Co-occurring Addictive and Psychiatric Disorders

American Society of Addiction Medicine recommends the following:

1. Clinicians working in all medical care settings, including primary care, specialty care for psychiatric or addictive disorders, other medical specialties and public health settings, should be educated about the prevalence and importance of co-occurring psychiatric and addictive disorders.

2. Clinicians referring patients to either mental health or addiction treatment should consider the possibility that co-occurring disorders are present in these patients.

3. Physicians and other health professionals treating patients for psychiatric or addictive disorders should carefully evaluate such patients for co-occurring disorders and incorporate attention to all of these disorders in the formulation of a treatment plan.

4. Treatment settings in which dual diagnosis patients receive care should assure that the training and competence of their staff members is sufficient to deal effectively with these patients. Where staff expertise is not adequate, dual diagnosis patients should be referred to appropriate services, or the treatment setting should develop cooperative treatment arrangements with other treatment facilities. Where such arrangements are made, frequent communication and close cooperation between the two treatment services and among all clinicians treating the patient are important.

5. Because families of persons with co-occurring disorders are often faced with special problems, family members should be included in the treatment plan and receive adequate and appropriate services.

6. ASAM’s Patient Placement Criteria for the Treatment of Substance Use Disorders: Second Edition-Revised should be used as a guide for therapeutic placement for dual diagnosis patients.

7. Health insurance carriers should be aware of the special treatment needs of dual diagnosis patients and provide adequate coverage for their care

8. Publicly funded addiction and mental health treatment at all levels of government (federal, state and local) should recognize the special needs of dual diagnosis patients in their program planning and budgeting.

9. Training in the recognition and treatment of patients with co-occurring disorders should be part of the curriculum in mental health and addiction education at all levels and for all professionals.

10. Research into the epidemiology, neurobiology, phenomenology, clinical course and treatment of these disorders should be a high priority for governments, universities and other research institutions.