Dual Diagnosis Treatment Centers For Co-Occurring Disorders

Last Updated: July 2, 2021

A link between substance use disorders and mental health problems is well established. There are millions of people in whom these two conditions co-occur. A dual diagnosis treatment facility specializes in helping people who are using addictive substances and have also been diagnosed with comorbid mental illness. Care providers at top-rated dual diagnosis treatment centers have expertise in addiction rehab for a variety of substances as well as concomitant therapy of a range of mental health conditions. What are the therapy models applied at these rehab centers? How can dual diagnosis treatment programs benefit an addict?

What is Dual Diagnosis Treatment?

The presence of co-occurring mental illnesses makes a recovery from substance abuse very challenging. Successful rehab for these comorbid conditions involves specialized care from professionals who can provide integrated treatment to the individual as a whole. All addiction counselors are not trained to diagnose mental disorders accurately. Care providers at holistic dual diagnosis treatment centers understand the complex interactions between the symptoms of mental illness and the triggers for substance abuse. Rehab at dual diagnosis facilities includes prescriptions of appropriate psychiatric medications to stabilize the client and control their psychological symptoms, making them more receptive to addiction treatment.

This high level of individualized care and support during inpatient rehabilitation allows many people with severe mental disorders, who would otherwise be too unstable for addiction rehab, to participate in substance abuse therapy. Dual diagnosis inpatient treatment is often a mentally ill person’s only chance at successful recovery from substance abuse.

How is Mental Health Linked to Addiction?

The National Institute on Drug Abuse (NIDA) reports that almost half the people who have a mental illness during their lifetime also battle addiction at some point. Although experts acknowledge the connection between addictive behaviors and mental health, the exact mechanism by which one affects the other is less clearly understood. In many patients, it is impossible to know the exact cause-and-effect relationship between substance abuse and psychiatric problems. Dual diagnosis group therapy activities and individual counseling can help establish whether the use of illicit substances is causing mental health problems or vice versa.

man with mental illness and addiction

In some individuals, pre-existing psychological issues drive the person towards drugs and alcohol as a coping mechanism. In others, excessive alcohol use or illicit drug abuse causes changes in brain chemistry and consequent psychoses.

It takes the expertise of a dual diagnosis psychiatrist and holistic rehab to sift through the sometimes conflicting and complicated signs and symptoms and develop a customized rehab plan for a mentally ill person with substance use disorder.

How to Recognize a Dual Diagnosis Disorder?

Many of the signs of substance abuse overlap with the physical, behavioral, and emotional symptoms of mental health disorders. This makes it difficult for family and friends to know what’s going on. The identification of co-occurring disorders and treatment of dual diagnosis patients is a highly specialized medical field.

For example, feelings of sadness, inability to concentrate, excessive worrying, mood swings, and withdrawal from family and friends can be caused by mental illness as well as substance abuse. It is often impossible to tell whether tiredness, lethargy, sleep problems, and hallucinations are related to a psychological cause or drug abuse. A change in eating habits, weight loss, and looking pale and undernourished may be attributed to eating disorders and can also be physical signs of addiction. This makes treating dual diagnosis an especially challenging task.

What Conditions are Treated at Dual Diagnosis Centers?

Some of the most common comorbid disorders treated at outpatient and inpatient dual diagnosis treatment centers include:

  • Anxiety and depression
  • Panic disorder
  • Dysphoria and mood disorders
  • Phobias (irrational fears)
  • Attention deficit hyperactivity disorder (ADHD)
  • Post-traumatic stress disorder (PTSD)
  • Obsessive-compulsive disorder (OCD)
  • Personality disorders (antisocial, narcissistic, anxious, schizoid)
  • Eating disorders (anorexia nervosa, bulimia nervosa)

Family, friends, and even healthcare providers sometimes fail to recognize and treat these psychiatric conditions, leading to a failure of substance abuse treatment. Integrated dual diagnosis treatment is necessary for successful long-term recovery from addiction.

