The Disease of AddictionFirst and foremost, it is essential to recognize and acknowledge that drug addiction is a mental ailment. Alcohol and drug use can alter your brain’s function and structure. Changes transpire on some of the brain’s mutual areas impacted by other psychological disorders such as depression, anxiety, and even schizophrenia. Substance use disorder (SUD) or disease of addiction is categorized by compulsive and usually uncontrollable cravings. Despite the overwhelming consequences of alcohol or drug use, an addicted person may continue to search for addicted substances unless they receive professional help and treatment.
What Does ‘Comorbidity’ Mean?Comorbidity is one way to describe a person who has both a psychological disorder and addiction. Nevertheless, the term also has a broader meaning – comorbidity can be used to define any circumstance where two diseases or disorders occur in the same individual. While this word can be applied to mental illnesses and substance use disorder (SUD), it can also define somebody who has anxiety and Parkinson’s disease, for example. A person with comorbidity does not need to have both disorders simultaneously. Sometimes, one ailment can initiate once the other seems resolved. Comorbidity insinuates that there’s some form of connection between the two conditions affecting both, how they progress, and their treatment.
Is Dual Diagnosis the Same as Co-Occurring Disorders?The short answer is no. Dual diagnosis is a more general word for two or more conditions that ensue in one person at the same time, whether psychological or physical. The presence of diabetes and heart disease could be considered a dual diagnosis. However, today, dual diagnosis treatment is most often used to define how people who have both, addiction and psychological illness, are treated. On the other hand, co-occurring disorders define a variety of diseases that usually occur along with substance use disorder (SUD). This term is almost exclusively used to refer to somebody who has a psychological disorder that contributes to or is a result of, alcohol or drug addiction. Nonetheless, an addicted person’s co-occurring disorder can also be cancer, HIV, hepatitis C or another disease.
What is a Co-Occurring Disorder?In 2019, 9.5 million U.S adults between the ages of eighteen to twenty-five were diagnosed with at least one co-occurring disorder together with a substance use disorder (SUD). Amid this population, only 742,000 individuals (7.8%) acquired treatment for both, mental health disorder and substance use disorder simultaneously. A co-occurring disorder refers to a person who has two or more psychological health disorders or medical illnesses. These co-occurring ailments may overlap and commence at the same time, or one may appear before or after the other. Moreover, there’s a strong relation between SUDs and other psychological health disorders. In fact, about half of the individuals with one disorder will eventually cultivate at least one more co-occurring psychological health condition in their lifetime. Additionally, co-occurring disorders can also aggravate each other’s level of severity.
Common Examples of Co-Occurring DisordersWhile there are many exclusive examples to list – any single substance addiction related to any individual psychological health condition – a few of the most common forms of co-occurring disorders include:
- Opioid addiction with PTSD
- Polydrug addiction with schizophrenia
- Cocaine addiction & panic/anxiety disorders
Why Are Co-Occurring Disorders So Prevalent?Researchers have identified three possible mechanisms that might illuminate why co-occurring disorders are so rampant:
1. Self-medicating –Psychological conditions or ailments can lead to substance use disorder as a means of coping with symptoms. This notion is casually termed “self-medicating.” However, this title may be misleading because although substance use can cover symptoms of some mental health conditions, at the same time, they also exacerbate symptoms in both the long and short term.
2. Overlapping risk factors –Common risk factors for substance use disorders and other psychological health conditions usually overlap. These may involve genetics as well as environmental factors, e.g., exposure to trauma, that can make an individual more likely to develop these problems.
3. Drug-induced brain changes –The use of drugs and alcohol can lead to changes in areas of the brain disrupted by psychological health disorders, which in turn, can increase somebody’s likelihood of budding symptoms of a psychological disorder that affects the brain. The parts of the brain affected by substance abuse disorders seem to be linked with parts associated with mood, impulse control, anxiety disorders, and even schizophrenia. For decades, scientists have studied the frequency of co-occurring disorders, and they have recognized that some psychological health disorders are related to substance use disorders more often than others. Psychological conditions that are most likely to occur alongside SUDs involve, but are not limited to:
- Mood disorders – About twenty percent of the general population with a substance use disorder also has one or more mood disorders, such as depression or bipolar disorder.
- Post-traumatic stress disorder (PTSD) – According to a national survey, individuals with post-traumatic stress disorder were, compared to those without it, as much as four times more likely to fulfill the criteria for a substance use disorder.
- Anxiety disorders – Approximately eighteen percent of the general population also has some form of co-occurring anxiety disorder. For example, marijuana use has a particularly strong connection with social anxiety disorder. Moreover, social anxiety disorder, panic disorder, and generalized anxiety disorder are all connected with an increased risk of co-occurring disorders.
- Personality disorders – Almost ten to fifteen percent of the general population has a personality disorder, paralleled to a prevalence rate of thirty-five to seventy-three percent in people treated for addiction. Personality disorders like borderline, paranoid, antisocial, and avoidant are some of the most commonly found disorders in people with SUD.
- Attention-deficit/hyperactivity disorder (ADHD) – ADHD is linked with an earlier onset age of substance use and a greater likelihood of usage of a variety of addicting substances. It is reported that the diagnosis of attention deficit and hyperactivity disorder poses a higher risk of SUD in adulthood. Among people with ADHD, the amount of inattention, hyperactivity, and impulsivity indicators displayed is positively concurrent with the risk of substance use.
