Evaluation and Treatment of Patients with Coexisting Mental Illness and Drug Abuse

A coexisting mental illness such as drug addiction is a mental condition that often coexists with other psychiatric illnesses. As many as six out of ten individuals with an illegal substance use disorder also have another mental condition, and the numbers are comparable among consumers of licit substances, such as tobacco and alcohol.

For these people suffering from a coexisting mental illness, treating one disorder becomes more complex as another condition becomes entangled. As a result, individuals entering care for either a drug use disorder or another psychiatric disorder such as coexisting mental illness should be evaluated for the presence of the other disease. According to research, treating both (or multiple) conditions together in an integrated manner is usually the best therapeutic option for these patients.

The Connection between Drug Abuse and Coexisting Mental Illness

A coexisting mental illness or concurrent diagnosis occurs anytime an individual suffers from drug overuse issues and psychological conditions such as anxiety and depression. It’s never easy to deal with drug overuse, high alcohol intake, or other addiction issues, and coexisting mental illness is harder when you’re still dealing with psychological conditions.

Both the coexisting mental illness and the substance abuse have particular symptoms that can interfere with how a person functions, have a healthy family life, cope with life’s challenges, and communicate with other people while you have such disorders. To make matters worse, a coexisting mental illness affects one another. If a coexisting mental illness is left untreated, the issue of drug overuse usually worsens. And where there is a rise in alcohol or substance misuse, there is generally an increase in mental health issues as well.

Many people are unaware that co-occurring drug abuse and coexisting mental illnesses are more widespread than they know. According to studies:

  • Substance misuse affects about 50% of people with serious a coexisting mental illness
  • 37% of alcoholics and 53% of opioid users get a significant mental disorder
  • 29 percent of all mentally ill people misuse substances

Although drug abuse and coexisting mental illness do not change when neglected, it could lead to them having a worsening condition – it is important to realize that you do mustn’t feel like this. Experts have lined up several activities patients can partake in to overcome their demons and communicate better with loved ones. You can resolve a coexisting mental illness, regain your confidence, and have a good life with the right counseling, self-help, and care.

How Drug Overuse Affects Mental Health

A person’s psychological health refers to how healthy they are both emotionally and psychologically. Those with mental illness conditions might express various symptoms; and as soon as you notice these, make time to show them care. A way to access mental health is by looking at the impacts of overconsumption of alcohol.

Abuse of drugs and alcohol has a connection to disrupting the lives of patients; it has been reported to lead to depression, anxious feeling, tiredness, loss of memory, and even death in more severe cases. Overuse of drugs and alcohol can affect how the brain works. Since most drugs are depressants, they can affect the psychological balance, thereby affecting imaginations, memories, stimuli, and actions. 

In our world today, we have all experienced tiredness, depression, and anxiety – whether from offices, schools, or at our houses – it affects us all. Research shows that these three major mental conditions are caused by substance abuse. This can also reduce serotonin amounts in the body; this leads to an alteration in the mood of the person. Heavy consumption of alcohol increases these conditions.

Misuse of drugs has been linked to mental health issues. This causes psychiatric conditions like PTSD, fears, and anxiety. These health problems are important when patients are finding it difficult to withdraw from their addictions.

This also has a huge impact on the brain well-being of patients. This is one of the major mental illness conditions that is caused by the overuse of drugs or alcohol. In this condition, the emotions and imaginations of the patient are impaired and seem to not exist.

Which is more Important, Drug Overuse or Mental Health Issues?

Drug addiction and coexisting mental illnesses like anxiety and depression are inextricably related, though neither always triggers the other. Substance abuse may trigger long brain reactions, whereas alcohol may worsen symptoms of overthinking and bad mood. Additionally:

Alcohol and other medications mostly are used by people to solve the effects of a coexisting mental illness. People also misuse substances to alleviate the effects of coexisting mental illness that’s not yet diagnosed, to endure bad feelings, or to improve their mood temporarily. Sadly, taking meds or alcohol without a prescription has negative consequences and often makes the condition it was intended to alleviate worse.