Why Self-Medicating With Drugs and Alcohol Does Not Work

The Substance Abuse and Mental Health Services Administration (SAMHSA) estimates that approximately 9 million Americans have co-occurring mental illness and substance use disorder that requires specialized care from trained professionals. Each of these individuals needs a customized dual diagnosis treatment plan to appropriately address all the mental health conditions and increase the chances of long-term recovery.

The potential risks of self-medicating for with drugs and alcohol for mental health issues include:

  • Incorrect diagnosis of mental illnesses
  • Delayed medical attention
  • Severe adverse effects from drug or alcohol use
  • Risk of dependence
  • Risk of overdose and death

depressed woman drinking alcohol

Sometimes people turn to self-medication due to lack of funds. However, self-medication practices are ineffective and dangerous. There are many affordable dual diagnosis treatment centers nationwide where help is available. Finding a free drug rehabilitation center may take some time and effort, but the results will be worth it.

What is the Treatment Approach at a Dual Diagnosis Program?

Co-occurring mental health and substance abuse problems exacerbate each other. It is often impossible to separate one from the other. The concept that a psychological condition such as depression cannot be treated if a person is drinking excessively is an outdated one. Experts agree that untreated psychiatric conditions are a common reason for drug and alcohol abuse relapse. This makes it imperative for mentally ill people with substance use disorder to receive care for both disorders simultaneously through medication management, counseling, and dual diagnosis meetings.

The treatment plan for dual diagnosis mental health and substance abuse is highly individualized, and no two people receive the same rehab. A practical integrated approach involves the following general steps:

  • Identification and treatment of psychological disorders that may be contributing to substance abuse.
  • Stabilization of the client’s mental health to ensure maximum chances of success with addiction treatment.
  • Tailoring of medications for psychological dysfunction to ensure they do not reduce motivation to succeed with substance abuse rehab.
  • Detoxification at an inpatient dual diagnosis treatment center to clear the illicit substance from the client’s body, with a gradual taper and medications to manage withdrawal symptoms.
  • Supportive care with exercise and nutrition to improve overall health.
  • Outpatient or inpatient psychotherapy, including modalities such as cognitive-behavioral therapy (CBT), dual diagnosis worksheets, and individual and group counseling to change patterns of thinking and teach coping strategies.
  • Introduction to dual diagnosis support groups to share frustrations, seek help, and celebrate successes.
  • Aftercare and relapse prevention strategies to ensure a long-lasting recovery.

An integrated approach to drug rehabilitation and psychological disorders is necessary to break the vicious cycle and put a stop to the interplay between addiction and mental illness.

In such instances, addiction rehab experts at long term dual diagnosis treatment facilities are trained to modify the program according to the client’s needs.

Advantages of the Dual Diagnosis Treatment Model

A dual diagnosis substance abuse approach takes into account the psychological factors that can affect a person’s struggle with addiction. By treating the underlying mental health disorders, the program at a dual diagnosis treatment center makes it easier for the person to tackle their addiction and maximizes their chances of success. Studies show that these integrated programs are effective in treating mood disorders such as anxiety and depressing, as well as co-occurring cocaine and opioid abuse by up to 95 percent. Special programs developed to address the needs of people with comorbid mental illness and substance abuse have been found to increase abstinence from drugs and alcohol, improve compliance with psychiatric medications, and result in overall improved coping skills and quality of life. Some of the benefits of outpatient and inpatient dual diagnosis rehab models include:

  • Receiving treatment for the root cause of substance abuse, i.e., any or all psychiatric conditions that may have led to addiction in the first place.
  • Learning to recognize and control potential triggers to prevent relapse.
  • Participating in dual diagnosis group therapy and counseling to aid recovery.
  • Developing plans for the future to remain clean.
  • Receiving holistic rehab for the mind and body for the best chance of success.

female patient talking to a doctor

It’s important to remember that there is no quick fix for substance abuse. Combine it with mental health issues, and therapy can take even longer. In general, long term dual diagnosis treatment centers offer programs ranging from 1 to 3 months. Follow-up aftercare may continue for several months after formal therapy is completed.

