffering from. Yet, it is possible for one condition to be accidentally overlooked, as the symptoms of each condition may closely mirror each other, and an individual may be diagnosed with only one part of the disorder. This can make treatment very difficult, as all present conditions should be treated at the same time to avoid added risk factors to the client’s health and safety.

Definition of Mental Health Issues

Mental health is an imperative component to the individual human and their overall health. Often referred to as the healthy balance in an individual’s mind, mental health includes a person’s emotions, psychological, social, and even physical well-being and is important at every single stage in the human life cycle.

Our mental health affects the way that we think, act, and feel. Issues with our mental health can affect our mood, our thoughts, our bodies, and the way that we perceive and interact with the world around us. Mental illnesses can be chronic conditions that affect an individual’s thinking, feelings, their moods, behavior and overall health. Mental illness is a serious issue across the United States that can have long-lasting, severe effects on the mind and body, and often can onset the misuse of outside substances and co-occurring disorders.

Definition of Substance Use Disorder

Substance use disorder is also a chronic condition that is characterized by drug-seeking behaviors, harmful consequences, severe side effects and long-lasting health conditions and changes to the brain. Substance use disorders are considered actual medical conditions that can be onset be either powerful prescription medications or illicit drug use.

Substance use disorders can often onset some times of mental health illness, and side effects, or magnifying pre-existing mental health issues and conditions. Addiction is a severe health epidemic in the U.S. that affects the minds and bodies of thousands of people. Addiction, like mental illness, can be treated. Rehabilitation programs can be frustrating and may feel long drawn out to individuals who undergo it, but treatment is well worth the struggle on the road to recovery.

Causes of Co-Occurring Disorders and Dual Diagnosis 

The causes of comorbidities or multimorbidities are often just as complicated as its diagnosis and treatment. Just because one condition existed before the other, does not always mean it was the cause for the other cognition forming and vice versa. Some disorders are onset by the use of drugs, and some mental health issues are the causes for drug use, sometimes they are altogether unrelated in their onsets. Both mental illnesses and substance use disorders can have many different onsetting factors, and they can occur separately from one another, even though these onsetting factors are usually very similar

Yet, just because someone abuses heroin for “recreational” pastimes, it does not mean they abuse the drug because of their mental illness. Likewise, just because an individual uses heroin, it doesn’t always mean they will develop a mental health condition like depression or a psychotic disorder. It is possible, and it does happen often (where one condition helps to start the other), but not all co-occuring conditions are a result of each other. Despite this fact, co-occuring conditions often have similar onsetting causes and factors. Common causes of both mental illnesses and substance use issues include:

What Causes Mental Illness?

Although mental illnesses have been around for some time now, the exact cause of mental illness still needs to be further researched. As a matter of fact, there is no single specific onsetting factor for most types of mental illnesses. Mental illness can occur as a result of many different factors, or even factors that are mixed together, including:

  • Genetics: Having mental illness run in your family tree can mean it may be carried down through your bloodline, but does not mean necessarily that you will also have a mental health condition.
  • The way your brain works: How you process information, whether you are prone to positive thinking, negative thinking, are more outgoing, closed off, etc.
  • Who you hang out: Your social group.
  • How you grew up: Did you have a happy childhood? Were you scared a lot, or very happy? Sometimes extremes of any type can be rather taxing on your mental health and certain types of mental illness.
  • What your environment is like: Is there a lot of stress in your environment? Do you see people you love often or are you alone a lot? It may not seem like your environment could play such a heavy role in the health and wellness of your mind but it is an imperative factor when considering mental illness.
  • Your culture: Our cultures and how they mix together.
  • Your life experiences: During and after childhood.
  • Other biological factors: If you have hormonal imbalances, other health issues, or medical conditions can also influence your mental health and whether or not you may develop a mental illness or not.
  • Drug and alcohol use: Whether you misuse or overuse drugs, alcohol, and even prescription medications, can play a huge part in your mental health. Drug and alcohol use can worsen mental health issues, or even onset new ones, creating severe and sometimes long-lasting effects.
  • Trauma: Traumatic life experiences and events in either early childhood, childhood, or even adulthood can also severely affect your mental health.
  • Stress: Everyone handles stress differently, and everyone deals with different levels of stress, but sometimes stress can get out of control and really mess around with your mindset, thus onsetting some types of mental illness, or adding to the effects of another.
  • Early life environment: Events in your adulthood can onset a great many different mental illnesses, but most often your early childhood plays a huge role in the way your mind develops and what kinds of emotions you will be predisposed to. Negative early childhood situations and circumstances can sometimes make you develop some types of mental illness in adulthood as a result.
  • Personality factors: Some traits we are born with can also onset mental illness. Traits like perfectionism, anxiety, or the fear of being rejected, can all add on negative emotions that mirror and exaggerate some types of mental illness like depression.

