The term “dual” refers to the treatment of both substance use disorders and co-occurring disorders simultaneously. This treatment model takes into account the relationship between addiction and psychosis and patients are viewed as having two primary chronic illnesses requiring specific treatment for each. (1)
The Diagnostic Statistical Manual of Mental Disorders, Fifth Edition (DSM-5) divides substance use disorders into three classifications: mild, moderate and severe. Addiction psychiatrists use criteria such as the patient’s desire to quit medication (but to no avail); repetitive and progressive decline in performance concerning work, personal and academic obligations; and continued usage of drugs despite severe adverse consequences. Of the 11 total criteria, a condition that meets 2-3 is considered mild; 4-5, moderate, and 6 or more, severe. Common disorders include alcoholism and addiction to marijuana, opioids, and cocaine.
Dual diagnosis disorders, also known as co-occurring disorders, are comorbid disorders that occur concurrently with substance use disorders. The significance of identifying dual diagnosis disorders lies in the presence of mental illness. Patients who have some form of mental health disorder such as depression, Bipolar disorder, schizophrenia, or chronic anxiety are more likely to develop an addiction to substance abuse than those who do not have a mental illness (SAMHSA, 2016).
(1) 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: https://www.ncbi.nlm.nih.gov/
(2) Minkoff, Kenneth (2006). An Integrated Treatment Model for Dual Diagnosis of Psychosis and Addiction. Psychiatric Services https://doi.org/