Substance Abuse, Alcoholism, and Co-occurring Disorders

Millions of people across the nation and world are living with alcohol and substance use disorders. According to the World Health Organization (WHO), there are about 3 million alcohol-related deaths each year across the globe. That’s one fatality every 10 seconds. 

The National Institute on Drug Abuse (NIDA) reports that 20.3 million American adults have a substance use disorder (SUD). 

That’s a lot of people struggling to live productive, healthy, and happy lives amidst an addiction issue. What’s more, of these 20.3 million, 7.7 million have co-occurring substance abuse and mental health issues.  

A co-occurring disorder is also known as a dual disorder, having a dual diagnosis, or comorbidities. Co-occurring disorders are simply the condition in which an individual has both a substance use issue and also a mental health issue. 

The substance use disorder may be abuse or dependency on alcohol or another substance. The mental health issue may be any form of mental health including types of anxiety, depression, or more severe mental health illnesses such as schizophrenia. 

If you think you or someone you love may be living with an alcohol or other substance use issue or have a co-occurring mental health issue, there is help and hope. Each day people, just like you, take the first brave step towards recovery and seek help. A joyful, peaceful, and productive life is possible. It’s important when seeking help to find a treatment center with experience and expertise in treating co-occurring disorders such as Futures Recovery Healthcare. 

Common Co-Occurring Disorders

Co-occurring disorders have been studied for many years. More than 25 years ago in 1979 two researchers noted that the correlation between depression and narcotics use may be more than a coincidence. Despite the emerging data shown years ago, the movement to further understand, help prevent and effectively treat co-occurring disorders has only recently gained momentum.

While there is a multitude of co-occurring disorders when it comes to substance abuse and mental health issues, some are more commonly found to occur together than others. Alcoholism and co-occurring disorders such as anxiety are one of the most common dual diagnosis. 

In general, the following mental health issues are some of the ones most commonly associated with substance abuse issues:

• Anxiety-related disorders
  • Social anxiety
  • Panic disorder
  • Post-traumatic stress disorder
  • Generalized anxiety disorder
  • Obsessive-compulsive disorder
• Mood-related disorders
  • Major depression
  • Bipolar depression
  • Dysthymia (chronic type of depression)
• Severe mental illness
  • Schizophrenia
  • Schizoaffective disorder 

NIDA reports that individuals diagnosed with anxiety or mood-related disorders are twice as likely to suffer from a substance use disorder. And the reverse is also true, those who are diagnosed with a drug or alcohol abuse issue are twice as likely to also have a mood or anxiety disorder. 

Other commonly linked conditions are related to alcoholism and co-occurring disorders such as bipolar disorder, antisocial personality disorder, schizophrenia, anxiety issues, and depressive disorders. There is also a link between depressive disorders and opioid use disorders (OUD). 

In many of these cases, it can be difficult to know if the substance issue caused the mental health issue or vice versa. Also, both conditions can exist simultaneously but one may remain hidden for some time. 

Anyone who has co-occurring disorders or a dual diagnosis faces even greater challenges in recovery. Not only can it be difficult to diagnose co-occurring disorders, treating both simultaneously—if not handled by experienced, professionals—can be tough. Often the symptoms of addiction hide the mental health issue and the mental health issues can be mistaken for symptoms of the substance abuse issue. 

That’s one reason why anyone with a co-occurring disorder seeks treatment at an addiction treatment center utilizing evidence-based treatment, compassionate, experienced staff, that understands the best treatment methods for dual diagnosis is essential to long term recovery. 

Understanding the Cause of Co-occurring Disorders

Many people who have a co-occurring disorder, as well as their loved ones, often want to know and understand which disorder came first or if one caused the other. The answers to this aren’t always straightforward and can be a challenge to uncover in many cases. Sometimes the mental health illness didn’t show any signs early on but progressed over time. In other situations, an individual’s memory about the first days of drug use and abuse may be foggy further complicating the uncovering of which came first. 

Despite the confusion in detecting if the substance use or mental illness came first, there are factors that are helpful to consider. 

• Certain substances that are abused can cause individuals to experience symptoms of a different mental illness. 
• Many times a person with a mental health issue uses alcohol or another substance to self medicate and ease or decrease the uncomfortable mental health symptoms.
• Main causes of both substance use issues and mental health issues often are overlapping. 

As mentioned some of the causes of both mental health issues and substance abuse issues are the same. There are both genetic and environmental components with both. Many people don’t understand why those people with alcohol or substance use disorders can’t or won’t stop using the drug or alcohol. They mistakenly believe that the individual lacks willpower or just doesn’t want to stop. In most cases, this is false. 

Both alcohol and drugs—when used over time—can alter the chemistry in the brain making it even harder to quit. This is why seeking treatment when you or your loved one is ready to get help is so crucial to recovery. 

The reasons one person becomes addicted to drugs or alcohol and another doesn’t involve many factors. Let’s take a look at some of the causes of both addiction and mental health issues. 

Heredity and Genetic Factors

Research shows that genetics accounts for 40-60% of a person’s predisposition for developing an addiction to alcohol or another substance. Genetics also has been found to play a role in other mental health issues like anxiety and depression. 

