Futures Recovery Healthcare

How Co-occurring Disorders Impact Addiction


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There are millions of people across the globe who have a mental health disorder including some type of substance use disorder (SUD) or alcohol use disorder (AUD). Of these millions, a large percentage have what is called co-occurring disorders or comorbidity. 

Comorbidity or co-occurring disorders is when an individual has two mental health disorders occurring. Usually, this is a substance use disorder and another mental health problem such as anxiety or bipolar disorder. These disorders can occur simultaneously, or, in some cases, one after another. When someone has co-occurring disorders, one disorder can negatively impact the other and make both worse. 

Individuals with mental health disorders are more likely than their counterparts without mental health issues to also have a SUD or alcohol use disorder (AUD). According to the Substance Abuse and Mental Health Services Administration’s (SAMHSA) 2018 National Survey on Drug Use and Health, about 9.2 million adults in the United States have a co-occurring disorder. 

These disorders impact people from all walks of life. People of different ages, genders, races, education levels, and socio-economic backgrounds all can be affected by both substance use issues and other mental health problems. 

A mental health disorder can be serious, common, and recurrent and range from mild to severe in nature. These disorders impact thinking, feeling, processing of emotions, the choices we make, and how we relate to ourselves and others. And while these can be serious, there is treatment that works. 

At Futures Recovery Healthcare we are focused on providing evidence-based treatment programs for those with substance use disorders, alcohol use disorders, mental health issues, and co-occurring disorders

How Co-occurring Disorders Impact Addiction

When it comes to having a SUD or AUD along with another mental health issue such as depression, people often want to know which came first. Was the mental health issue of depression present first? Did the mental health issues develop as a result of misusing and abusing alcohol or another substance? 

It can be difficult to determine specifically which came first. And, for the most part, it is not necessary to get treatment and recover. According to the National Institute of Mental Health (NIMH), research has found three main reasons why SUDs, AUDs, and other mental health problems may occur together. These are: 

  • There are common risk factors for developing both an AUD or SUD as well as other mental health issues. Some of these factors are genetic. This can be seen in families where SUD, AUD, or mental health issues are recurrent generation after generation. However, it’s important to note that this doesn’t mean that an individual in a family with these issues is destined to have the same problems. 
  • It has been found that mental health issues contribute to the use of alcohol or other substances. Many individuals suffering from anxiety, for example, may reach for that glass of wine in order to ‘calm the nerves’ or ‘take the edge off’. This self-medicating is an individual’s seemingly only way to ward off the uncomfortable feelings associated with their mental health disorder. And while initially, the substance may seem to help, over time it will only make the mental health issue worse. And in worst-case scenarios, a SUD or AUD will become full-blown. 
  • Substance use and abuse, particularly chronic abuse, can change the brain’s structure. Oftentimes, this leads to the development of mental health issues. 

As you can see, both addiction and mental health issues can make the other worse. Both short and long-term use of drugs impacts the way the brain works. The use of a drug, either illegal or legal, can either cause symptoms of mental health problems, such as hallucinations or paranoia. 

There are certain drugs that can contribute to mental health problems that exist and in some cases even cause the development of mental health issues. These drugs are: 

  • LSD
  • PCP
  • Marijuana
  • Cocaine
  • Inhalants
  • Ketamine
  • Kratom
  • MDMA
  • Prescription drugs
  • Methamphetamine
  • Steroids

It’s important to remember that this list is not exhaustive and any misuse of alcohol or drugs—both illicit and legal—can exacerbate or contribute to the development of other mental health issues. 

When a person has an AUD or SUD and a co-occurring mental health issue, it can be very difficult to determine what is the cause of these specific symptoms. The person must first stop using the substance in order to determine which symptoms are from a SUD and which may be from the other mental health issue. 

This is one reason why getting treatment at the same time for both a SUD or AUD and whatever mental health disorders are also present. Futures specializes in the successful treatment of co-occurring disorders. 

Not all addiction treatment centers are experienced or able to treat co-occurring disorders. If you or a loved one have a SUD, AUD, and another co-occurring mental health disorder seek treatment at a rehab experienced in treating individuals with co-occurring disorders. 

