More About Dual Diagnosis Treatment Centers
Dual diagnosis means having a substance use disorder (SUD) and a mental health disorder at the same time.1 For example, a person with alcohol use disorder (AUD) may also experience depression, and the symptoms of each condition can affect the other.
The National Institute on Drug Abuse (NIDA) recommends addressing both conditions as part of treatment rather than treating them separately, as research suggests an integrated approach may lead to better outcomes.2
You may also hear dual diagnosis referred to as “co-occurring disorder” or “comorbidity,” and the terms are often used interchangeably. Some clinical resources, including the Substance Abuse and Mental Health Services Administration (SAMHSA), favor the term co-occurring disorder as more current, person-first language.3 However, both terms refer to the same general concept, and this page uses them together because “dual diagnosis” is still commonly used when people search for treatment.
What Are the Most Common Dual Diagnoses?
An SUD can occur alongside many different mental health conditions. Some of the most common co-occurring conditions include anxiety, depression, post-traumatic stress disorder (PTSD), bipolar disorder, or a personality disorder.2,3
According to the 2024 National Survey on Drug Use and Health (NSDUH), an estimated 21.2 million adults aged 18 and older had both an SUD and a co-occurring mental health disorder in the past year.4 Having both conditions, however, does not necessarily mean that one caused the other.
How Do I Know If I Have a Dual Diagnosis?
A licensed healthcare professional can evaluate whether you have both an SUD and a mental health disorder. Providers often use criteria from the Diagnostic and Statistical Manual of Mental Disorders, 5th Edition (DSM-5) to diagnose each condition.5 They’ll also consider whether your symptoms are related to separate conditions or whether some may be caused by substance use, withdrawal, or another condition.3
The evaluation process may include screening and a more comprehensive assessment of your substance use, mental health symptoms, family history, and past treatment. This information can help your provider better understand what you’re experiencing and recommend treatment based on your individual needs.
Symptoms of Co-Occurring Disorders
The symptoms of co-occurring disorders can vary depending on the conditions involved. For an SUD, the DSM-5 looks at whether a person has experienced at least two of the following symptoms within a 12-month period:5
- Using a substance in larger amounts or for longer than intended.
- Wanting to cut back or stop but being unable to do so.
- Spending a lot of time getting, using, or recovering from a substance.
- Experiencing cravings or strong urges to use.
- Having difficulty meeting responsibilities at work, school, or home because of substance use.
- Continuing to use despite problems with relationships or other social consequences.
- Giving up or reducing important activities because of substance use.
- Using substances in situations where it may be physically dangerous, such as before driving.
- Continuing to use despite knowing it may be worsening a physical or mental health problem.
- Needing more of a substance to get the same effect, known as tolerance.
- Experiencing withdrawal symptoms when reducing or stopping use.
Mental health symptoms depend on the specific condition. For example, someone with an anxiety disorder may experience ongoing worry or physical tension, while someone with depression may experience low mood, fatigue, or a loss of interest in activities they once enjoyed.5,6 Only a professional evaluation can determine which mental health symptoms are present and how they relate to addiction.
Causes and Risk Factors for Dual Diagnosis
There isn’t a single cause of co-occurring disorders. Instead, a combination of genetic, environmental, and life experiences can contribute to the development of both substance use and mental health disorders. Research suggests that some of the same genetic factors may increase a person’s risk for both types of conditions.2
Life experiences can also play a role. Childhood trauma, family conflict, and other adverse experiences earlier in life are associated with an increased risk of substance use as well as mental health conditions such as anxiety and depression.7 Social and environmental factors, including unstable housing and a lack of supportive relationships, may further contribute to this risk.2,7
Treatment for Dual Diagnosis
Integrated treatment addresses an SUD and a mental health disorder as part of the same treatment plan and is widely recommended for people with co-occurring disorders.3,8
The specific approach can vary considerably depending on the conditions being treated, the severity of symptoms, withdrawal risks, and a person’s individual needs.
Not everyone will need the same services or move through the same levels of care. Depending on a person’s needs, dual diagnosis treatment may include one or more of the following:3,9
- Detoxification: This may be recommended when stopping or reducing a substance could cause significant or potentially dangerous withdrawal symptoms. This can be especially important with substances such as alcohol and benzodiazepines.
- Inpatient/residential treatment: Live-in programs provide a structured environment with around-the-clock support. Depending on the program, care may include medical services, psychiatric care, therapy, and other support for co-occurring conditions.