Mental health and mental illness are both very complex. There are many factors that can affect both states of the mind, and interact with each other, creating greater risk for developing more severe mental health issues. But, however fragile mental health and illness may seem to be at times, it is very unlikely that any one of these offsetting factors would cause a mental illness to develop on its own. It is not impossible, but it is very unlikely. More often than not, it takes a mixture of any of these factors to onset mental illness over time.

  • Genetics 
  • Drug use
  • Alcohol use 
  • Pre-existing health conditions
  • Other biological factors (ex. Height, weight, gender, overall health, etc.)
  • Stress
  • Environmental influences
  • Early life environment 
  • Brain region involvement 
  • The way your mind works (ex. Process information, perceives the world, etc.)
  • Trauma 
  • Adverse childhood experiences.
  • Personality factors (ex. Perfectionism, people-pleasing, self-esteem, etc.)
  • Your family history 
  • Adverse adulthood experiences.

Substance Abuse and Co-Occurring Disorders

Both substance abuse and mental health disorders are serious conditions, with high-risk for developing more severe complications that could lead to life-threatening events or circumstances. The effects associated with co-occurring disorders are even more so, as symptoms can be magnified and exaggerated for every disorder present.

Despite the magnification of signs and symptoms of disorders, dual diagnosis can be hard to assess. This is because symptoms of co-occurring conditions typically tend to mirror each other, and while one disorder may be found and diagnosed, the other may go unnoticed. Typically mental health disorders will coincide with drug misuse more often than with alcohol addiction, but both avenues are well known in co-occurring disorder information and knowledge.

More than 7 million adults suffer from co-occurring disorders in the U.S. with nearly 40% of individuals who suffer reporting that they first had a mental illness that onset their use of outlying substances, which eventually led to their substance abuse and addiction. Individuals who suffer from co-occurring disorders tend to suffer more severe hardships due to their dual diagnosis, oftentimes finding it hard to maintain a job, relationships, and even their own general health.

Types of Common Co-Occurring Disorders

Co-occurring disorders come in many different shapes, types, and forms with many different potential combinations. They can be extremely hard to track and define, as some types of disorders will mimic others, and different types of combinations may be used where three or more sets of symptoms are used at once. Some types and combinations of disorders are more frequently occuring than others though, with some having life-long developmental phases and others being experimental uses that spiraled out of control. The most common types of co-occurring disorders include:

  • Mood disorders: Including disorders like depression and bipolar disorder, these types of mental health issues affect a person’s mood in huge fluctuations or mostly negative emotions. Typically individuals will use substances that increase moods of euphoria for a short amount of time to counteract these effects.
  • Personality disorders: Often involving long patterns of unhealthy, inflexible thinking cycles, personality disorders are very broad in nature, but generally make it hard for individuals to live productive day-to-day lifestyles. Typical examples would include antisocial personality disorder, borderline personality disorder, and narcissistic personality disorder.
  • Anxiety disorders: Typically inspiring intense feelings of fear, dread, and uneasiness, anxiety disorders can have very crippling effects on the individuals who suffer from them. There are many different types of anxiety disorders, like panic disorder or claustrophobia, but they all manage to have very similar symptoms and effects, and individuals will typically abuse substances that help them relax in an effort to calm down from frequent episodes.
  • Psychotic disorders: Individuals who suffer from psychotic disorders typically lose touch with reality and experience a large range of hallucinations and delusions. The most common type of psychotic disorder is schizophrenia. Symptoms can often include declining hygiene, lack of care for self, suspiciousness of others, and declining motivation / work performance.
  • Eating disorders: Eating disorders are typically about a lot more than food, even though they are characterized by disturbances or obsessions in eating behaviors. There are many different types of eating disorders that stimulate a wide variety of symptoms in a broad range of people. Individuals who suffer from eating disorders can have a wide variety of body shapes and sizes and different relationships to food, and thus may use substances to achieve different effects (like eating more or less) when it comes to nutrition consumption.

Who Qualifies For Dual Diagnosis Treatment?

Identifying the origin of co-occurring symptoms and disorders can be difficult, and determining whether or not an individual is even suffering from a dual diagnosis can also be hard, but it is not impossible. Dual diagnosis treatment is not for everyone. For instance, individuals who only suffer from one type of disorder do not need all of the extended treatments and rehabilitation time that someone who has a co-occuring disorder will need. 

Co-occuring disorder treatment is meant for individuals who suffer from a dual diagnosis. It does not matter what type of dual diagnosis that they have, or what combination of symptoms they experience, their treatment team will help them develop and work through the most promising recovery program designed to fit them and their specific needs. The only requirement is that they be medically diagnosed with a co-occuring disorder, and that they are ready to take the time to work towards recovery. 

Addiction treatment and mental illness recovery can be hard, frustrating, and long-drawn out. But in the end, treatment is always worth the time you put into it, so that you can live your healthiest, happiest life possible down the road. Don’t wait to seek out treatment, call us here at Saint John’s Recovery Place today, to see what your treatment options and next steps should be. 

