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Understanding Dual Diagnosis

Providing Trusted, Evidence-Based
Treatment for Three Decades and Counting

If you or a loved one is experiencing addiction, we’re here to help.

Female patient with counselorThe term “dual diagnosis”is used in reference to individuals who suffer from alcoholism or other drug addiction simultaneous with another mental illness. This is also known as “co-occurring disorders.” While patients with coexistent issues comprise a large percentage of the addiction community, very little is known about it outside of the medical profession.1

The following sections provide an introduction to the complex and diverse world of comorbid health situations today.

How Common Are Co-occurring Disorders in the U.S. Today?

  • Approximately 7.9 million Americans have co-occurring disorders.2

  • More than 50% of drug-abusing individuals have at least one other mental health issue.1

  • Nearly a third of those with a mental illness also suffer from an addiction to alcohol or other drugs.2

  • The risk of suicide is much greater for those who have more than one mental health issue.3

  • Co-occurring disorders are prevalent among military veterans and the armed forces community.2

  • Prisons hold a significant number of dual-diagnosis patients under lock and key. More than 20% of U.S. inmates have multiple mental health issues.2

  • Co-occurring disorders are common among the homeless. Their health issues largely go untreated. Isolation is part of the issue.Limited access to health services is another factor.2

Factors That Contribute to Dual Diagnosis

  • Genetic makeup may predispose some individuals to having one or more mental health issues.4
  • Stress can play a factor in producing a dual diagnosis. Trauma can too. In addition, exposing children to drugs can draw them into addiction. With this addition can come other mental illnesses.4
  • Major changes in the brain occur during adolescence. This can make drug use more likely. It can also lead to other mental health issues.5
  • Many serious mental disorders are possible with dual diagnosis: Bipolar disorder; personality disorder; manic depression; obsessive-compulsive disorder; panic anxiety disorder; post-traumatic stress syndrome; eating disorders; and schizophrenia.6

What Are Some Unique Characteristics of Dual Diagnosis?

  • Due to the complexity of symptoms, co-occurring disorders can be difficult to diagnose. Each additional condition makes the task more challenging. They intertwine. They synergize. They exacerbate. They intensify. In many cases, one disorder is treated while other issues are ignored.6
  • Patients with co-occurring disorders often have more severe symptoms than those caused by either issue alone.7
  • There can be many causes for co-occurring disorders. Drugs can bring on other mental issues. Mental illness can lead to use drugs. People may “self-medicate” symptoms. Drug abuse and other mental illnesses can have the same root causes.5
  • Dual-diagnosis rehab tends to be more complex. As a result,treatment often takes longer than for one health issue.6

Why Are Alcoholism and Addiction Part of the Co-occurring Equation?

  • Drugs can affect many key brain circuits involving: learning and memory; reward; decision-making; and behavior control. All of these circuits are maturing well into early adulthood. This is why early exposure to drugs of abuse is so bad; it may change the way the brain develops. Likewise, early symptoms of a mental health issue may lead to drug use.5
  • Though drug abuse commonly occurs with other mental issues, one does not have to cause the other. This is true even if one appears first.6
  • The regions of the brain involved in drug abuse and other mental issues are often the same. As a result, brain changes caused by one issue may bring on another.5

How Is Treatment Different for Co-occurring Disorders?

Young addict with counselor

  • Research suggests that comorbid conditions should be treated at the same time.8
  • Screening for multiple health issues in primary care settings is important. It can help doctors treat all conditions early.2
  • Since patients often have more than one mental health issue, drug-abuse patients should be checked for other mental issues. Likewise, patients with a mental health issue should be checked for drug abuse.4
  • Since mood disorders increase the chance of drug abuse, treating such conditions is vital. Likewise, treating drug abuse can reduce the chance of developing a mood disorder.5
  • It’s important to screen and assess inmates for mental health issues; many of them have co-occurring disorders. This should be a concern for the criminal justice system. Screening for both physical and mental symptoms could be standard protocol for all prisoners.2
  • Since co-occurring disorders often aren’t diagnosed or treated, many people end up: caught in a downward spiral, ill for a long time, homeless, thinking suicide, or dying early from poor health.2
  • The first major hurdle for dual-diagnosis patients is often detox.1
  • Matching treatment settings and services to people’s needs is essential.7
  • Behavioral therapy is often a basic part of a dual-diagnosis treatment plan. Patients’ beliefs impact their thoughts and actions.1
  • Medications can also help many patients; it is often combined with counseling. Some medications may benefit many health issues.4

It’s Not “One Size Fits All”

The right plan and length of treatment for a patient should depend on the type and degree of need. Recovery is often a long process; it may call for many layers of treatment.7

When it comes to Dual-Diagnosis patients, “integrated care” is generally viewed as the most effective means of treatment.  This means that there’s seamless integration of all needed care.9 The treatment team works closely on the best ways to help the patient, to make sure each part of the plan supports the whole person.10

Many alcohol treatment centers are not equipped to properly treat dual-diagnosis patients. People with co-occurring disorders should check to make sure that the center they choose can treat all of their needs.2

Michael’s House is a residential alcohol and drug rehab treatment facility. It is located in Palm Springs, California. We help dual-diagnosis patients get the comprehensive care they need. Our evidence-based strategies can break the cycle of addiction and help maintain control over any other mental health issues.

Contact Michael’s House today on our 24/7 toll-free line for more information or advice.


Dual Diagnosis.” National Alliance on Mental Illness, 2017. Web. Accessed 2 July 2017.

2Co-occurring Disorders.” Substance Abuse and Mental Health Services Administration. 8 March 2016.Web. Accessed 2 July 2017.

3Risk Factors for Suicide Attempts in Dual Diagnosis Patients.”, U.S. National Library of Medicine, National Institutes of Health.Web. Accessed 2 July 2017.

4 “Comorbidity: Addiction and Other Mental Disorders.” DrugFacts, National Institute on Drug Abuse. March 2011.Web. Accessed 2 July 2017.

5Comorbidity: Addiction and Other Mental Illnesses.” National Institute on Drug Abuse. September 2010.Web. Accessed 2 July 2017.

6Drug Abuse and Mental Illness.” Fast Facts: Questions and Answers, National Drug Intelligence Center, U.S. Department of Justice.Web. Accessed 2 July 2017.

7Principles of Drug Addiction Treatment: A Research-Based Guide (Third Edition).” National Institute on Drug Abuse. December 2012.Web. Accessed 2 July 2017.

8Comorbidity: Addiction and Other Mental Illnesses.” Research Report Series, National Institute on Drug Abuse. September 2010.Web. Accessed 2 July 2017.

9Comorbid Drug Abuse and Mental Illness.” A Research Update from the National Institute on Drug Abuse, U.S. Department of Health and Human Services. June 2007.Web. Accessed 2 July 2017.

10 Flynn, Patrick M., Ph.D.,, “Co-Occurring Disorders in Substance Abuse Treatment: Issues and Prospects.” Journal of Substance Abuse Treatment, Volume 34, Number 1, Pages 36-47, January 2008.Web. Accessed 2 July 2017.