Co-Occurring Disorders and Alcohol Addiction 

Very often, people suffering from alcohol use disorder (AUD) are diagnosed with a co-occurring mental disorder. Statistics show that around one-third of 20.3 million AUD sufferers across the country experience co-occurring disorders. Unfortunately, only about 50 percent of these people receive appropriate treatment. The main obstacles to higher treatment participation are high costs.1

In the majority of cases, it is hard to establish which disorder came first. Once several health issues are present at the same time, they are believed to enhance each other’s activities. If left untreated, they can lead to lead to negative long-term outcomes, some of which may be lethal.1

What Are Co-Occurring Disorders? 

Even though it is primarily used to refer to cases of alcohol addiction accompanied by some mental health disorder, the term ‘co-occurring disorder’ also refers to cases in which a person suffers from several mental disorders at once. Co-occurring disorders are strikingly prevalent, especially in cases of substance abuse. Possible explanations for why this happens include:1,2

• Risk Factor Overlapping: Common risk factors for both AUD and other mental health issues are genetics and a myriad of environmental influences. These usually join forces to produce the negative effects of co-existing disorders.

• Self-Directed Medicating: To alleviate the symptoms of their mental illness, people may resort to alcohol consumption. Heavy and prolonged use of this stimulant may lead to AUD without the resolution of symptoms of the initial disease.

• Substance-Induced Brain Alterations: Alcohol consumption itself may create certain changes in brain chemistry, which may make a person more prone to the development of mental disorders.

Signs and Symptoms of Co-Occurring Disorders Related to Alcoholism 

The combination of AUD and co-occurring disorders is often accompanied by various telltale signs and symptoms. Some of these are more related to the mental illness one goes through, while the others are characteristic of alcohol abuse. Some of the former include:3,4

• Sleeping and eating habit changes
• Losing interest in regularly attended activities
• Experience of severe emotional highs and/or lows
• Loss of focus and/or concentration
• Heightened irritability
• An increase or decrease in libido
• Isolation from friends and family
• Hallucinations, delusions, and/or paranoia
• Physical pain 
• Participation in risky activities
• Suicide thoughts or attempts

On the other hand, signs and symptoms associated with alcohol use disorder (AUD) include the following:5

• Being frequently late at work
• Isolating oneself from family and friends
• Difficulty completing daily tasks at the workplace, school, or home
• Participating in risky behavior
• Experiencing withdrawal symptoms

How to Diagnose Co-Occurring Disorders and Alcoholism? 

All the symptoms of a co-occurring disorder should be promptly and adequately addressed. Every treatment should be preceded by the right diagnosis. To be as precise as possible, specialists commonly employ multi-level assessments to discover all the complexities of the health issue. These commonly include a variety of both physical and mental tests, as well as consideration of the patient’s medical history.6

Diagnostic techniques are usually based on a variety of screening tools. Some of these tools are:7

• Addiction Severity Index (ASI).
• Mental Health Screening Form III
• Alcohol Use Disorder Identification Test
• Columbia-Suicide Severity Rating Scale
• The University of Rhode Island Change and Assessment Scale
• Symptom Checklist-90-Revised
• Structured Clinical Interview for DSM-V (SCID-5)
• Psychiatric Research Interview for Substance and Mental Disorders (PRISM)

What are the Types of Co-occurring Disorders Seen with Alcohol Abuse? 

The existence of co-occurring disorders may be experienced in a variety of ways. How one handles their issues significantly depends on which disorders they develop. Some of the disorders that most commonly accompany alcohol addiction include:1,2,8,9

• Anxiety disorders: A lot of heavy alcohol consumers develop some of the various disorders on an anxiety spectrum. These involve social anxiety, generalized anxiety disorder, and panic disorder, among others.

• Mood disorders are also prevalent among sufferers of alcohol and other types of addiction. It is estimated that around 20 percent of substance abuse sufferers experience at least one mood disorder, such as depression or bipolar disorder.

• Personality disorders: Conditions such as borderline, antisocial, paranoid, and avoidant disorders are at least three times more prevalent among alcohol addiction sufferers than they are in the general population. 

• Post-traumatic stress disorder (PTSD): People with PTSD also possess a higher risk of developing various sorts of substance use disorders, including AUD.

