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Treating Concurrent Disorders

We care for people with the most complex and severe mental health and substance use problems in British Columbia — many of whom have a concurrent disorder, or a co-occurring mental illness and addiction. We advocate for a whole-person treatment approach.

Person taking notes and person sitting opposite

What is a concurrent disorder?

We use the term concurrent disorder when a person has both a substance use and a mental health disorder at the same time. For example, people with a concurrent disorder might have schizophrenia and an opioid addiction, or post-traumatic stress disorder and an alcohol addiction.

Adding to the complexity of a concurrent disorder is the fact that people with this diagnosis often live with other challenges that can further complicate their illness. This makes recovery even more challenging:

  • An additional mood or personality disorder that makes a client feel particularly anxious, fearful or paranoid
  • A chronic physical illness
  • A history of poor health or dental care due to social barriers
  • Unstable housing and/or unemployment
  • Stigma

Trauma and concurrent disorders

Many patients and clients with concurrent disorders have also experienced trauma, including abuse, neglect, sexual assault, or other adverse experiences, including adverse childhood experiences. Research has clearly shown that trauma is often correlated with mental health and substance use — even more so among women.

An integrated approach to mental health and addiction treatment

Looking at where a person's mental illness or substance use may have come from is key. Root causes are rarely straightforward, but mental illness, addiction, and trauma are often closely linked. Someone may use alcohol to numb the pain of a past trauma, or an opioid to self-medicate for a mental illness, for example. If clinicians try to treat only the substance use, they may miss the core of the problem.

One of the most common illnesses linked to substance use is Post-Traumatic Stress Disorder, or PTSD. A client with untreated PTSD may become anxious and hypervigilant. They may turn to substances to cope, which often make the PTSD worse — and their illness becomes even more complex. They may lose functioning in other areas of their lives, making it even more difficult to seek treatment.

Treating a concurrent disorder

Due to all these factors, concurrent disorder treatment is very complex, requiring comprehensive assessments and diagnoses, expertise from an interdisciplinary team of specialized professionals, and a great deal of time. This is why most of our programs are several months long. Our patients require much more than medication and counselling while on their road to recovery.

Research has shown that patient and client outcomes are better when we treat people using a whole-person approach, addressing substance use, mental illness, chronic health conditions, triggers and trauma, while also identifying and developing personal strengths and resiliency, within one care plan.

Tools our professionals often use include the following:

  • Motivational interviewing
  • Cognitive behavioural therapy
  • Emotion regulation skill building
  • Medication management such as opioid agonist treatment

Concurrent disorder resources

We recommend the following resources for mental health and substance use professionals who treat concurrent disorders:

SOURCE: Treating Concurrent Disorders ( )
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