There’s no doubt, having a SUD and co-occurring disorder can complicate both issues. Getting the right treatment for all issues is essential.

What is the Right Treatment for Co-occurring Disorders? 

According to the National Institute on Drug Abuse (NIDA), many of the people who so desperately need treatment, never get it. The NIDA reports that of the millions who need treatment for co-occurring disorders, more than 52% receive no treatment at all. What’s more, only 9.1% of these millions get treatment for both a SUD and a co-occurring mental health problem. 

As mentioned, it is vital to get treatment for both a SUD or AUD and any co-occurring mental health problems. However, for many, in fact, most, getting the proper treatment isn’t as easy as it sounds. Not only does an individual have to acknowledge they have an issue and need help, but they must also find the right treatment center and be able to pay for it. 

The NIDA reports the following as barriers to treatment for individuals with co-occurring disorders: 

  • Unable to afford treatment
  • Not knowing where to get the right treatment
  • Trying to handle the problems on their own
  • Fear of being committed to a psychiatric treatment facility 
  • Fear of what others will think
  • Don’t believe treatment will work
  • Lack of time
  • Worries about privacy

However, evidence reveals that treatment does work. 

When it comes to treatment for co-occurring disorders, there are certain things to look for in any program. The first step is to be sure that the treatment center or centers you are considering treat co-occurring disorders. After that, going to an addiction treatment center that completes a thorough and comprehensive evaluation is imperative. This will be the step that can help to determine what co-occurring disorders are present and guide treatment plans. 

Any treatment plan, whether for an AUD, SUD, or other mental health issues should be tailored to each person’s unique situation and needs. For example, it is important to consider the following:

  • Combination of the individual’s specific mental disorders and symptoms
  • Age
  • Substance(s) used or misused
  • Specific mental disorders
  • Once these have been properly assessed, a treatment plan should consist of several components each specific to the individual’s unique situation and treatment needs. In all cases, behavioral therapy should be a part of the plan. 

Research shows that certain types of therapy work better than others when treating SUD, AUD, and mental health issues. Here are two of the most effective types of behavioral therapy when it comes to addiction and co-occurring disorders:

  • Cognitive-behavioral therapy (CB)

In this type of therapy, also known as ‘talk therapy’, professionals help individuals learn to cope with difficult situations by working through irrational thoughts and in turn, changing behaviors and responses. 

  • Dialectical-behavioral therapy (DBT)

In DBT, the focus is on being mindful and in the present moment. This type of therapy also teaches skills to help individuals cope with stressors including challenging relationships, controlling emotional responses, and the reduction of self-harm or self-destructive behaviors. 

In addition to behavioral therapies, at times, medications are needed to help with either the substance use disorder, the mental health issue, or both. Medication-assisted treatment (MAT) can be very helpful for many, especially in the beginning stages of recovery. Stabilizing the body and mind is essential to progress through the recovery process and heal. 

It is common for individuals in MAT to have co-occurring disorders. Some of the most commonly occurring disorders are: 

  • Major depressive disorder
  • Anxiety and mood disorders
  • Post-traumatic stress disorder (PTSD)
  • Schizophrenia
  • Bipolar disorder
  • Attention deficit hyperactivity disorder (ADHD)

No matter which type of substance you use, no matter which type of co-occurring mental health disorder you or your loved one may have, there is help and recovery is possible. No matter how discouraged, defeated, or hopeless you may feel now, recovery and going on to live a happy life with peace of mind is possible. 

Here are some resources for finding help:

National Institute of Mental Health Help Finder

SAMHSA’s Behavioral Health Treatment Finder

SAMHSA’s National Helpline (1-800-662 HELP or 1-800-662-4357)


National Suicide Prevention Lifeline (1-800-273-8255)

It’s never too late to get help. But, it’s also never too soon to get help. The sooner individuals with co-occurring disorders seek help, the better. You can read more about co-occurring disorders, alcoholism, and substance abuse here.

Learn more about Futures’ treatment programs for adults with co-occurring disorders today and start healing tomorrow. Call us today at 866-804-2098


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