Man drinking aloneMany people who struggle with a drug or alcohol problem do so as a way of coping with depression, stress or other mental health concerns. Others face mental health concerns after drugs or alcohol trigger or worsen symptoms. The term co-occurring disorders is used to describe the overlap between these mental health and substance use issues. Some co-occurring disorders are more common than others. All co-occurring disorders are cause for concern and immediate treatment.

  • Alcoholism and antisocial personality disorder. Alcoholism and antisocial personality disorder are commonly co-occurring concerns. People with antisocial personality disorder are often impulsive and thrill seeking. They are able to ignore or deny the consequences of their actions. The Mayo Clinic2 lists substance abuse and addiction as common complications related to antisocial personality disorder because of these and other reasons related to the disorder’s symptoms.
  • Marijuana and schizophrenia. When individuals with preexisting mental health concerns use marijuana, serious co-occurring disorders can develop. The American Journal of Psychiatryreports, “Rates of cannabis use disorder as high as 53% have been reported in some studies of patients with first-episode schizophrenic psychosis, and cannabis use has been associated with an earlier age at onset of schizophrenia, an elevated risk of developing psychosis, and a higher relapse rate after remission of acute psychotic symptoms in the first episode.”3 Although marijuana does not cause issues such as schizophrenia, using the drug can trigger or worsen symptoms. Individuals with schizophrenia are also more likely to turn to marijuana and other drugs to self-medicate symptoms.
  • Cocaine and anxiety disorders. Cocaine can produce a wide range of mental illness symptoms. According to Psychology Today,long-term cocaine use leads to, “psychosis, paranoia, depression, anxiety disorders, and delusions.”4 Cocaine can worsen pre-existing anxiety disorders or lead to the development of anxiety symptoms.
  • Opioids and post-traumatic stress disorder (PTSD). PTSD involves stress reactions that affect individuals during and long after they experience physical or psychological trauma. These reactions contribute to self-medication and make opioid and other drug abuse more likely. The American Journal of Drug and Alcohol Abuse explains, “Prescription opioid use problems are a risk factor for co-occurring PTSD symptom severity… Patients with prescription opioid use problems should be carefully evaluated for PTSD symptoms.”5 Drug use may lead to PTSD symptoms, or PTSD symptoms may lead to drug use.

No matter the challenges you face, you are not alone. The National Alliance on Mental Illness reports that “roughly 50% of people living with a mental health condition also have a problem with substance abuse. This creates a dual diagnosis or co-occurring disorder.”1 The details of co-occurring disorders change from person to person, but experiencing multiple health challenges doesn’t have to feel isolating or stigmatizing. Understanding, support and professional help are available.

The Relationship Between Mental Health and Addiction

Co-occurring disorders develop for many different reasons. They may have a genetic source, as genes contribute to both addiction development and mental health. However having a genetic predisposition towards addiction does not guarantee that one will develop. The same applies to mental health disorders. One theory that explains why some people develop co-occurring disorders and others do not is the stress-vulnerability model. This model suggests that environmental and biological vulnerabilities work together to lead to the expression of mental health or addiction issues. Biological vulnerabilities include genetic or early-life triggers for health issues. Environmental vulnerabilities include the challenges faced in everyday life such as financial struggles, traumatic experiences or relationship problems. These combine to put individuals at risk for co-occurring disorders. Other risk factors include the following:

  • Prescription or recreational drug use
  • Lack of social support
  • Lack of positive coping skills
  • Stress

These and other issues combine with genetic and environmental factors to create co-occurring mental health and addiction concerns.

Integrated Treatment for Co-Occurring Disorders

No matter the cause, co-occurring disorders can be treated. Treating a co-occurring disorder comes with challenges. Integrated treatment can meet these challenges. The Substance Abuse and Mental Health Services Administration explains, “People with co-occurring disorders are best served through integrated treatment. With integrated treatment, practitioners can address mental and substance use disorders at the same time, often lowering costs and creating better outcomes.”6 Integrated treatment leads to immediate and long-term healing. It does this by accomplishing the following:

  • Helping patients understand substance abuse and mental health
  • Helping patients recognize the impact of their substance use
  • Involving friends and family in the recovery process
  • Working with patients to establish goals and develop ways to accomplish these goals
  • Connecting patients with job training, life skills training and other services that help them return to normal life
  • Providing specific therapy and counseling for co-occurring disorders

All aspects of co-occurring disorders need specific, coordinated care. Integrated treatment offers this care. With the right treatment, anyone can start on the path back to health and happiness.

Find Integrated Treatment for Co-Occurring Disorders

Black Bear Lodge offers professional, compassionate treatment for co-occurring disorders. We approach recovery using the integrated treatment model. We offer personalized, in-depth care so that patients can heal physically, mentally and emotionally. Our experienced staff is available any time to answer your questions and help you begin your healing journey. Please reach out today, and learn more.


1How Can I Get Help for My Substance Abuse Issue and Mental Health Condition?” National Alliance on Mental Illness. Accessed 11 Oct. 2017.

Antisocial Personality Disorder.” Mayo Clinic. 4 Aug. 2017. Accessed 11 Oct. 2017.

3 Green, Alan, et al. “Schizophrenia and Co-Occurring Substance Use Disorder.” Mar. 2007. Accessed 11 Oct. 2017.

Cocaine.” Psychology Today. 11 Nov. 2016. Accessed 11 Oct. 2017.

5 Meier, Andrea, et al. “Co-Occurring Prescription Opioid Use Problems and Posttraumatic Stress Disorder Symptom Severity.” The American Journal of Drug and Alcohol Abuse. 2014. Accessed 11 Oct. 2017.

Co-Occurring Disorders.” Substance Abuse and Mental Health Services. 8 Mar. 2016. Accessed 11 Oct.  2017.