Dual Diagnosis Treatment Centers in New Jersey

What Is Dual Diagnosis?

The term dual diagnosis, also referred to as co-occurring disorders, has been used for many years to describe people who have been diagnosed with both a mental health disorder—like depression or anxiety—and a substance use disorder. In recent years, however, most literature replaced the term “dual diagnosis” with “co-occurring disorders,” since “dual diagnosis” was too broad a term and included individuals with mental health and developmental disorders as well.⁴

Diagnosing an individual with a substance use disorder and another co-occurring mental health disorder can be challenging for treatment providers since symptoms that commonly occur during substance intoxication can mimic or share symptoms of other mental illnesses.

Research indicates that co-occurring disorders are generally complex and intertwined in such a way that one of the disorders may influence the development, course, and response to treatment of the other.⁵ As a result, the standard of care for co-occurring disorders is to treat both disorders at the same time.^4,5

Co-occurring disorders may include any combination of one or more mental disorders with substance use disorder, but some of the most common mental disorders that co-occur with substance use disorder include:^4,6,7

• Generalized and other anxiety.
• Major depression.
• Persistent depressive disorder (dysthymia).
• Attention-deficit hyperactivity disorder (ADHD).
• Bipolar disorder.
• Post-traumatic stress disorder (PTSD).
• Borderline and antisocial personality disorders.
• Panic disorder.
• Social anxiety disorder.
• Schizophrenia.
• Anorexia nervosa.
• Bulimia nervosa.
• Binge eating disorder.

To give a bit of perspective, studies estimate that about 47% of individuals diagnosed with bipolar disorder will also have a substance use disorder.⁸ Similarly, roughly 40% of individuals diagnosed with major depression will also be diagnosed with an alcohol use disorder, the medical term for alcohol addiction.⁸

In New Jersey, recent statistics on co-occurring disorders indicate the following:^3,9

• Among the adults treated in the state’s mental health system for mental illness in 2020, 22% also received a substance use disorder diagnosis.
• In 2020, 24,931 individuals in New Jersey were diagnosed with co-occurring mental health and substance use disorders.
• Of those individuals, only 12,740 received treatment for their co-occurring disorders in rehabs in New Jersey.

Signs of a Mental Health Disorder

Only a trained professional can diagnose someone with a mental health disorder and/or substance use disorder, according to the criteria outlined in the Diagnostic and Statistical Manual of Mental Disorders, 5^th edition. However, these symptoms may indicate the need for further evaluation. When an individual has a mental health disorder, some of the signs they may exhibit can include:¹⁰

• Angry outbursts or feelings of intense anger.
• Social isolation.
• Difficulty understanding or relating to people.
• Concentration problems.
• Changes in normal sleep patterns, such as sleeping too much or too little.
• Being tired or having low energy.
• Feelings of intense sadness.
• Changes in appetite.
• Changes in sex drive.
• Intense worry over gaining weight.
• Suicidal thoughts or attempts.
• Seeing or hearing things that other people do not see or hear.
• An inability to perceive changes in one’s own personality, feelings, and behaviors.
• Misusing alcohol or other substances.
• Experiencing extreme mood changes, including uncontrollable highs.
• Experiencing physical ailments with no obvious cause.
• Excessive worries and fears.
• An inability to complete daily activities due to anxiety or stress.

Signs of a Substance Use Disorder

Criteria for substance use disorders are also outlined in the DSM-V, and symptoms vary based on the substance, but the general warning signs of a substance use disorder may include:¹¹

• Taking more of a substance than the individual initially intends.
• Having strong cravings or urges to use a substance.
• Using a substance leads to arguments about using with loved ones.
• Spending a lot of time, money, and/or energy to locate a substance, use it, and recover from using it.
• Abandoning activities or hobbies that were once loved and instead using the substance.
• Being unable to fulfill roles and obligations at work, home, and school.
• Using a substance in risky situations, such as driving.
• Continuing to use the substance, even though they know it makes a medical or mental health condition more severe.
• Trying to cut back or stop using the substance but being unable to do so on their own.
• Becoming tolerant, which means they need more and more of the substance to keep feeling the effects of it.
• Experiencing signs of withdrawal if they stop using it.

Dual Diagnosis Treatment in New Jersey

If you or your loved one need treatment for a co-occurring disorder, you may be interested in finding options for a dual diagnosis treatment center in New Jersey. There are 207 programs that treat people with co-occurring substance use and mental health disorders in New Jersey.³

What to Expect

When you enter treatment for co-occurring disorders, integrated treatment means that you receive medical and therapeutic interventions and care for both disorders concurrently. ¹² Integrated treatment aims to help individuals with co-occurring disorders learn how to maintain sobriety or drastically reduce their substance use as well as manage the symptoms of their mental illness through effective counseling, evidence-based behavioral therapy interventions, and sometimes medications.¹²

Integrated treatment varies for everyone, depending on their specific needs, but may include:¹³

• Medical detoxification. Detox is necessary for some people to safely manage the physical and psychological symptoms associated with withdrawal from substances. Detox is not treatment, but rather a first step to prepare a person for treatment.
• Inpatient treatment. Inpatient or residential treatment requires you to live in a closely supervised environment and receive various forms of counseling, behavioral treatments, education and other structured activities.
• Outpatient treatment. Outpatient services allow you to continue living at home but attend treatment at the facility. These onsite sessions range from a few hours to 20 hours per week. Depending on the type of outpatient treatment, you might be able to continue working or attending school while you receive treatment.

