Dual Diagnosis Treatment Centers in Texas
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About 45% of adults aged 18 and older with a substance use disorder—the medical condition characterized by an uncontrollable use of a substance despite the negative consequences—also had another mental health condition occur concurrently in 2020.1 Luckily, treatment facilities exist to provide care and services for these co-occurring disorders. In fact, more than half of the treatment facilities in Texas offer services for individuals with co-occurring mental health disorders and substance use disorders.2
What Is Dual Diagnosis?
A dual diagnosis, also referred to as “co-occurring disorders,” means an individual has been diagnosed with both a substance use disorder and another mental health disorder like depression or anxiety.3 Substance use disorders often co-occur with other mental health disorders, and diagnosing someone with a substance use disorder and another mental health condition can be challenging for treatment providers, since symptoms that commonly occur during substance intoxication or withdrawal can mimic or share symptoms of other mental illnesses.
When a substance use disorder co-occurs with another mental illness, it doesn’t necessarily mean that one caused the other—and healthcare providers can find it difficult to distinguish which disorder came first. Although it can be helpful to providers to know which came first, research indicates that co-occurring disorders are generally complex and intertwined in such a way that one of the disorders can influence the development, course, and response to treatment of the other.4 Because of this, 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 more common mental disorders that occur with substance use disorder include:5,6
- Generalized and other anxiety
- Major depressive disorder.
- Persistent depressive disorder (dysthymia).
- Bipolar disorder.
- Attention deficit hyperactivity disorder (ADHD).
- Post-traumatic stress disorder (PTSD).
- Borderline and antisocial personality disorders.
- Panic disorder.
- Social anxiety disorder.
- Anorexia nervosa.
- Bulimia nervosa.
- Binge eating disorder.
Signs of a Mental Health Condition
Every mental health disorder comes with its own criteria, or specific set of symptoms outlined in the Diagnostic and Statistical Manual of Mental Disorders, 5th edition, which is used by clinicians who are trained to diagnose individuals. However, there are some general warning signs that point to the possibility of a mental health condition, including:7
- Excessive worrying or fear.
- Regularly feeling incredibly sad.
- Problems thinking clearly and concentrating.
- Extreme mood swings.
- Prolonged feelings of anger or irritability.
- Avoiding family, friends, and social activities.
- Having difficulty understanding or relating to people.
- Changes in sleep habits.
- Feeling tired or low energy.
- Changes in appetite.
- Changes in sex drive.
- Experiencing delusions.
- Experiencing hallucinations.
- An inability to perceive changes in one’s own personality, feelings, and behaviors.
- Misusing alcohol or other substances.
- Experiencing physical ailments with no obvious cause.
- Having suicidal thoughts.
- An inability to complete daily activities due to anxiety or stress.
Signs of Substance Use Disorder
Criteria for substance use disorders are also outlined in the DSM-V, and the symptoms of each type of substance use disorder differ based on the substance, but the general warning signs that an individual might be struggling with substance addiction include:8
- Difficulty or inability to stop using drugs or alcohol even when they want to.
- Experiencing withdrawal when substance use is stopped.
- Having difficulty functioning normally or coping with stress without alcohol or drugs.
- Having trouble completing tasks at home, school, or work because of substance use.
- Inability to stop using even after substance use has caused or worsened physical or mental health conditions or interpersonal relationships.
- Isolating from family and friends or spending time with new friends in order to use substances.
- Frequently tardy or absent from school or work as a result of substance use.
- Not appearing intoxicated after ingesting large amounts of a substance (increased tolerance).
- Participating in risky physical behaviors such as driving under the influence.
- Spending a lot of time getting, using, or recovering from the effects of a substance.
Without treatment, having a substance use disorder and a co-occurring mental disorder typically will worsen the severity of symptoms that arise from one or both disorders.4
Dual Diagnosis Treatment Centers in Texas
Integrated treatment programs screen, assess, and treat individuals who have substance use disorders that co-occur with other mental disorders.
- In 2020, 27,078 individuals were treated in Texas’ 509 substance use rehab facilities.2
- Of those, 273 facilities provided dual diagnosis rehab in Texas.2
- Nearly 23,000 individuals aged 18 and older were diagnosed with co-occurring mental and substance use disorders in Texas in 2020.2
- However, only 11,393 received treatment specifically for co-occurring disorders that year.2
What to Expect in Dual Diagnosis Treatment
In an integrated treatment program, an individual receives medical and therapeutic interventions and care for both disorders concurrently.9 Integrated treatment aims to help people with co-occurring disorders learn how to maintain sobriety or significantly reduce their substance use as well as manage the symptoms of their mental illness though effective counseling, evidence-based behavioral therapy interventions, and sometimes medications.9
Integrated treatment varies for each person to meet their needs, but care may include:3,5
- Detoxification: In many instances, detoxification is the first step in the recovery process. During medically managed detox, the body rids itself of the substances and withdrawal symptoms are experienced and managed while under the supervision of medical professionals, who work to keep the individual as safe and as comfortable as possible.
- Inpatient treatment: Inpatient rehabilitation centers provide housing and 24/7 medical and mental health care for the duration of treatment. Therapy, support, and medication (if needed) help individuals learn alternative ways of coping with thoughts and issues that brought on their substance use as well as the symptoms of their co-occurring disorders.
