The term dual diagnosis is often used interchangeably with the terms
co-morbidity, co-occurring illnesses, concurrent disorders, comorbid
disorders, co-occurring disorder, dual disorder, and, double trouble. Professional literature has
used a confusing array of terms and acronyms to describe co-occurring
disorders or a dual diagnosis.
Individuals who experience a dual diagnosis often face a wide range of
psychosocial issues and may experience multiple interacting illnesses
(more than two). The term "co-occurring disorders" is becoming a
common term used to refer to dual diagnosis, or co-occurring substance
abuse disorders and psychiatric or emotional illnesses.
Dual Recovery Anonymous defines "dual
diagnosis" as meaning that an individual has two separate but very
- A psychiatric diagnosis
- A substance abuse diagnosis which may include both drugs and alcohol
A dual diagnosis occurs when an individual is affected by both chemical
dependency and an emotional or psychiatric illness. Both illnesses may
affect an individual physically, psychologically, socially, and
spiritually. Each illness has symptoms that interfere with a person’s
ability to function effectively and relate to themselves and others. Not
only is the individual affected by two separate illnesses, both illnesses
interact with one another. The illnesses may exacerbate each other and
each disorder predisposes to relapse in the other disease. At times the
symptoms can overlap and even mask each other making diagnosis and
treatment more difficult.
A person may sincerely try to recover from one illness and not
acknowledge the other. As a person neglects his or her mental illness,
that illness may recur. This recurrence may, in turn, lead a person to
feel the need to "self-medicate" through drug use. Over time,
the lack of progress toward recovery on both fronts may trigger feelings
of failure and alienation. Perhaps the greatest tragedy is the damage that
occurs to the individual’s self-esteem.
There is no single type of dual diagnosis. The reason is, that there
are numerous forms of psychiatric illness. There are also many patterns of
alcohol or drug abuse. As a result, a variety of different forms of dual
or multiple disorders are possible.
A variety of problems are possible as a result of a dual diagnosis. For
- Psychiatric symptoms may be covered up or masked by alcohol or drug
- Alcohol or drug use or the withdrawal from alcohol or other drugs
can mimic or give the appearance of some psychiatric illness.
- Untreated chemical dependency can contribute to a reoccurrence of
- Untreated psychiatric illness can contribute to an alcohol or drug
Other problems and consequences that are associated with dual disorder
- Family problems or problems in intimate relationships.
- Isolation and social withdrawal.
- Financial problems.
- Employment or school problems.
- High risk behavior while driving.
- Multiple admission for chemical dependency services due to relapse.
- Multiple admissions for psychiatric care.
- Increased emergency room admissions.
- Increased need for health care services.
- Legal problems and possible incarceration.
The term "dual diagnosis" can have different connotations and
definitions depending upon who is using it. Professionals and service
providers may have a narrower definition than that used by Dual Recovery
Anonymous. For our purpose in dual recovery it does not matter how long or
to what degree we have been affected by either of our no-fault illnesses. Membership in the Fellowship of Dual Recovery Anonymous does not
require professional referral and is not dependent upon the extent of
social services and
professional care a person has utilized. Our Second Tradition states that:
"D.R.A. has two requirements for membership; a desire to stop using alcohol
and other intoxicating drugs, and a desire to manage our emotional or
psychiatric illness in a healthy and constructive way."
An individual is in dual recovery when they are actively following a
program that focuses on their recovery needs for both their chemical
dependency and their psychiatric illness.