The use of booze and heavy substances may raise the real dangers of coexisting mental illness. Since coexisting mental illnesses can be a result of various factors like biology, natural atmosphere, and additional factors, it is impossible to say whether drug abuse ever causes them directly. However, for those that are predisposed to developing a coexisting mental illness, consuming illegal substances could drive them to get worse. For instance, opioid painkiller abusers are more likely to develop psychological conditions, and overuse of drugs has been related to causing schizophrenia.

Substance addiction can worsen any coexisting mental illness. Substance abuse can exacerbate or even cause new symptoms of coexisting mental illness. Alcohol and substance abuse can also interfere with treatments like drugs for treating anxiety, depression and for enhancing moods, rendering them useless at treating the condition and slowing down rehabilitation.

Signs of Drug Abuse

Prescription narcotics (like opioid pain relievers, meds for sleeping, and other disorders), drugs used for mainly recreational purposes (like cocaine or marijuana), and heavy drinks are all examples of abused substances. However, this disorder that results from abusing or overusing hard drugs and heavy drinks is not determined by the type of drug used or the type of alcohol consumed.

Rather, it boils down to how misused substances impact your wellbeing and human interactions. To sum it up, an individual has a coexisting mental illness or an issue with abusing substances whether your substance or alcohol use can be problematic to your livelihood. Answering these queries can assist a patient to determine if they have this problem or not. If you have a lot of “yes” responses, it is most probable that your alcohol consumption rate or substance intake is now a huge issue.

  • In the past or present, do you like the need to reduce your consumption of heavy drinks or hard drugs?
  • Is it necessary for you to take an illegal substance or booze to have a good impact on how you feel or appear?
  • Did you attempt to reduce intake but were unable to?
  • Do you tell the truth about how often or how much substance you take?
  • Do you finish your prescription drug faster than you expected?
  • Has anybody shown worry over your drug or alcohol intake?
  • Have you felt guilt, bad, or sorry about your drug or alcohol consumption?
  • Did you regret anything you did or said while intoxicated?
  • Has your use of alcohol or drugs caused issues in your life?
  • Have you had trouble with the law due to how you consume heavy illegal substances?

Overview of the Research

This report is part of the technical assistance program on the treatment of coexisting mental illness. Every material used in this publication, apart from the passages in a quote, can be found by all members of the public. They have permission to copy, remake, and share it with others. We would appreciate it if you cite the source. Several members served as the Government project officers.

The views expressed are for the people that were part of the panel that formed the consensus; neither do the views represent that of CSAT nor the DHHS. No endorsement is allowed from both of these organizations. The recommendations here do not replace personal care of patients and therapy sessions of mental illness treatment plans.

Meaning of TIP?

Diffusion of these treatment protocols, TIP, can be considered as the last stage during the method that starts with a recommendation from professionals on the issue of AOD abuse and coexisting mental illness treatment. These include healthcare professionals, researchers, program managers, and professionals in the areas of justice or social work.

As soon as you have chosen a topic, CSAT forms a panel, having participants from important government organizations and entities, go through the entire program chosen. 

Recommendations from a different set of people comprising experts who don’t work for the government and know about the issue are then transmitted from this federal panel to their members. It meets for 72 hours in Washington and formulates theories and reaches a protocol agreement. Its members include coexisting mental illness, FAOD treatment abuse programs, health facilities, city centers for health, counseling, criminal and child protection organizations, with private citizens. A panel chair is responsible for ensuring true group consensus reflects the final work.

The next process is an analysis by another set of individuals of members who work as professionals of the proposed guidelines and protocol. Their leader accepts the publication document once its recommendations and responses are reviewed. This TIP reflects the true therapy plan of victims in all treatment programs known for the high standard and innovative treatment of AOD abuse.

The treatment protocol for mental illness offers viable data about the care of victims of drug overuse and mental conditions. It also treats people that suffer from anxiety issues, AOD, and other mental conditions. It provides practical data regarding various institutions that treat psychological conditions. Experts are considering how they can properly manage victims by using alternative treatment methods.

The protocol of mental illness shows a different approach to CSAT in its objective, which is to ensure there’s an improvement in the treatment methods of mental conditions.

The Foreword

TIPs and coexisting mental illness delivers best-practice guidance for physicians, program administration, and payers to improve CSAT’s mission to enhance treatment of substance overuse patients. Such a process comes from an in-depth look at every discovery of clinical and health services for treating coexisting mental illness. The product is produced unanimously by experts made up of clinic scientists, doctors, leaders, and health leaders. 

