Co–occurring Disorders and Their Impact on Addiction

  • Deborah A. Young


Comorbidity, is a part of the addiction that is widely overlooked by counselors and those that treat the addicted persons. Meaning that it is more than likely not treated, mainly in part due to the lack of properly trained professionals that can recognize as Capuzzi & Stauffer put it, ” for a client to present with a single addiction, without a coexisting addiction or addictions, or coexisting psychiatric disorders would be the exception rather than the rule”.

Keywords: Comorbidity, Addiction, Treatment, Substance Abuse

Most persons that have been diagnosed with critical mental illness issues are also substance abusers. Alcohol and drugs exacerbate the levels of the mental illness, mainly because a person uses any mind altering substance has a sensitivity to the substance of choice, most with mental illness use different substances to self medicate and/or deal with different situations and symptoms. This is not what one would want to do because it is a temporary fix at best, and it leaves the client looking for and wanting the same effects that brought them to the point of abusing the substance in the first place.

Co – Occurring Disorders

Persons with co – occurring disorder main interference with treatment is their feelings, meaning the types of behaviors that lead up to their addictions. In Treatment Improvement Protocol (TIP) series No. 43 it states ” These symptoms may indicate either underlying co-occurring disorders that would be present regardless of substance use (i.e. Independent or primary disorders”). Identifiable co- occurring disorders may be identified at the time of admission to an OTP and it is possible or the disorders to present themselves during MAT (medication assisted treatment). The MAT providers must be able to tell the difference between those with co-occurring disorders and be able to know the type and be exact with their diagnosis if not addressed in the right manner, this could cause problems and hinder the client recovery and could as well cause major setbacks in the recovery of the client. The need for a precise assessment of the disorder and a timely intervention with the right therapies in place, both psychiatric and therapy for substance abuse, will help the professional as well as the client to give and have a more effective treatment plan.


Psychology Today says, “Substance abuse is, a maladaptive pattern of substance use manifested by recurrent and significant adverse consequences related to the repeated use of substances. Individuals who abuse substances may experience such harmful consequences of substance use as repeated failure to fulfill roles for which they are responsible, legal difficulties, or social and interpersonal problems. It is important to note that the chronic use of an illicit drug still constitutes a significant issue for treatment even when it does not meet the criteria for substance abuse”. (Saxon & Calsyn, 1995).

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Symptomatic relapse, hospitalizations, financial problems, social isolation, family problems, homelessness, suicide, violence, and some not always talked about schizophrenia and schizoaffective disorders. There are many more that can and will complicate the treatment of a co-occurring disorder, if misdiagnosed and the professionals are not aware or are un- learned in dealing with those that are not just addicted but suffering from co-occurring disorders.

It is important that the professional that is going to treat this type of addict, must be familiar with the signs and symptoms of one with co – occurring disorders, treatment is much more challenging than that of the addict that does not suffer from this type of disorder.

The Ritual Stage of Addiction. The ritual stage of addiction is perhaps the most dangerous part of addiction, to the health of the addict causes physical harm as well as having a great impact on their psychological well being. After all addictions are a behavior so to try to stop an addiction one faces many challenges.

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The ritual stage is where the user uses a process to obtain, use and react to their drug of choice. This is the point where the addict becomes fully consumed in his/her addiction and the things that are related to their abuse. Obtaining, using, and responding which turns into a habitual cycle, which becomes repetitious this is the way that the addict achieves their psychological satisfaction. Clear understanding of the ritual and the reasons why to end the rituals, and that is best done when the addict is no longer psychologically dependant on the substance and all dependence to the drug and its effects are no longer present the person can then move ahead in their quest for sobriety.

Addiction is addiction, it doesn’t matter what it is, sex, gambling, eating, all of these have the same common premise and that is to make the body or mind feel better, to mask whatever pain exist, or to better (so they think), deal with the problems they are facing. Which does not the source of addiction important, but the mind set of the person that is important and the reasoning behind using.

Impact of Addiction in Society. Most, in fact, all that are addicted have a negative impact on society as a whole, from higher crime rates, to the families that are broken and lost. There is a high toll on those that the addict comes into contact with. The family suffers because they have to learn to live with the addict they have to basically change their lifestyles to accommodate the addict as well as the family unit suffers financially, the love is gone and the selfish ways take over and leave his family struggling to deal with the aftermath of the addicted person’s behavior.

The public as a whole feels the wrath of the addict through the penal system this not only causes the community pain because of the actions of the addict, some steal and violate homes to achieve what they need in order to obtain the high that they are looking for, in turn they are punished with jail, most are indigent and therefore, in order for them to be in the system the state and taxpayers must pay for their care and their time that they must stay incarcerated, and most do not receive any types of treatment which means they come back out without the proper resources and go right back to what they were doing that got them there in the first place.The work place would also have negative impact, addiction in the workplace is more common place than realiazed, nurses and doctors for instance, this is a recipie for danger and disaster, they impact the medical field negatively because after all you go to them for help. According to NBC ” Doctors and Nurses go for years under he radar and are treating patients as they are under the influence of the very drugs they prescribe to the patients that need them” (Magrath, 2010). It’s a dangerous and scary thought that the person you trust to treat you may just be addicted to drugs and or alcohol.


Center for Substance Abuse Treatment. Medication-Assisted Treatment for Opioid Addiction in Opioid Treatment Programs. Rockville (MD): Substance Abuse and Mental Health Services Administration (US); 2005. (Treatment Improvement Protocol (TIP) Series, No. 43.) Chapter 12. Treatment of Co-Occurring Disorders. Available from: // (Year). Article Title. Journal Title,

McGrath, T. (Writer) (2010). Addicted Docs Put Patients in Peril [Television series episode]. In Mens Health. New York, NY: NBC. Retrieved from //

Saxon, A., & Calsyn, D. (1995). Effects of psychiatric care for dual diagnosis patients treated in a drug dependence clinic. American Journal of Drug and Alcohol Abuse. , 21(03), 303-313. Retrieved from //



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