- Outpatient treatment: Outpatient care can include regularly scheduled therapy, medication management, and other services while a person continues living at home or in a type of sober housing.
- Partial hospitalization programs (PHPs): A type of outpatient treatment, PHPs provide structured treatment for several hours a day while allowing people to live outside the treatment facility. They may be appropriate for people who need more support than traditional outpatient care but do not require 24-hour residential treatment.
- Intensive outpatient programs (IOPs): Another type of outpatient treatment, IOPs provide more frequent and structured treatment than standard outpatient care while allowing people to continue living at home or in a supportive living environment.
- Sober living: Some people transition to a supportive, substance-free living environment during or after formal treatment. Ongoing care may also include outpatient therapy, medication management, peer support groups (e.g., Alcoholics Anonymous or Narcotics Anonymous), recovery groups, and other services that help support longer-term recovery.
The therapies and services offered within these settings also depend on the conditions being treated. A treatment plan may include behavioral therapies such as cognitive behavioral therapy (CBT) and dialectical behavior therapy (DBT), medication management when appropriate, case management, and peer or family support.8,9
For people with more complex needs, providers may also use approaches such as assertive community treatment or intensive case management to help coordinate mental health, substance use, medical, and social services.3
Evidence Base
Research supports addressing substance use and mental health issues together as part of an integrated treatment approach. In one randomized controlled trial, people receiving integrated treatment for an SUD and co-occurring anxiety or depression experienced greater improvements in both substance use and mental health symptoms compared with those receiving usual care.10
Broader reviews of the research have also found benefits to coordinating care for both conditions rather than treating them separately.8,11 Based on the available evidence, NIDA recommends integrated care for people with co-occurring substance use and mental health disorders.2
Cost and Insurance
The cost of dual diagnosis treatment can vary based on the level of care, length of treatment, services provided, and other factors. Many health insurance plans include benefits for mental health and addiction treatment, and federal parity laws generally require these benefits to be treated comparably to medical and surgical benefits when they are offered.
Your coverage and out-of-pocket costs will depend on your specific plan and the services you need. You can use the insurance verification tool on this page to learn more about your benefits.
Find Dual Diagnosis Treatment Near Me
If you’re living with both a substance use disorder and a mental health condition, finding a treatment program that addresses both may help support your recovery. Recovery.com can help you find dual diagnosis treatment centers that provide care for co-occurring conditions. Use the search features on this page to explore treatment centers near you and filter your options based on location, level of care, insurance, amenities, and other preferences. You can compare programs and learn more about their treatment approaches, services, and what to expect before reaching out.
Sources:
- Substance Abuse and Mental Health Services Administration. (2025). Co-Occurring Disorders and Other Health Conditions.
- National Institute on Drug Abuse. (2024). Co-Occurring Disorders and Health Conditions.
- Substance Abuse and Mental Health Services Administration. (2020). Substance Use Disorder Treatment for People With Co-Occurring Disorders (TIP 42).
- Substance Abuse and Mental Health Services Administration. (2025). 2024 National Survey on Drug Use and Health, Annual National Report.
- American Psychiatric Association. (2013). Diagnostic and Statistical Manual of Mental Disorders (5th ed.).
- Substance Abuse and Mental Health Services Administration. (2025). Screening and Treatment of Co-Occurring Disorders.
- Substance Abuse and Mental Health Services Administration. (2024). Risk and Protective Factors for Substance Use That Present in Childhood.
- Iqbal, M. N., Levin, C. J., & Levin, F. R. (2019). Treatment for Substance Use Disorder With Co-Occurring Mental Illness. Focus (American Psychiatric Publishing), 17(2), 88–97. https://doi.org/10.1176/appi.focus.20180042
- Substance Abuse and Mental Health Services Administration. Treatment Settings for Co-Occurring Disorders.
- Wüsthoff, L.E., Waal, H. & Gråwe, R.W. The effectiveness of integrated treatment in patients with substance use disorders co-occurring with anxiety and/or depression - a group randomized trial. BMC Psychiatry 14, 67 (2014). https://doi.org/10.1186/1471-244X-14-67
- Yule, A. M., & Kelly, J. F. (2019). Integrating Treatment for Co-Occurring Mental Health Conditions. Alcohol research : current reviews, 40(1), arcr.v40.1.07. https://doi.org/10.35946/arcr.v40.1.07