The work of this panel gets looked at and criticized as it develops by field reviewers. The method involves a lot of entities and has bridged the huge divide between what doctors need and viable research work in practical practice with TIP talent, dedication, and hard work. Appreciation should be shown to people that came to help promote our field of drug abuse.

Chapter One

Introduction of Findings


Individuals with an alcohol-based psychiatric disorder, coexisting mental illness, and other medications (AOD) and need treatment are substantially different from care and therapy requirements of mental disorders or AOD. This Treatment Enhancement Protocol (TIP) includes ideas on how to treat double disorders and coexisting mental illness patients.

A panel consisting of different entities was formed to include counselors who specialize in addiction cases, psychologists of patients, therapists, social health workers, other doctors, nurses, and active professional participation in the care of individuals who have coexisting mental illness and dual disorders. The panel also included consumers.

The protocol was primarily written for the care workers. It includes, however, details and treatment instructions for coexisting mental illness for use in various treatment settings by healthcare providers. For instance, it is useful for people working in care, hospitals, and in different environments for mental wellbeing. Some guidelines are also directed at healthcare managers and planners on the treatment of coexisting mental illness.

A careful effort to provide knowledge felt to be clinically significant by the panel that sets the consensus for treating coexisting mental illness has been made. While several clinical subjects are extensively studied, some are listed briefly and some are fully ignored.

The aim of the protocol is not to provide a comprehensive explanation of all potential problems related to the care of dual disorders and coexisting mental illness patients. Instead, the key purpose is to make realistic and useful care decisions.

Consequently, by combining this advice with other TIPs, the utility of this TIP can be improved. This enables the creation of treatment protocols that are according to particular treatment criteria for treating coexisting mental illness.

What is Contained

Definitions and Models

The second chapter – facilitates AOD and dependency definitions and treatment process. The potential associations between using AOD and mental health conditions are also defined.

Chapter 3 — Speak about the care schemes used in individuals that have dual conditions explains similarities, disparities, and disadvantages, such as coexisting mental illness health conditions, treatment system with addictions, and other health facilities. In the same way, the most widely used treatment models are described: focused treatment of every illness, concurrent therapy for all disorders, and combined solutions of the diseases. The chapter addresses the crucial aspects of treatment and general evaluation of the care of dual and coexisting mental illness patients.


The fourth chapter describes several key areas of concern for programming providing care for double disorders. Politics and planning; support and recoup; gathering information and assessment of needs; production of the program; screening, evaluation, regard; handling cases; personnel and training; social welfare, medical aid, and justice cases.

This chapter can be of specific use to managers and policy planners to discuss the possible connections and discrepancies between coexisting mental illness and the recovery system for dependence. The semi-line structure here enables service planners to quickly monitor those sectors that have to do with funds and compensation, program planning, and handling cases.

Particular Psychiatric Conditions

Although whole books on psychiatric disorders and mental illness can be published, this TIP explains disorders that are the cause of most psychiatric issues in those that have double conditions.

Strategies may be created by integrating chapters to treat patients with complicated coexisting mental illness. For instance, borderline treatment methods may be created by integrating approaches that experts suggest for curing different mental conditions.

Both the content and style of these chapters differ greatly, reflecting the disagreements between the members of the consensus panel who wrote them. As the reader will benefit from these variations in style, the differences have been maintained.


Chapter nine summarizes the treatment types used for treating psychological conditions in individuals that have double mental disorders. The step-by-step treatment model is discussed to mitigate substance addiction risks and drug interaction warnings for coexisting mental illness are checked.

Staff members in the addiction program of coexisting mental illness meet more and more patients who are required to engage in the rehabilitation from prescription medication. Health personnel, therefore, need to be aware of and how the main drugs for treatment are used to treat coexisting mental illness. Agencies engaged in an advisory psychiatrist will also want to discuss the problems posed here with the psychiatrist.

For further analysis on coexisting mental illness, a bibliography is given. A brief description is given in Appendix B of the study cost data on dual disorders. It contrasts the treatment plans of mental illness with attributes such as pay and operating costs.