Treating Concurrent Disorders
BCMHSUS staff care for people with the most complex and severe mental health and substance use problems in British Columbia. Many of these people have a concurrent disorder.
What is a concurrent disorder?
A concurrent disorder is when a person has a substance use disorder and a mental illness at the same time. Examples:
- Being diagnosed with schizophrenia and living with an opioid addiction
- Having a post-traumatic stress disorder and an alcohol addiction
People with concurrent disorders often have other challenges that can complicate their illness. This makes recovery even more challenging. Examples include:
- An additional mood or personality disorder that makes a client feel particularly anxious, fearful or paranoid
- A chronic physical illness
- A history of poor health or dental care due to social barriers
- Unstable housing and/or unemployment
- Stigma
Trauma and concurrent disorders
Many patients and clients with concurrent disorders have experienced trauma. Trauma can include:
- Abuse
- Neglect
- Sexual assault
- Other negative experiences, including negative childhood experiences
Research has shown that trauma is often connected with mental health and substance use. This connection is even stronger among women.
An integrated approach to mental health and addiction treatment
Looking at where a person's mental illness or substance use may have come from is key. Mental illness, addiction, and trauma are often closely linked. Someone may use alcohol to numb the pain of a past trauma, or an opioid to self-medicate for a mental illness, for example. If clinicians try to treat only the substance use, they may miss the core of the problem. Spending time with the client or patient to uncover the root causes of their concurrent disorder will help the client’s or patient’s recovery.
One of the most common illnesses linked to substance use is post-traumatic stress disorder, or PTSD. A client with untreated PTSD may become anxious and hypervigilant. They may turn to substances to cope. This often makes the PTSD worse and makes their illness even more complex. They may lose the ability to function in other areas of their lives, making it even harder for them to seek treatment.
Treating a concurrent disorder
Due to all these factors, treating concurrent disorders is very complex. People living with a concurrent disorder need more than medication and counselling to support their recovery journey. Our specialized team of interdisciplinary professionals offers patients and clients comprehensive assessments and diagnoses. We know that treatment takes time, which is why most of our programs are several months long.
Research has shown that patient and client outcomes are better when we treat people using a whole-person approach. One care plan will address substance use, mental illness, chronic health conditions, and triggers and trauma. That same plan will also identify and develop a client’s personal strengths and resiliency.
Our professionals use the following tools:
- Motivational interviewing
- Cognitive behavioural therapy
- Emotion regulation skill building
- Medication management such as opioid agonist treatment
Concurrent disorder resources
We recommend the following resources for mental health and substance use professionals who treat concurrent disorders: