Co-occurring disorders (once called dual disorders or dual diagnosis) is the term for experiencing two conditions at once. It most commonly refers to a person who has both a substance use disorder and a mental health condition. This population is at higher risk for negative outcomes. It can be challenging for these patients to feel that they are receiving quality care, as healthcare professional training and systems have historically not fostered combined treatment. We now know that addressing both issues at the same time–a model called integrated treatment–is essential to improve patient outcomes.
The integrated approach needs to be used in all levels of care. Models that promote screening for substance use disorders in mental health treatment settings, and for mental health in substance use disorder treatment settings, are one essential step, but not sufficient. Finding higher levels of care for people who need this kind of care remains challenging. It remains difficult to find treatment providers and payment systems that support addressing both conditions simultaneously.
The Substance Abuse and Mental Health Services Administration (SAMHSA) has developed a useful website on this important area of systems evolution.
The Agency for Healthcare Research and Quality (AHRQ) created Interventions for Substance Use Disorders in Adolescents: A Systematic Review. This review aims to inform health care providers, policymakers, and a clinical practice guideline update from the American Academy of Child and Adolescent Psychiatry (AACAP) about the currently available evidence on interventions for adolescents to reduce or cease substance use. The review addresses both behavioral and pharmacological interventions used for adolescents or young adults with problematic substance use or a diagnosis of a substance use disorder (SUD), excluding tobacco.