Finding Treatment for Dual Diagnosis

No two addicted individuals with psychological problems are the same. Some people struggling with severe mental health issues and addiction require dual diagnosis residential treatment to get clean, while others can benefit from an outpatient program. The final choice will depend on various factors, such as:

  • The substance of abuse (for example, some facilities specialize only in opioid addiction).
  • The duration and frequency of abuse (this could determine whether a person needs inpatient or outpatient care).
  • The type and severity of mental health conditions (some centers may have staff that is experienced in treating certain illnesses, for example, eating disorders or PTSD).
  • The person seeking rehab (some facilities are only for women, while others specialize in teen drug rehabilitation).
  • The cost of the treatment (private drug rehab can be expensive, and an individual may need to seek out low-cost or free dual diagnosis treatment centers.

To choose the best rehab for dual diagnosis, it’s a good idea to compare top dual diagnosis treatment centers in the local area and see which one meets the unique needs of an addicted person.

Best Dual Diagnosis Treatment Centers in the US

Here is a list of 5 of the best outpatient and inpatient dual diagnosis treatment facilities in the country:

Beachway Therapy Center in West Palm Beach, Florida: One of the nation’s best-known residential dual diagnosis treatment centers, this facility offers customized multimodal therapies away from the toxic environment of daily life.

Hickory House in Greenfield, Indiana: With physicians on the staff that treat addiction complicated by co-occurring mental illness, this private drug rehab for adults offers discreet, safe, and comfortable care through innovative and creative treatment approaches.

Covenant Hills in Orange County, California: Counted among the leading Christian dual diagnosis treatment centers in America, this program offers structured treatment models based on the client’s specific medical and spiritual needs.

The Oaks Treatment Center in La Paloma, Tennessee: Situated on a beautiful campus, this facility offers the full gamut of addiction treatment services, including a dual diagnosis rehab program and a unique music therapy program.

Safe Harbor Treatment Center in Costa Mesa, California: This long term residential treatment dual diagnosis facility offers concurrent therapy for mental disorders and alcohol or drug addiction for women through a variety of treatment approaches.

Those suffering from substance use disorder and mental illness should not lose heart. With specialized care at a dual diagnosis rehab, they can overcome their addiction, gain a handle on their psychological problems, and go on to lead a fulfilling life free of drugs.


Page Sources

  1. Common Comorbidities with Substance Use Disorders. Part 1: The Connection Between Substance Use Disorders and Mental Illness. National Institute on Drug Abuse. https://www.drugabuse.gov/publications/research-reports/common-comorbidities-substance-use-disorders/part-1-connection-between-substance-use-disorders-mental-illness
  2. Key Substance Use and Mental Health Indicators in the United States: Results from the 2018 National Survey on Drug Use and Health. SAMHSA. https://www.samhsa.gov/data/sites/default/files/cbhsq-reports/NSDUHNationalFindingsReport2018/NSDUHNationalFindingsReport2018.pdf
  3. Stephen J Schoenthaler, Kenneth Blum, Lyle Fried, Marlene Oscar-Berman, John Giordano, Edward J. Modestino, Rajendra Badgaiyan. The effects of residential dual diagnosis treatment on alcohol abuse. J Syst Integr Neurosci. 2017 Jul; 3(4). https://www.ncbi.nlm.nih.gov/pmc/articles/PMC5576155/
  4. Stephen Magura, Andrew Rosenblum, Cherie L. Villano, Howard S. Vogel, Chunki Fong, Thomas Betzler. Dual-Focus Mutual Aid for Co-occurring Disorders: A Quasi-Experimental Outcome Evaluation Study. Am J Drug Alcohol Abuse. 2008; 34(1): 61–74. https://www.ncbi.nlm.nih.gov/pmc/articles/PMC3525112/

Published on: August 31st, 2016

Updated on: July 2nd, 2021

About Author

Juliette Siegfried, MPH

Juliette has been working in the health communications field since 1991, when she began working at the National Cancer Institute of the National Institutes of Health in Bethesda, Maryland. Her initial campaigns focused on smoking cessation and cancer prevention. Juliette later moved to the corporate side of health communications, including working at Kaiser Permanente, where she designed interactive computer-based training for health education.