9 Treatment Options for Concurrent Disorders

Concurrent disorder is a term that refers to co-occurring substance use and mental health problems. It covers various combinations of problems, such as an eating disorder and an alcohol problem, schizophrenia and cannabis dependence, borderline personality disorder and nicotine dependence, and depression with opioid use disorder.

Other terms used to describe these issues are dual disorders, dual diagnosis, and co-occurring substance use and mental health problems. However, in Ontario, dual diagnosis is often used to describe when a person has both an intellectual or learning disability and a mental health problem.

These problems can co-occur in various ways. They may be active at the same time, or one can trigger the development of the other, and vice versa, with their symptoms fluctuating in severity and form.

Many people wonder, “Which came first: the mental health issue, or the substance use issue?” While it’s a difficult question to answer definitively, it’s often more helpful to view them as separate problems interacting with one another.

What is a substance use disorder?

According to the DSM-5, which is the standard manual for diagnosing mental health conditions, substance use disorders are classified by the type of drug involved, such as alcohol, cannabis, tobacco, opioids, inhalants, stimulants, hallucinogens, and sedatives.

These disorders share key features of addiction, including persistent use despite negative consequences, neglecting daily responsibilities, spending excessive time obtaining the substance, and experiencing cravings, tolerance, and withdrawal symptoms.

Signs and Symptoms of a Concurrent Disorder

There isn’t a universal symptom or cluster of symptoms for all concurrent disorder combinations. However, these combinations can generally be categorized into five key groups:

1. Substance use and a mood or anxiety disorder, such as bipolar or obsessive-compulsive disorder.
2. Substance use and a severe and persistent mental health disorder, such as schizophrenia.
3. Substance use and a personality disorder, such as paranoid or antisocial personality disorder.
4. Substance use and an eating disorder, such as anorexia nervosa or binge-eating disorder.
5. Other substance use and mental health disorders, such as gambling or sexual disorders.

The Complex Relationship Between Mental Health and Substance Use: Contributing Factors and Risks

There is no single or simple cause of concurrent disorders. Each person’s experience is different. Below are some factors that may contribute to the development of both a mental health and a substance use problem.

• Some individuals with mental health issues use substances to cope with their symptoms. While substance use is risky in these situations, it can help people forget their problems or provide temporary relief.
• The effects of substance use may mimic signs of mental health disorders, such as mood swings, anxiety, impulsiveness, or even hallucinations. This is commonly referred to as a “substance-induced mental health disorder”.
• Substance use can lead to significant disruptions in people’s lives and relationships. For instance, substance use may cause conflicts within families or friendships, leading to social isolation. These indirect effects can contribute to the development of mental health problems.
• Biological predispositions, such as a family history of mental health disorders or genetic factors, or traumatic events, such as emotional or physical abuse, can lead to the development of co-occurring mental health and substance use problems.

Substance use and mental health problems can also influence each other in multiple ways, including the following:

• Substance use may worsen mental health issues.
• Substance use can mimic or hide mental health symptoms.
• People may turn to substances to escape symptoms of mental health problems.
• Substance use may reduce the effectiveness of mental health medications or lead individuals to miss doses, thus impacting their overall treatment.
• A relapse in one disorder can trigger symptoms of the other disorder.

People living with concurrent disorders are at increased risk of additional problems, such as relapse, hospitalization, potential involvement with the criminal justice system, homelessness, social isolation, financial instability, and worsening physical health.

Treatment Approaches

To provide effective treatment for co-occurring disorders, an integrated treatment approach is recommended. Integrated concurrent disorder treatment involves coordinating both substance use and mental health interventions simultaneously, rather than treating each disorder separately without considering the other.

Common therapeutic options for concurrent disorder treatment include a tailored mix of the following:

1. Cognitive Behavioural Therapy (CBT): This form of talk therapy helps individuals recognize and change negative thinking and behaviour patterns. CBT is effective in treating many substance use and mental health disorders by focusing on the relationships between thoughts, feelings, and actions.
2. Dialectical Behavioural Therapy (DBT): This form of therapy focuses on mindfulness, emotional regulation, and interpersonal relationships.
3. Acceptance and Commitment Therapy (ACT): This form of talk therapy encourages people to embrace their thoughts and feelings rather than fighting or feeling guilty for having them.
4. Integrated Group Therapy: This form of talk therapy combines addiction treatment with mental health treatment within a group setting to facilitate discussions that address both issues concurrently.
5. Relapse Prevention Therapy: This treatment approach involves working with the patient to develop strategies to help individuals recognize and manage warning signs of relapse.
6. Motivational Interviewing: This is a client-centred approach that helps patients resolve ambivalence in treatment, and strengthen their motivation to make long-term changes.
7. Family Therapy: This form of therapy involves family members directly within the treatment process to improve communication, address interpersonal conflicts, and adjust familial dynamics that contribute to substance use and mental health problems.
8. Psychoeducation: This form of treatment teaches patients about their disorders, including environmental triggers, health consequences, and alternative coping strategies to manage symptoms effectively.
9. Medication-Assisted Therapy: Medications, along with counselling and behavioural therapies, are used to treat substance use disorders and support recovery. These may include medications to manage mental health symptoms, like benzodiazepines or antipsychotics.
   • a. Medications for substance use problems can be short-term or long-term. There are three main types:
     1. i. Aversive medications: These medications cause unpleasant physical effects if substance use continues.
     2. ii. Craving reduction medications: These medications alter brain chemistry to block the pleasurable effects of drugs.
     3. iii. Substitution medications: These medications reduce withdrawal symptoms and cravings.

Additional Treatment Options at the Metamorphosis Centre for Change

The Metamorphosis Centre for Change provides holistic concurrent disorder treatment plans integrated with the nine options mentioned above. Our approach combines traditional therapies like CBT and DBT with experiential therapies that focus on mind and body wellness, such as tai chi, yoga, art therapy, music therapy, and meditation. These concurrent disorder treatments are essential in cultivating greater self-awareness, focus, and well-being.

We also offer many mind/body integrative therapies, including EMDR (eye movement desensitization and reprocessing) therapy, equine therapy, acupuncture, massage, and outdoor adventure therapy.

Our focus is always on you as an individual. With a flexible range of treatment options, we address the physical manifestations of mental health and substance use problems to promote lasting well-being and prevent relapse.

Conclusion

The Metamorphosis Centre for Change’s Concurrent Disorders Treatment Program shines as a beacon of hope for individuals navigating the intertwined challenges of addiction and mental health.

Our holistic and integrated approach, tailored to the individual needs of each patient, embodies a commitment to comprehensive care. Our clinical team of addiction counsellors and therapists work to create a program that not only alleviates immediate struggles, but also paves the way for long-term recovery and lifelong success.

To learn more about why choosing the Metamorphosis Centre for Change can be the best decision for yourself or a loved one, or to receive answers to any questions that you have about concurrent disorder treatment, please reach out to us at 1-888-616-1678 or through this form.

A friendly and knowledgeable member of our team will be happy to speak with you and provide the information needed to help you make the most informed decision possible.