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Integrated Treatment for Co-Occurring Disorders

Many people are hesitant to check into rehab for their drug use or alcohol use disorder. They hear statistics about relapse and feel hopeless, like attending rehab won’t actually help them in the long run, and they’ll frequently return. In some cases, this “one step forward, two steps back” phenomena can be attributed to improper treatment.

While you are ultimately responsible for your own choices, including whether or not to use drugs, the quality of the rehabilitation you receive can have a significant impact on your ability to make the right choices. 

Many people with substance use disorders simultaneously experience mental health disorders. Treating both at the same time can lead to a better outcome for patients who want to live healthy, happy, sober lives. 

What Are Co-Occurring Disorders?

Co-occurring disorders, also referred to as “dual diagnosis,” means that someone is simultaneously experiencing a mental health disorder and a substance use disorder. Although these disorders are technically separate, they are often deeply embedded within each other. 

Substance Use Disorders

Substance use disorders are often referred to as alcoholism or drug addiction. Any dependence, physical or psychological, on a non-necessary substance can be classified as substance use disorder. 

While many illicit drugs and medications can be addictive, many people find that addictions to opioids, benzodiazepine drugs, and alcohol are among the most challenging to overcome.

Mental Health Disorders

Mental health disorders used to carry a heavy stigma, but modern research has changed the way most people regard mental health. Statistics show that many mental health disorders are more common than previously thought. One in five American adults will experience a mental health disorder in their lifetime, with anxiety disorders and depression being among the most prevalent. 

Any mental health disorder can occur in conjunction with a substance use disorder. It’s not only people with certain types of mental health disorders that have a desire to abuse substances. Substance abuse disorders can affect anyone, including those who would otherwise be regarded as mentally healthy. 

What is the Connection Between Mental Health and Substance Use Disorders?

Mental health and substance abuse disorders often work together to create a vicious cycle. People living with untreated mental health disorders often find day to day live to be distressing. They feel pervasive sadness, a heightened state of worry, paranoia, or lingering effects of past trauma that prevent them from participating in activities that typically bring others joy. 

Many people with mental health disorders are hesitant to get help. They might feel embarrassed or weak. They fear judgement, or have a difficult time with the vulnerability involved in discussing their feelings with a stranger. They attempt to stifle or ignore their feelings, and the outcome is never good.

People who do not get help in a timely manner may feel tempted to self medicate. They might find that when they drink alcohol, they no longer feel as anxious. Stimulant drugs may combat some of the lethargy that comes with depression, although the effect comes at a high financial and physical cost. 

Sometimes, the substance doesn’t necessarily counteract any of the symptoms of the mental health disorder. 

Instead, it provides an escape route that prevents people with mental health disorders from feeling isolated with their thoughts. They use drugs or alcohol as a way to run away from themselves, altering their consciousness until the things that formerly weighed heavily on them can no longer be identified. They’ll continue to run to these substances as a way to cope with their negative feelings. 

Some patients with mental health disorders will develop substance abuse disorders because they did seek proper treatment. This is common in people who take prescription medication for anxiety. The doctor will give them the prescription and the patient either does not know that these prescriptions were only designed for short term use, or fails to supplement them with therapy at their doctor’s request.

This substance use forms a dangerous dependency faster than most people realize. They begin to count on the substance to feel “normal”, as it alters their brain chemistry and may be physically addictive. The drug use disorder takes the place of mental health medications or therapy. 

In the end, the mental health concerns are never resolved and the new issue of a substance abuse disorder is thrown into the mix.

What Happens If These Disorders Are Treated Separately?

Anyone with a substance use disorder needs treatment for that disorder, whether or not it comes in conjunction with a mental health disorder. People addicted to substances like alcohol, opioids, or benzodiazepine drugs require medically assisted inpatient detoxification to safely remove the substance from their bodies and restore normal balances of vital natural chemicals. 

While this is a giant first step for people with co-occurring disorders, it is not the only first step. 

When the substance is removed from the system and the body begins to heal, the underlying source of the addition still has not been treated. The crutch has been removed, leaving the patient alone with the mental health disorder that inspired the substance abuse disorder in the first place. 

The drug is gone, but the problem is far from solved. Without treatment for the mental health disorder, these patients have no idea what to do next. They aren’t feeling any better. Their mood and mindset haven’t changed. They’ve simply lost their only coping mechanism, as unhealthy as it may have been.

Patients with untreated mental health disorders are more likely to turn back to substance abuse disorders because they have no idea what else to do. Those feelings aren’t going away, and they’ll look for relief wherever they can find it. That’s why patients with co-occurring disorders are so prone to relapse. They’ve only been partially helped.

How Does Integrated Treatment Reduce the Risk for Relapse?

Integrated treatment for co-occurring disorders treats the entire patient, rather than one aspect of a larger picture. It’s not simply removing the drugs and hoping for the best. It’s uncovering the root of the patient’s desire to use, exploring beneficial avenues for their mental health, and equipping them with healthy coping mechanisms. 

Many people with mental health disorders deal with low self-esteem. They don’t realize that they deserve to be happy and healthy. They don’t understand that they’re worth the time and the effort it takes to truly feel better. They cannot conceptualize that they are far from alone. 

Time and research have significantly decreased the stigma surrounding mental health. We understand how prevalent mental health disorders are, and that treating them is just as important as treating physical health disorders.

Some people with co-occurring disorders may, at least temporarily, require medication like antidepressants or non habit forming anti-anxiety medications to help them cope. Unique and innovative therapies can be used in conjunction with other treatments to empower people living with mental health disorders.

Group therapies, individual therapies, and exercises intended to be performed alone can help people living with certain mental health disorders change their mindsets. The ability to recognize, understand, and interpret their feelings can help them take a rational approach to the way that they handle those feelings. 

The end goal with integrated treatment for co-occurring disorders is to give patients better options and stronger coping skills. At the end of a successful course of treatment, patients will realize that drugs aren’t the answer to what ails them. Patients will be presented with healthy solutions and encouraged to follow those recommendations.

Many people with co-occuring conditions may remain lifelong therapy patients, with or without the assistance of psychiatric medications. Recovery is a state intended to be maintained forever, and staying sober may require a devoted effort to maintaining mental health.

The Takeaway

There is no substance use disorder treatment that can promise a zero percent rate of relapse. Drug use is a choice. If you exercise your free will and make the decision to use drugs, you can undo all of the progress you’ve made in understanding and overcoming your addiction.

People with co-occuring conditions may feel more inclined to make the choice to use drugs, simply because they do not see any alternatives to self medicating. That’s the issue that integrated treatment is designed to address. 

Each patient is more than just their substance use disorder. People with substance use disorders are real human beings with deep feelings, and some of them require more help than others to feel whole again. Every patient is worth that effort, whether or not they believe it. 

If you’ve seen limited success from drug or alcohol rehabilitation programs in the past, you may benefit from integrated treatment for co-occurring disorders. If you live with anxiety, depression, bipolar disorder, post traumatic stress disorder, or any other mental health disorder that causes you distress, you may benefit from integrated treatment significantly more than typical rehabilitation. 

Sources:

https://www.ncbi.nlm.nih.gov/books/NBK92254/

https://screening.mhanational.org/content/im-afraid-talk-anyone-about-my-mental-health

https://www.health.harvard.edu/addiction/addiction-to-prescription-drugs