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Dual Diagnosis


Dual diagnosis is an informal term that refers to people who have been diagnosed with two coexistent medical conditions. The dual diagnosis can relate to any two illnesses or disorders, but the term is most often used when referring to people who have a drug, alcohol or behavioral addiction problem at the same time as a mental health disorder.

While the term ‘dual diagnosis’ is widely used, many addiction and mental health experts prefer to use other terms, partly because there is no consensus on what dual diagnosis actually means. For example, it is not unusual to hear people referring to estimated figures for people with addiction and mental illness, and describing them as dual diagnosis. However, it is inaccurate to use the word ‘diagnosis’ unless an actual diagnosis has been made. That is why professionals increasingly prefer to use terms like ‘coexistent’ or ‘co-morbidity’ instead.


Problems diagnosing coexistent conditions

It is the nature of many mental illnesses that those who have them are unaware there is a mental health problem. They often believe that the symptoms they have are related to something else. Medics can also find it difficult to diagnose mental health problems since they rely to a large extent on what people tell them to try to get to the source of the problem. Another problem is that the symptoms of drug or alcohol abuse can mask those of mental disorder, and vice versa.


Common pairings in dual diagnosis

Doctors and addiction treatment specialists have noted that there is a clear correlation between certain mental health disorders and the types of substances to which people are addicted. Quite often, the addiction arises as a direct result of people taking medication to alleviate the symptoms of their mental health disorder. This is especially the case when a mental health disorder has not been diagnosed.

Experts believe that the high incidence of coexistent addiction and mental health issues is largely due to the fact that people naturally build tolerance to many types of drug when they use those drugs for prolonged periods. When people have an undiagnosed mental health problem, they may receive treatment for the symptoms, but the root cause of the problem remains unaddressed. Since the illness itself is not being treated, it is unlikely to go away, and patients will continue to seek relief. They need to increase the amount of medication they take to achieve the same level of relief, and this leads to them eventually becoming addicted.

People with OCD or PTSD often take relaxant drugs to help them cope with the symptoms of their condition. Therefore, it is not uncommon to find that when a diagnosis of OCD or PTSD is made, a large proportion of those patients are addicted to benzodiazepines or tranquilizers.

People with bipolar disorder may end up being addicted to two different classes of drugs, namely stimulants and sedatives. When they are in the depressed phase of bipolar disorder, they take stimulants to make themselves feel better, and can develop an addiction to these. In contrast, when their illness takes them into the manic phase, they may take relaxants to slow themselves down, and can also develop an addiction to those drugs.


Numbers affected by coexistent conditions

In Florida, approximately 200,000 people have a serious mental illness according to figures from SAMHSA. The same body estimates that 50% of people in Florida with serious mental illness have coexistent addiction problems. That means around 100,000 Florida adults are likely to have coexistent conditions.



Effective treatment needs to address both the addiction and the mental illness. That means people with coexistent conditions should look for treatment centers that can provide access to mental health specialists as well as addiction recovery services.