It’s no secret where and how a person grows up can significantly contribute to certain parts of their adult life. When it comes to mental health issues such as depression, anxiety, or mood disorders as well as addiction, the environment can weigh in on these too.

Environmental Factors

Lack of parental supervision—Those individuals who lack proper supervision and discipline at home have a higher risk of addiction. 

Drug Use of parents/guardians—If a person’s parents are substance or alcohol users themselves or engaged in criminal activity that individual is more likely to develop an addiction. 

Living in poverty—Growing up in poverty or in a poor neighborhood also increases the chances of an individual having an addiction later in life.

Peer pressure—Friends and peers influence whether or not an individual will use alcohol or a drug in adolescence. This is also a factor in the development of addiction.

Drugs/alcohol in the home or at school—When children are exposed to drugs or alcohol they are more likely to try it. 

Trauma

Adverse or difficult childhood experiences are associated with using drugs or alcohol at an earlier age and having problems with addiction later in life. 

Types of Trauma Associated with Addiction:

• Physical abuse
• Sexual abuse
• Separated or divorced parents
• Family member with an addiction, in prison or who has another mental health issue
• Neglect; physical or emotional
• Witnessing violence
• Verbal or emotional abuse

All of these factors, heredity, environment, and childhood trauma can be part of the cause of addiction as well as contribute to the development of other mental health issues. Finding a treatment center with a holistic approach that understands the complex interactions of co-occurring issues is important if you think you may have a dual diagnosis. At Futures, we are committed to treating the whole person which includes not just addiction behaviors but also co-occurring and underlying issues like depression, anxiety, mood disorders, eating disorders, and more. 

Signs of Alcohol or Substance Use Disorders 

Comorbidity with substance abuse and mental health issues can include any number of mental health issues. As mentioned, there are some mental health issues like depression, anxiety, and mood disorders that are more commonly associated with substance abuse however this is not an inclusive list by any means. If you think you have a mental health illness in addition to an alcohol or substance use disorder it is suggested that you do some preliminary research on the condition you suspect you have. When you are ready to seek treatment, be sure to go to a facility with experience in treating co-occurring disorders.

However, it’s also critical to determine if you have a substance use issue as well. If you suspect you may be struggling with an addiction, you most likely are and the sooner you get treatment the better it will be for you and your loved ones. 

10 Signs of Addiction to Alcohol or Drugs

1. Alcohol or substances are taken for longer than intended or in greater amounts.
2. Cutting down or stopping usage is unsuccessful. 
3. Time is spent trying to get the drug or in recovering from use of it. 
4. You experience cravings.
5. Using the substance causes issues in fulfilling responsibilities at home, work, school, etc. 
6. Relationships and social interactions are negatively impacted by use. 
7. Activities once important are given up as a result of using the substance. 
8. Use of the substance continues despite negative physical or psychological consequences. 
9. Experiencing withdrawal symptoms when not using the substance. 
10. Showing tolerance and needing to drink more or use more of the drug to get the same effect. 

According to the Substance Abuse and Mental Health Services Administration, if you have experienced two of the above symptoms in the last twelve months than you may have a dependency on alcohol or drugs. The more you have experienced and the more often you experience them determines—in part— the severity of the disorder or addiction.

Diagnosis of Co-occurring Disorders

No matter what type of issue a person has, substance abuse, alcohol addiction, depression, an eating disorder, anxiety, or more, it is crucial to obtain an accurate diagnosis at a treatment facility with experience and capabilities to treat the co-occurring issues.

Diagnosing a co-occurring disorder can be challenging, particularly for those clinicians who are not trained and accustomed to working with those with a dual diagnosis. The approach for both diagnosis and treatment must be comprehensive. Any individual who enters treatment for an alcohol or another substance abuse issue should be screened for a co-occurring mental health issue and vice versa. 

Since the diagnosis of co-occurring disorders can be complex it is important for treatment centers to not only thoroughly evaluate the patient at the beginning of treatment but also observe and look for any other mental health issues after a period of abstinence from the substance. 

Finding the Right Treatment: Key to Long-term Recovery

The most recent research into comorbidity suggests treating both alcohol or substance use disorder and mental health illness concurrently. It’s important to know that those who have co-occurring disorders can experience symptoms that are more tenacious, severe, and resistant to treatment than those who do not have a dual diagnosis. However, there are thousands of people with dual diagnoses who do recover and live in long-lasting recovery. 

In some cases, medication along with behavioral therapy is suggested for those with co-occurring disorders. Behavioral therapy is the foundation for recovery from substance and alcohol abuse with or without a co-occurring disorder. Research has shown the following therapies to show success in treating comorbidity: 

• Cognitive-behavioral therapy
• Dialectical behavioral therapy
• Integrated group therapy
• Family therapy
• Community support groups

Futures offers both evidence-based therapies and innovative treatment approaches for all of their patients. From their core inpatient program to their experiential and adventure-based program, Futures understands the complex disease of addiction and co-occurring disorders and offers multiple pathways to recovery to those who are ready for help. 

No matter what type of substance abuse issue you have, no matter if you have or don’t have a co-occurring mental health problem, there is hope and recovery is possible. If you are ready to get help or learn more contact Futures confidentially online or call us at 561-475-1804.