Within treatment programs, whether inpatient or outpatient, there are treatment approaches that are helpful for both substance use disorders and mental health disorders. These treatment interventions may include:^6,13,14

• Cognitive-behavioral therapy (CBT). CBT challenges an individual’s negative or irrational thoughts and behaviors and provides a method to manage and change their thoughts—and ultimately their behavior—for the better.
• Dialectical behavior therapy (DBT). DBT includes the concepts of mindfulness, which, when applied to specific coping skills that are taught in DBT, can help people learn to be more aware of what’s happening to them in the moment, manage their emotions, strengthen relationships, and reduce self-harm.
• Contingency management (CM). CM also helps people change behaviors through positive reinforcement. CM provides incentives or rewards to reinforce positive behavior, such as passing a drug test or attending a certain number of mutual-help groups.
• 12-Step facilitation. These community-based support groups, such as Alcoholics Anonymous (AA) or Dual Diagnosis Anonymous, encourage continuing attendance after treatment ends to promote lasting recovery.

Benefits of Dual Diagnosis Treatment

As previously mentioned, integrated treatment is considered the standard of care when it comes to treating individuals with co-occurring substance use and mental health disorders.⁴ Research indicates that integrated treatment produces superior outcomes over programs that treat the disorders separately and can lead to positive outcomes, including:¹⁵

• Reducing the individual’s substance use or helping them abstain from it completely.
• Targeting mental health symptoms and improving the individual’s functioning.
• Increasing the chances of successful treatment and lasting recovery for both disorders.
• Improving an individual’s quality of life.
• Decreasing the likelihood of hospitalization or serious harm.
• Lowering the probability of medication interactions.
• Increasing the chances of an individual being in a stable housing environment.
• Lessening the risk of the individual being involved in criminal activity.

Dual Diagnosis Medications

Medications used in addiction treatment to aid individuals in managing withdrawal symptoms, helping control cravings for a substance, and increasing rates of long-term recovery, may be combined with medications to treat the symptoms of a mental health disorder.⁴

Medications that may be used during and beyond formal treatment include: ⁴

• Buprenorphine, naltrexone, and methadone. These FDA-approved medications help individuals with opioid use disorder increase abstinence, reduce the risk of relapse, and mitigate the negative outcomes of opioid addiction.
• Acamprosate. This is a prescription medication that can help some people stop drinking. Notably, however, it does not help manage withdrawal.
• Naltrexone. Similar to its use for treating opioid use disorder, naltrexone also blocks the effects of alcohol on the body.
• Disulfiram. Disulfiram causes an individual to experience unpleasant side effects, such as nausea and vomiting, when they consume alcohol.
• Antidepressants. Antidepressants may be used to treat the symptoms associated with depression and anxiety.
• Anxiolytics and sedatives, including benzodiazepines. These medications me be prescribed for short periods to reduce symptoms of anxiety or stave off panic attacks.
• Selective serotonin reuptake inhibitors (SSRIs). SSRIs treat the symptoms of PTSD.
• Mood stabilizers, anti-seizure medications, and antipsychotic medications. These may be prescribed to help relieve the symptoms associated with bipolar disorder.
• Antipsychotic medications. These are commonly used to treat individuals with schizophrenia and other psychotic disorders.
• Non-stimulant and stimulant medications. These help individuals with ADHD.

Is Dual Diagnosis Treatment Covered by Insurance?

Due to government regulations, such as the Affordable Care Act (ACA) and the Mental Health Parity and Equity Act (MHPEA), many commercial insurance programs must cover mental health and substance use treatment.¹⁶ The ACA ensures that treatment for substance use and mental health disorders is considered an essential benefit, requiring insurance providers to offer similar coverage for substance use and mental health disorders as they do for other physical health disorders.¹⁷ The ACA also ensures that restrictions for mental and behavioral health conditions aren’t more restrictive than they are for physical health conditions.¹⁷

However, dual diagnosis coverage depends on several factors. The type of policy and plan determines the specific services covered. If you have commercial insurance, you can call the number on the back of your insurance card and find out which treatment programs might be covered by your plan.

Medicaid and Medicare Coverage of Dual Diagnosis in New Jersey

Medicare and Medicaid may cover your treatment for a co-occurring disorder in New Jersey. Recent data suggests that around 60% of treatment programs in New Jersey accept Medicaid and around 29% accept Medicare.³

The best way to find out about Medicare or Medicaid coverage is to call the treatment program that you are interested in and find out their policies on coverage.

How to Choose the Best Dual Diagnosis Treatment Center

It can be a challenge to find the right treatment program for co-occurring disorders, but there are some questions that you can ask the treatment program to help guide you in your decision. When seeking the best option for yourself or a loved one, ask questions, including:¹⁸

• How does the program utilize evidence-based practices that are based on research? Which treatment approaches does the rehab program utilize? Are there any statistics on treatment outcomes that the program can provide to demonstrate treatment effectiveness?
• Is treatment individualized and tailored to your specific needs? For example, if you really need help locating stable housing, does the program offer this service?
• What does the program do to address the changing needs of an individual in treatment? If you are doing well and then relapse during treatment, how does the program handle this? If you need more intense services, can the program adjust and do this for you?
• How long does the program last for most people? Will the planned treatment be long enough to be effective?
• Will the program use the ideas and concepts of 12-Step programs, such as AA or Narcotics Anonymous? These mutual-help, group-based models can be an effective component for ongoing recovery.

American Addiction Centers offers treatment for addiction and co-occurring disorders across the nation, including at several locations in the northeast. For help in finding a program, call us at .