• Attention Deficit/Hyperactivity Disorder (ADHD): A variety of symptoms associated with ADHD may make a person more prone to alcohol addiction, particularly if ADHD is present early in childhood.

What are the Risk Factors for Co-Occurring Disorders? 

Researchers have identified numerous risk factors for the development of alcoholism-related co-occurring disorders. These can be divided into several categories:10

• Genetic and epigenetic influences: Besides genetic predisposition to alcohol addiction and/or certain mental health problems, various environmental factors can affect gene activity. A stressful environment and diet are some of the factors that may be the culprits.

• Stress: One of the consequences of elevated stress levels is a decrease in behavioral control, which in turn may lead to the development of mental health disorders and increased consumption of alcohol.

• Trauma and/or bad early-age experiences: Patients who went through serious psychological pain in their childhood or while experiencing traumatic events such as war are much more likely to develop a variety of mental health issues.

Factors that Cause Co-Occurring Disorders Due to Alcohol Addiction

A whole host of factors are identified as probable and/or possible causes of alcohol addiction coupled with a mental illness. These may be classified into three following groups:11

• Genetic factors: A person’s genetic makeup is one of the primary factors in determining the likelihood of developing alcohol use disorder or any associated mental health problems. These issues may arise in a wide variety of pathways.

• Mental health issues: Sometimes mental problems may drive one’s alcohol addiction or the development of certain other mental health disorders. For example, anxiety may provoke both increased alcohol consumption and depression.

• Environmental factors: It is often the case that residing in a certain environment may lead to unwanted consequences. Increased stress at work, for instance, may lead to both alcohol abuse and the development of certain mental health issues.

How Do Co-Occurring Disorders Impact Alcohol Addiction?

Different mental disorders may lead to alcohol addiction. Alcohol addiction can also lead to the development of serious co-occurring mental disorders. For example, a person suffering from depression may start to drink excessively in order to numb the unpleasant symptoms. Such a practice may lead to alcoholism and all its associated symptoms, likely without helping much in overcoming the symptoms of depression.6

In a similar vein, alcoholism may bring about a whole host of mental issues, including depression and anxiety. In some patients, alcoholism and a co-occurring disorder may arise as a consequence of a third condition. For instance, environmental factors such as stress or even some physical ailment may lead to both alcohol addiction and mental health issues.6

What is Integrated Treatment for Co-Occurring Disorders and Alcohol Addiction? 

The integrated treatment presents standard-of-care alcoholism and co-occurring disorder treatment. It incorporates a wide variety of techniques and practices, as well as long-term hospitalization if needed. A panel of experts takes care of all disorders patients face, implementing a range of physical, therapeutic, and psychological interventions. Medications are commonly introduced as well. In certain cases, integrated treatment can only focus on a patient’s medical detoxification.6,12,13

This line of treatments commonly incorporates a range of therapeutic techniques, including:1,6,13

• Cognitive behavioral therapy
• Dialectical behavioral therapy
• Motivational enhancement
• Contingency management
• Mutual-support groups

Integrated treatment for co-occurring disorders and alcoholism is believed to have numerous benefits. Research has shown that patients attending this sort of treatment are more likely to stay engaged during the course of their treatment. They are also thought to be more able to reach sobriety, live independently, see symptom reduction, and maintain employment.6,13

How to Find Integrated Treatment for Alcohol Addiction and Co-Occurring Disorders Near Me? 

Before opting for a particular co-occurring disorder treatment, patients should be aware of several factors. The first of them concerns whether experts employed at a facility are sufficiently trained and experienced to offer adequate treatment. The next one has to do with various therapy modalities. Does the facility offer continuous counseling or behavioral therapies? Does it include various inpatient and outpatient treatment options? What also needs to be considered is whether there is sufficient aftercare support and whether the treatment of choice is covered by the patients’ insurance provider. Patients who belong to certain demographic groups (say LGBTIQ community or war veterans) should also explore whether the facility offers treatment catered to their needs.12

The best way to find the right treatment for co-occurring disorders is to use an online locator developed by the Substance Abuse and Mental Health Services Administration (SAMHSA). Using this platform, patients can see what treatments in their proximity suit them best. People who are unsure about what to do can also contact our fully confidential 24/7 helpline dedicated to alcohol addiction sufferers. Our navigators will be more than willing to offer any crucial information concerning topics as wide as treatment-associated costs and stages of alcoholism.

Frequently Asked Questions