Symptoms of Co-Occurring DisordersIt is not easy to distinguish the difference between mental illness and addiction at times, considering there can be several overlapping symptoms between them. Therefore, to avoid confusion and be sure, a psychological health diagnosis should be performed while the individual is abstinent, and there isn’t any form of the drug in their system. While every psychological disorder has varying symptoms, nonetheless, there are some general signs and signals that point to the possibility of a particular mental disorder. Some of those symptoms and signs involve:
- Dropping activities or hobbies that were once important.
- Changes in sleeping and eating habits.
- Feeling afraid often without cause.
- Experiencing extreme emotional lows and/or highs.
- Having difficulty focusing or thinking clearly.
- Increased irritability.
- Isolation from family and friends.
- Lack of attention to personal hygiene.
- Inability to see these changes in one’s personality or behavior.
- Increased or decreased libido.
- Suffering from physical ailments without any cause.
- Suicidal thoughts or suicide attempts.
- Loss of touch with reality, such as paranoia, delusion, or hallucinations.
- Participating in risky behaviors such as promiscuousness or substance use.
- Facing withdrawal when substance use is halted.
- Inability or difficulty to stop consuming drugs even when they want to.
- Having difficulty coping or functioning with stress without drugs or alcohol.
- Frequently absent from or tardy at school or work.
- Having trouble completing tasks at school, home, or work due to substance use.
- Isolating from friends and family or spending time with unusual or different friends.
- Participating in risky behaviors, for e.g., driving under the influence.
- Inability to stop using even after it has worsened or caused harm to a mental or physical health condition or interpersonal relationships.
- Spending a lot of time using, getting, or recovering from the effects of a used substance.
- Increased tolerance or the inability to get intoxicated even after ingesting huge amounts of a substance.
IOT Program for Mental Health DisordersSeveral people depend on individual therapy for medical support, but there are times when they need additional support, which cannot be provided by individual therapy sessions. Those who are battling mental health disorders are in need of more comprehensive psychological health services such as those within an intensive outpatient treatment.
What Is Intensive Outpatient Treatment (IOT)?Intensive outpatient treatment takes place in a structured therapeutic setting with a group that typically meets three to five times a week for around three to four hours every day. The treatment program usually runs for five to eight weeks. Intensive outpatient treatment might be a suitable treatment option for people in various situations, including those on leave from school or work and those requiring more support than weekly counseling. In addition to this, IOT is usually the next step for patients who’ve received inpatient care or have undergone a fractional hospitalization program for their psychological health disorder. It also serves as a preventative measure before an individual pursues inpatient treatment. Intensive outpatient treatment therapy treats a variety of psychological disorders, including:
- Bipolar disorder
- Suicidal or homicidal thoughts
- Mood disorders
- Panic attacks and panic disorder
- Post-traumatic stress disorder (PTSD)
- Personality disorders
Intensive Outpatient Treatment (IOT) MethodsThe core intensive outpatient treatment method encompasses group therapy sessions— family and individual counseling sessions can be planned on an as-needed basis. Chicago Rehab Center uses a variety of therapies, such as:
- Dialectical Behavior Therapy (DBT)
- Cognitive Behavioral Therapy (CBT)
- Group Processing
- Motivational Interviewing
- Skill-building exercises
Intensive Outpatient Treatment (IOT) OutcomesThe goal of intensive outpatient treatment (IOT) is to help you manage your psychological condition or disorder more effectively. People in the program are typically struggling in their day-to-day lives and require intensive support. With the completion of IOT, you can anticipate the following treatment outcomes:
- Positive coping skills
- Ability to control impulses and regulate emotions
- Problem-solving skills
- Improved self-esteem and self-awareness
- Recognizing unhealthy behaviors
- Practicing asking for and receiving support
Intensive Outpatient Treatment (IOT) Chicago at CRC InstituteOur intensive outpatient treatment program in Chicago at CRC Institute offers a thorough program that provides therapy to people struggling to function on a regular basis and people who are in crises. Our therapy groups are designed in such a way that each individual receives adequate attention. Whether you call it dual diagnosis, comorbidity, or a co-occurring disorder, proper diagnosis and treatment are vital to offer you the best chance of recovery. It can be challenging to untangle many of the interrelating signs and symptoms of alcohol or drug abuse and certain psychological disorders to make sure appropriate support and care are provided. That is why you need the help of substance use disorder and co-occurring disorder specialists who understand the nuances of IOT and dual diagnosis treatment. At Chicago Rehab Center, we specialize in evidence-based intensive outpatient treatment (IOT) to make sure you receive the highest quality of care. If you feel that your psychological health condition has added to a substance abuse disorder or vice versa, we are here to help. Contact us today to learn more about dual diagnosis treatment and care.
Reviewed by Dr. Beth Dunlap
Dr. Beth Dunlap, a board-certified addiction medicine and family medicine physician, is the medical director at CRC Institute, where she is responsible for overseeing all the integrated medical services at the Institute. Beth completed medical school, residency, and fellowship at Northwestern University, where she continues to serve on the faculty as a member of the Department of Family and Community Medicine. She has extensive experience in addiction medicine at all levels of care, and her clinical interests include integrated primary care and addiction medicine, harm reduction, and medication-assisted treatment.