Co-occurring disorders – aka COD, or general pathology, and often also described as dual diagnosis (see below) – is the term used to describe the condition of suffering from an addiction and mental illness simultaneously. The addiction – which is typical to a substance abuse, but may also be behavioural – may begin independently, or as a result, of the mental health issue. Diagnosis – of both the addiction and the mental disorder – is rendered more complicated by the occurrence of symptoms which may result from one or the other of the two (or more) disorders in question; similarly, treatment of either issue is made significantly more difficult by the problems created by both. People suffering from co-occurring disorders are more likely to relapse and to struggle with other issues including homelessness and diseases related to risky behaviour including HIV and hepatitis C.
Substance use disorder (SUD) – also often described as a drug use disorder (DUD) – technically refers to the use of one or a variety of substances which cause damage to the user, but is most often used to describe the condition of addiction to and dependence on a substance of abuse. Individuals with substance use disorder will continue to consume the substance or substances in question despite the manifestation of detrimental effects upon their lives; this can include the destruction of important relationships, financial ruin, and/or physical harm potentially extending to death.
Mental health disorders – most commonly known as mental illness, or occasionally as psychiatric disorders – are behavioural or psychological activities that impair normal functioning in an individual, and/or cause significant distress to the sufferer. There are a great many defined mental health disorders, with an array of causes, and with effects varying from extremely minor to completely incapacitating. Some of the most common mental health disorders which occur alongside addiction include depression, paranoia, and psychosis – though any can contribute towards the development of an addiction, and similarly can be exacerbated – or in many cases brought on – by substance abuse.
In the terminology of addiction and substance abuse, “dual diagnosis” and “co-occurring disorders” are often used interchangeably. Technically speaking, however, dual diagnosis refers simply to the manifestation of two or more health conditions in the same person at the same time – so, for example, someone suffering from both hepatitis and congestive pulmonary disorder could be described as having a dual diagnosis. The phrase “co-occurring disorders”, however, tends to be used much more strictly to refer to the simultaneous occurrence of a mental health disorder and a substance abuse disorder in the same person.
It is possible that an individual addict may suffer from a separate disorder – mental or physical – entirely independently of their addiction; unfortunately, it is also possible that the addiction can be caused by, and/or cause, a vast array of other conditions. The medical profession uses the term “co-occurring disorders” to describe any of those eventualities, as long as a substance abuse disorder is present in the patient in question.
The approach to treatment of co-occurring disorders will vary significantly from one patient to another – as always, each individual case is unique and there is no hard and fast “one size fits all” treatment, and just as the symptoms and effects of the abuse of one substance will differ from that of another, so will the manifestations of and required treatment for any given mental health disorder. For various reasons – including the difficulty of diagnosing each condition separately when the symptoms they may produce can overlap, the challenges related to getting a precise picture from an addict, and the restrictions on services available to admitted substance users – many people suffering from co-occurring disorders will not get the right treatment for both conditions simultaneously.
Many health professionals, and many rehab facilities, now attempt to treat both conditions of a dual diagnosis simultaneously as a way of making extremely complicated treatment as simple as possible. In a good proportion of cases, it is possible to decide whether or not one condition has caused another – and in these cases treating that primary condition typically has positive benefits for the treatment of the secondary condition. In other cases, unfortunately, where no initial cause can be determined, medical professionals must approach each condition individually – which can be significantly more challenging for a variety of reasons, including complications relating to individual medicines (which may alleviate one condition whilst exacerbating the other) and to the need to find appropriate therapy models beneficial for both conditions.
Regardless of the specific relationship between the conditions in question, treatment for co-occurring disorders invariably begins with a detoxification period during which the system of the addict can be cleansed of substances of abuse. Obviously if the substance in question is being used as treatment of the mental health disorder this complicates both that treatment and the detox process and in this instance the medical team involved will need to use their judgement on how to find the right balance between overcoming the substance abuse disorder and not exacerbating the mental health issue.
If you think you have a co-occurring disorder, then Primrose Lodge can offer you the effective rehab treatment you need to combat both issues. Our clinical team of highly-skilled therapeutic and medical staff specialise in the diagnosis and treatment of this condition, and can successfully treat patients who are suffering from both an addiction and mental health disorder.
Integrated treatment is the process of coordinating treatment for each co-occurring disorder in a dual diagnosis without creating a division between the treatment for the mental health issue and that provided for the substance abuse disorder: the treatment process is considered holistically with every disorder considered to be a part of the overall problem. Typically, treating one or the other disorder separately without paying attention to the companion disorder leads to failure on both counts, whereas treating both conditions together in one combined process, addressing where possible the causes of addiction as well as the factors contributing to the mental health disorder, is significantly more likely to have long-term positive results in terms of abstinence from substances of abuse as well as an improvement in mental health. Of course, many people suffer from mental health issues which can never be wholly remedied – however, with integrated treatment delivered professionally and at a high quality, the substance abuse disorder, at least, can be fully addressed whilst the worst impacts of the co-occurring mental health issue can be ameliorated.