Treatment for Co-Occurring Disorders

Despite the difficulties and unique conditions co-occurring disorders present to both clients and clinicians, there are treatments available for individuals who struggle with dual diagnosis. In the past, mental health disorders and substance misuse were treated separately, taking only one condition into consideration at a time, but researchers have found over time that the body and mind must be treated as a whole, and now co-occurring disorders are treated simultaneously.

Treating both disorders at once takes time, often lasting longer than the average inpatient rehabilitation program. But, the process does work. Successful treatment of both disorders remembers to treat both illnesses as one, working to treat both the physical and mental effects of the disorders at once. Tyocialy co-occuring disorder treatment includes the use of medication-assistance, behavioral therapy, and  other therapy types that allow individuals to learn how to treat their body with more care (ex. Nutrition therapy, exercise therapy, adventure therapy, skill building).

The only real differences between normal drug and alcohol rehab and dual diagnosis treatment is the time put in, and the level of supervision. Typically, it is unadvised for anyone who struggles with mental illness or addiction to try and undergo treatment on their own, the same is stressed for individuals who suffer from multiple disorders. Not every treatment program will look exactly the same, and not every treatment option will work for every individual. It is important to remember that recovery is not a race, and that each person who undergoes it has the main goal of recovery, just in their own time. Otherwise, treatment for co-occurring disorders works largely the same way as any other type of substance abuse rehabilitation treatment. Individuals will:

At St John’s Recovery Place our number one priority is helping you feel whole again. We want to see you recover from and learn better ways to manage all of your chronic illnesses, and we want to help you learn how to be you again in as holistic a setting and manner as possible. If you want to learn more about what we offer here at SJRP, call 833-397-3422 today to speak with a representative who can help answer all of your personal questions. Don’t wait to seek out help for your addiction, we want to get you on the path to healing as soon as possible, so you can be healthy and happy again sooner.

What To Expect In Dual Diagnosis and Co-Occurring Disorder Treatment 

The dual diagnosis treatment guidelines are constantly being updated in an effort to better support clients who suffer from comorbidities. Not every treatment program is made the same, and not all facilities follow every guideline, which can leave holes in the overall treatment clients receive. 

But here at SJRP we want to make sure you receive the best treatment, tailored to suit you and your specific needs. As a result, your treatment will probably involve multiple screenings to determine where you are at in your recovery, and what adjustments need to be made to your treatment program. Typically, dual diagnosis treatment programs are a lot like other types of alcohol and drug treatment plans. You can participate in the same types of therapies and activities, but will commonly have more hands-on, supervised, medical assistance, re-evaluation, and more monitored and managed medication-assisted treatments for a longer period of time than the average rehab program.

The combination of mental illness and substance use disorders can make treatment very difficult. Each disorder must be treated as a separate entity, at the same time as the other, with equal consideration as to the effects one treatment may have on another. Dual diagnosis treatment takes a lot of planning, thinking, and consideration, but overall included the same types of treatment opportunities as other rehab programs. 

Treatment Plans for Dual Diagnosis Treatment Programs 

Even though dual diagnosis clients need a great deal of highly specialized treatments and special considerations, they can still participate in the same types of treatment programs and rehabilitation services offered to other recovering substance users. Of course, the treatments they undergo will have to be tailored to fit their specific needs, but generally individuals who undergo dual diagnosis treatment can participate in all the same kinds of therapies and rehab programs. Common rehabilitation programs offered to individuals with a dual diagnosis include:

dual diagnosis treatment

Common Co-Occurring Disorders 

Co-occurring disorders come in many different shapes, types, and forms with many different potential combinations. They can be extremely hard to track and define, as some types of disorders will mimic others, and different types of combinations may be used where three or more sets of symptoms are occurring at once. 

Some types and combinations of disorders are more frequently occurring than others though, with some having life-long developmental phases and others being experimental uses that spiraled out of control. There is no one comprehensive list that can give all of the disorders or their co-occurring counterparts. But, the most common types of co-occurring disorders include:













Panic Disorder







SUD Psychotic




Binge Eating


Dual Diagnosis Treatment Near You 

Even though co-occurring disorders are hard to treat and diagnose, you are in luck. If you or your loved one struggles with a dual diagnosis, there is hope. St John’s Recovery Place can help you recover from addiction and co-occurring disorders in a holistic manner. Although not every treatment center may be ready, willing, and equipped to treat you in the way that you need, at SJRP we offer specialized treatment modification for all of our clients to offer hope and healing when both seem to have been lost.

Above all, we want to see you recover to live a healthy, happy, and productive life. If you aren’t sure if SJRP is the right fit for you but want to learn more about our treatment programs and what we stand for, call today to speak with an admissions representative at 833-397-3422. In crisis and in recovery, SJRP is with you every step of the way.

U.S. Department of Health and Human Services: SAMHSA: Substance Abuse and Mental Health Services Administration. Co-Occurring Disorders and Other Health Conditions. (2020, August 19). (2020, September 1). 

Medline Plus: Trusted Health Information for You. Dual Diagnosis. (2020, August 4). (2020, September 1). 

National Institute on Drug Abuse: Advancing Addiction Science. What Are “Co-Occurring Disorders”