Treating Co-Occurring Disorders in Addiction Recovery

Content reviewed by Karen Rubenstein, LMFT

Co-occurring disorders are when a substance use disorder (SUD) and mental health disorders occur simultaneously. There is a high prevalence of co-occurring conditions for several reasons, one being that many mental health conditions and SUD share similar causes and risk factors. Effective recovery from co-occurring disorders requires addressing and treating both conditions at the same time. To overcome the challenges of co-occurring disorders, treatment must aim to heal the root cause(s) of both conditions.

Prevalence of Co-Occurring Disorders

The Substance Abuse and Mental Health Services Administration’s (SAMHSA) 2018 National Survey on Drug Use and Health found that, “Approximately 9.2 million adults in the United States have a co-occurring disorder.” Further, the National Institute on Drug Abuse (NIDA) explains that over 60% of individuals who seek treatment for SUD also meet the criteria for another mental health disorder.

Why Do SUD and Mental Health Disorders Often Co-Occur?

Several factors contribute to the high prevalence of co-occurring disorders in the United States. First, as SUD is considered a mental health disorder, this condition shares similar underlying risk factors with other mental health disorders. For example, in addition to genetic risk factors, one significant risk factor that can make individuals more susceptible to developing either SUD or another mental health condition is exposure to trauma. Unresolved childhood trauma and trauma during adulthood can change the brain. These changes can make an individual more vulnerable to using substances or struggling with their mental health.

Another reason why these conditions often co-occur is that individuals who struggle with mental health disorders are more likely to self-medicate. Self-medicating with drugs or alcohol can quickly lead to the development of addiction. Finally, substance use can cause long-lasting changes in the brain that may contribute to the development of mental health disorders.

The Challenges of Treating Co-Occurring Disorders

Treatment for co-occurring disorders has come a long way in the last several years. However, there are still several challenges involved when treating co-occurring disorders. The following are just a few examples.

Self-Medicating Practices

One of the most significant challenges involved with treating co-occurring disorders is self-medicating. Many individuals believe that their substance use may actually be benefiting their mental health. For example, an individual who struggles with symptoms of mania may use marijuana to help mellow their mood. Those who struggle with anxiety may use “liquid courage” to make them feel more comfortable in certain situations. Unfortunately, self-medicating practices do not help individuals overcome the underlying psychological issues that may have contributed to their mental health.

If an individual seeks mental health treatment without acknowledging their underlying substance use problem, they are less likely to achieve recovery. However, if an individual is open to understanding how their self-medicating practices have developed into SUD, they are at an advantage. Effective treatment must address all underlying issues to mediate their motivation to self-medicate.

Increased Risk of Relapse

Another challenge involved with treating co-occurring disorders is an increased risk of relapse. Treatment must address all underlying psychological issues, such as intrusive thoughts, problematic substance use patterns, mental health disorders and unresolved trauma, to name a few. Without treating all underlying issues, these issues will continue to perpetuate repeated substance use and/or distressing mental health symptoms.

Another reason why the relapse may be increased due to co-occurring disorders is that when individuals begin to engage in introspection during treatment, they may feel as if they will regain control over their substance use. They may believe that they are no longer using substances to self-medicate but choosing to partake in alcohol or drugs. However, consciously choosing to engage in substance use is still considered a relapse and must be taken seriously. Remember that recovery is a lifelong journey.

The Value of Integrated Treatment for Co-Occurring Disorders

Individuals who seek treatment for SUD should be screened for additional mental health disorders and vice versa. This is because treatment will be significantly less effective unless all conditions are treated together. The process of treating both SUD and co-occurring mental health disorders is known as integrated treatment.

Integrated treatment relies on collaborative care. With integrated treatment, facilities utilize both mental health and substance use interventions together. They do this by bringing together multiple providers and/or healthcare professionals to treat all physical and emotional aspects of each condition. SAMHSA explains that integrated treatment can improve treatment outcomes as well as the quality of life for individuals who struggle with co-occurring disorders. Additional benefits of integrated treatment include:

  • Reduced or discontinued substance use
  • Improvement in psychiatric symptoms and functioning
  • Increased chance for successful treatment and recovery for both disorders
  • Improved quality of life
  • Decreased hospitalization
  • Reduced medication interactions
  • Increased housing stability
  • Fewer arrests

It is vital to understand that every treatment facility will navigate treatment for co-occurring disorders differently. Even when facilities specialize in co-occurring disorder treatment, they may not necessarily utilize an integrated treatment approach. Typically, treatment centers that use both an integrated and holistic approach ensure that individuals can effectively heal from their co-occurring disorders as well as the underlying emotional and psychological issues that contributed to them.

Casa Palmera is a mental health and addiction treatment facility that recognizes the challenges involved with treating co-occurring disorders. We utilize a combination of integrated, holistic and individualized treatment approaches to ensure that our patients have the best chance of recovering from their co-occurring conditions. To learn more about our program options, contact us today.


This blog is for informational purposes only and should not be a substitute for medical advice. We understand that everyone’s situation is unique, and this content is to provide an overall understanding of substance use disorders. These disorders are very complex, and this post does not take into account the unique circumstances for every individual. For specific questions about your health needs or that of a loved one, seek the help of a healthcare professional.