- Outpatient treatment: An outpatient program offers services that are similar (even identical) to inpatient programs, including therapy and support, while they live at home or in a sober living environment. There are various levels of outpatient care—from programs that take place once a week to therapies that happen several days each week.
Integrated treatment may utilize multiple evidence-based therapeutic techniques to help people with mental health disorders including substance use disorders. These therapies may include:10
- Cognitive-behavioral therapy (CBT). CBT is a form of psychotherapy that challenges a person’s negative or irrational thought or belief patterns and provides a method for coping and changing their behaviors.
- Dialectical behavior therapy (DBT). This therapy implements mindfulness techniques to encourage an individual to be more aware of what is happening around them in the moment, strengthen relationships with others, and reduce negative emotions and actions such as substance use and suicidal behavior.
- Contingency management. Individuals receive rewards for positive and healthy behaviors such as passing a drug test or avoiding self-harm.
- Mutual-help groups. Individuals attend community-based support groups tailored to people with substance misuse (e.g., Alcoholics Anonymous) and/or with co-occurring disorders such as Dual Diagnosis Anonymous.
Benefits of Dual Diagnosis Treatment
The integrated treatment model is considered to be the standard of care when treating individuals with co-occurring substance use and mental health disorders.5 Research indicates that this treatment approach is superior to treating both disorders separately and can lead to many positive outcomes, including:11
- Reducing the person’s use of the substance or helping them abstain from it completely.
- Targeting mental health symptoms and improving the individual’s functioning
- Increasing the chances of successful treatment and recovery for both disorders.
- Improving a person’s quality of life.
- Decreasing the chances of hospitalization and serious harm.
- Lowering the chances of interactions between medications.
- Increasing the likelihood of the individual being in a stable housing environment.
- Lessening the risk of being involved in criminal activity.
Dual Diagnosis Medications
Combined psychopharmacological interventions involve medications given to an individual to help reduce addiction to or cravings for a substance in addition to medications given to treat the symptoms of a mental health disorder.5 Medications that may be used during—and beyond—formal treatment may include:5
- Antidepressants to treat symptoms associated with depression and anxiety.
- Anxiolytics and sedatives including benzodiazepines are sometimes prescribed for short periods to reduce symptoms of anxiety or stave off panic attacks.
- Selective serotonin reuptake inhibitors (SSRIs) to treat the symptoms associated with PTSD.
- Mood stabilizers, anti-seizure medications, and antipsychotic medications may help relieve symptoms associated with bipolar disorder.
- Antipsychotic medications are commonly used to treat individuals with schizophrenia and other psychotic disorders.
- Non-stimulant and stimulant medications help individuals manage symptoms of ADHD.
- Disulfiram may be prescribed for people with alcohol use disorder to disincentivize drinking by causing unpleasant side effects such as nausea and vomiting when alcohol is consumed.
- Acamprosate normalizes brain activity dysregulated by addiction and during post-acute withdrawal for those with alcohol use disorder.
- Methadone, buprenorphine, and naltrexone are all FDA-approved medications used for people with opioid use disorder to increase abstinence, reduce the risk of relapse, and mitigate negative outcomes of opioid addiction.
- Naltrexone is also used to treat individuals with alcohol use disorder, as it can block the euphoric effects of alcohol intoxication.
Our Dual Diagnosis Treatment Center in Texas
American Addiction Centers (AAC) has top-quality treatment centers located across the country. Greenhouse Treatment Center in the Dallas-Fort Worth area provides co-occurring disorder treatment. AAC’s integrated treatment approach for co-occurring disorders can help you to learn how to effectively manage the potentially debilitating and life-threatening conditions to live a happy and healthy life.
Is Dual Diagnosis Treatment Covered by Insurance?
Dual diagnosis insurance coverage varies depending on several factors. The type of policy and plan determines the specific services covered. However, the Affordable Care Act and the Mental Health Parity and Addiction Equity Act changed how insurance providers cover substance use and other mental health disorders.12 The Affordable Care Act 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.13 The Affordable Care Act also ensures that restrictions for mental and behavioral health conditions aren’t more restrictive than they are for physical health conditions.13
Medicaid and Medicare Coverage of Dual Diagnosis in Texas
If you are a recipient of Medicare or Medicaid, you can verify your benefits for dual diagnosis treatment in Texas. Start by contacting the facility where you’d like to enroll and find out if they have co-occurring disorder treatment services. Next, they can see if they are in-network with your insurance provider.
There are 137 Texas rehab centers that accept Medicare and 290 facilities that accept Medicaid in the state.2
How to Choose the Best Dual Diagnosis Treatment Center
An integrated approach to treatment will take into account the treatment needs of the individual. Questions to ask a facility you’re considering include:
- Is the facility licensed and accredited?
- What treatment models does the center offer?
- How long is the program?
- Does the program adequately cover both conditions concurrently (substance use and mental health disorder)?
- Does the dual diagnosis program specifically address your unique issues and patterns of substance use?
- Is the program staffed by trained professionals who are familiar with co-occurring disorders?
- Is the treatment facility in-network with your insurance?
- If your insurance doesn’t cover treatment in its entirety, what financing options are available?
- What kind of aftercare or continuing care support does the facility offer?