Over 25 years ago a study about alcoholism drew attention to a budding literature describing a relationship between substance use disorders and mental health issues among substance abuse patients.
Despite those findings, the effort to create an effective response and method to treat mental health issues is a more contemporary concern of substance abuse treatment.
Many times, when someone is suffering from alcohol or substance use, they are also suffering from another mental health disorder, which is referred to as a co-occurring disorder.
The mental health disorder could be the reason some people use alcohol, or it could be a side effect of the alcohol use. Either way, the best way to treat alcoholism and co-occurring disorders is simultaneously.
Co-occurring disorders, also known as dual-diagnosis, is what is used to refer to one person having two disorders at the same time, a substance use disorder and a mental health disorder. Substance use disorders include alcohol or drug abuse, or, alcohol or drug dependence.
Individuals with substance use issues are particularly at risk for developing chronic diseases or primary conditions. The coexistence of both a substance use disorder and a mental health issue, likewise referred to as a co-occurring disorder, is quite common among patients in medication-assisted treatment (MAT).
Patients with mental illness are shown to be more likely to suffer a substance use disorder compared to those who are not affected by a mental condition. As per SAMHSA’s 2018 National Survey on Drug Use and Health, an estimated 9.2 million adults in the US alone suffer from a co-occurring disorder
It is also worth noting that combining drugs used in MAT with anti-anxiety medications, like Xanax and Valium, can have adverse effects on the patient.
Substance use disorder can be broken into two different diagnoses:
There are multiple different types of mental health disorders. The most common for people who have substance dependency are mood related or anxiety related disorders. For people with substance use disorder, there is a higher percentage of people who also have severe mental illness.
Severe mental illnesses are described as ‘severe’ due to the length and intensity of episodes they experience. The two most common severe mental illnesses with substance disorders are schizophrenia and schizoaffective disorder.
Both have also been labeled as ‘thought disorders’ since they have symptoms such as hallucinations and delusions, where they either see or hear things that are not there.
The more common disorders for people with substance use (particularly alcohol use) disorders are:
Depression is a mood disorder that affects someone’s thoughts, feelings, and actions. It is probably the most common mental health disorder in the United States and affects people of all backgrounds, ages, or gender.
Depression consists of symptoms such as:
When someone stops drinking alcohol immediately, going ‘cold turkey’, it can be very dangerous due to intense withdrawal symptoms. This can increase symptoms of depression, leading to an increased risk of self-harm, or even suicide.
Symptoms of schizophrenia include:
There was a study that found that at least 1/3 of people with schizophrenia abuse alcohol, possibly even more. Interestingly, it has been observed the drinking often begins before the schizophrenia does. This is possibly because drinking begins as self-medication when people first begin experiencing a few small hallucinations, before full-blown schizophrenia.
Panic Disorder and Anxiety Disorder
Obsessive-Compulsive Disorder (OCD)
A lot of people who suffer from an anxiety disorder also have alcoholism and co-occurring disorders, which could make their symptoms a lot worse and their recovery harder. As with all disorders, it is essential to find proper treatment.
Treatment for alcoholism and co-occurring disorders, aka dual-diagnosis, is best approached by treating the two disorders at the same time. Many providers have programs that understand that alcoholism, and any co-occurring disorder, often need two separate approaches.
It also requires individualized care to best guide the patient’s successful recovery. Treatment can take place at both long or short-term treatment centers. When someone first seeks treatment, it is best to withdrawal from alcohol in an inpatient setting due to the physical harm and risk from alcohol withdrawal.
Treatment programs for people who abuse alcohol and have co-occurring disorders are very different from treatment programs for people who just abuse alcohol.
The patient will be a part of more than one program during treatment at an inpatient facility to address both disorders, which means multiple professionals will be working with them as a care team. This includes therapists, doctors, nurses, case managers, and more, all focused and working together for the patient’s best interests.
The treatments include two different approaches used at the same time for each disorder, with a team of care providers. These approaches can include different therapies such as cognitive behavioral therapy, motivational therapy, marital and family therapy and more.
Medicated assisted treatment is also available and a few approved medications to assist with alcohol use disorder are disulfiram, naltrexone, acamprosate. All treatment providers for co-occurring disorders offer some form of support groups, as well as information for outside AA (or other) meetings if they are preferred. Many also hold official AA meetings at their facility.
If you or a loved one are suffering from alcohol use, drug use, and/or mental health conditions, it is very important to reach out for help.
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