Dual Diagnosis Treatment in Massachusetts

It’s common for people with substance use disorders to also struggle with other mental health disorders.¹ Studies show that simultaneous treatment of addiction and co-occurring conditions is typically more effective overall than treating one after the other.²

If you are seeking information about dual diagnosis rehab options in Massachusetts, this article can help you better understand what dual diagnosis is, the symptoms and signs, and where to get help.

What Is a Dual Diagnosis or Co-Occurring Disorder?

The term dual diagnosis is sometimes used to describe people who struggle with a substance use disorder and another form or other forms of mental illness. However, it is more common to hear clinicians refer to these patients as having co-occurring disorders.³

It is often hard to know if a mental health problem came first, as addiction and mental illness share many common risk factors, like genetics, environment, and trauma. In some cases, people begin to misuse substances to cope with an existing mental health issue. In others, substance use contributes to the development of a co-occurring disorder^.1

Reportedly, in Massachusetts in 2016 around 52% of people treated for substance use disorder had been treated for a mental health disorder in the past.⁴

Signs You Need Treatment for a Co-Occurring Disorder

Only a medical professional can determine if a patient has a substance use disorder or a mental health disorder. However, recognizing some of the following criteria used by clinicians when diagnosing a substance use disorder may be an indication to seek a professional evaluation:⁵

• Expressing a desire or making several unsuccessful attempts to cut back or stop using substances
• Continuing to misuse substances despite it causing conflict with loved ones
• Having strong cravings or urges to use a substance.
• Continuing to use a substance despite the knowledge it has caused or worsened medical or psychological issues
• Using substances in high-risk settings, such as driving
• Taking more of a substance or using it for a longer period than intended
• Spending a lot of resources and time looking for a substance, using it, or recovering from substance use
• Failing to fulfill responsibilities at home, work, or school
• Giving up previously enjoyed activities, such as hobbies or sports, in favor of using substances
• Developing tolerance, which means more and more of a substance is needed to experience the desired effects
• Experiencing symptoms of withdrawal when abstaining or using less of the substance

Each mental illness has its own specific set of diagnostic criteria. More on the signs and symptoms of common co-occurring psychological disorders can be found in their respective links below:^1,6

• Anxiety
• Depression
• Bipolar disorder
• Attention-deficit hyperactivity disorder (ADHD)
• Schizophrenia
• Personality disorders
• Posttraumatic stress disorder (PTSD)

If you believe a mental health disorder is being worsened by substance use or is contributing to your substance use, consider seeking professional co-occurring disorder treatment.

Dual Diagnosis Treatment in Massachusetts

There are Massachusetts rehab centers that offer integrated treatment of addiction and co-occurring disorders. One such option is AdCare. AdCare offers a special focus on people with co-occurring disorders on an outpatient basis.

What to Expect in MA Co-Occurring Disorder Treatment

There are various treatment settings for addiction and co-occurring disorders, some of which include:^7,8

• Inpatient treatment, where you stay 24/7 in a closely supervised environment and receive various forms of treatment and a structured schedule of activities.
• Standard outpatient treatment, which only requires visiting the facility several times per week. This option is the most flexible, allowing patients go home at night and even go to school or work while receiving treatment.
• Intensive outpatient care, which typically involves visiting the facility for between 6 and 30 hours per week.

There are numerous approaches for treating substance use and mental health disorders. However, some treatments are effective for a variety of mental illnesses. Some of these include:⁹

• Cognitive-behavioral therapy (CBT), which is a type of behavioral therapy that is designed to help people cope with difficult emotions by challenging unhelpful thoughts and ultimately changing behaviors.
• Dialectical behavioral therapy (DBT), which involves opposing concepts of change and acceptance, teaching skills that can help people to regulate emotions and reduce harmful behaviors.
• Contingency management (CM), which can also help people change behaviors through positive reinforcement, where treatment programs offer vouchers or other incentives for positive behaviors.

Benefits of Dual Diagnosis Treatment

Integrated treatment is generally the most effective approach to treatment of addiction and co-occurring disorders. Studies have shown that treating these conditions simultaneously has superior outcomes when compared to treatment where only one type of disorder is treated at a time.¹⁰

People with co-occurring disorders often display poor adherence in drug or alcohol programs, and integrated treatment helps to remedy this. These programs often also address other issues that affect many people with co-occurring disorders, including homelessness and unemployment.¹⁰

Is Co-Occurring Disorder Treatment Covered by Insurance?

Yes, insurance companies are required to provide coverage for mental health and substance use treatment;¹¹ however, the extent of the coverage depends upon numerous factors that are listed in the summary of benefits and coverage for the individual policy.

Coverage also may depend on whether your insurance company agrees that you meet the criteria for treatment. Your specific treatment setting or length of stay will be determined by your assessment and what your insurance company agrees is necessary.

Medicaid & Medicare Coverage of Co-Occurring Disorder Treatment in Massachusetts

Medicare and Medicaid also covers co-occurring disorder treatment in Massachusetts.¹² You can check with the rehab center you are interested in to see if they accept Medicare or Medicaid. Or, if you have commercial insurance, the treatment program can also check and see if your insurance is accepted by the facility.

American Addiction Centers’ (AAC) facilities allow you to check your insurance coverage online by filling out a confidential online form.

How to Choose the Best Co-Occurring Disorder Treatment Center in Massachusetts

When seeking a treatment center, certain questions can help you find the best possible treatment for yourself or your loved one. For example, consider asking:¹³

• Does the program use evidence-based treatment practices? What kind of treatment does the program use? Many people find holistic treatment approaches beneficial, but these should be provided in conjunction with practices that are backed by scientific research.
• Is the treatment based on individual needs and not a “one-size-fits-all” approach? Can the program address your needs, such as help with co-occurring disorders, parenting, or finding employment?
• Does the program adjust to a person’s changing needs? How will the program adapt to relapses? Does the treatment approach change as the person’s needs change? Will the program add services as needed?
• Is the treatment long enough to work? In general, longer durations of treatment are associated with better outcomes. In addition to detox and rehab, treatment facilities should provide aftercare planning and support.
• Does the program use the ideas and concepts of mutual support and 12-Step programs? These group-based models, such as AA and NA, can be an effective component of ongoing recovery.