Integrated Care for Co-occurring Conditions (COSII)
What is a Co-occurring Condition?
People who have experienced both an emotional/psychiatric and alcohol or drug related issue
are said to be persons with “co-occurring conditions” or disorders. ‘Mental
health issue’ refers to different kinds of brain disorders; for example, depression (lasting
feelings of sadness or helplessness), bipolar disorders (extreme mood swings – highs
and lows), or schizophrenia (a partial or complete break from reality) are all examples of
disorders where brain chemistry is unbalanced. ‘Alcohol or drug related issue’ refers
to the use of alcohol or any illegal drug in a harmful or dangerous way. Not being able to
limit or control the use of substances is also considered a brain disorder.
Many people with co-occurring disorders have experienced trauma. The effects of trauma can
often affect the way the world is experienced. People with mental health, substance abuse,
and trauma frequently have physical health issues as well. Cooccurring conditions can include
a number of difficult experiences that improve when a person embraces and develops their own
ongoing journey of self-discovery/recovery.
Co-occurring conditions are common, but there are many who are not aware that they could be
a person with both diagnoses. One of every two individuals with substance use or mental health
issues has experienced the other at some point in their lives. It is estimated that 9 million
people in the United States have co-occurring conditions/disorders.
Recovery is a process, not a result. Louie L’Amour once said, “You can be so focused
on the destination that you miss out on the journey”. It is helpful if a person gets
integrated treatment that looks at all issues at the same time. It takes many domains of our
life to make a whole being. The recovery journey captures hope. Embraced with courage, it happens
over a lifetime and is a changing, unpredictable process that is often marked by unexpected
setbacks. However, on the recovery journey people can and do achieve meaningful lives in personally
satisfying ways.
Which came first? It’s not easy to know whether the mental health or substance use issue
occurred first. Someone with psychiatric concerns may drink or use drugs for the same reasons
others do, such as attempting to feel calmer, happier, or more sociable. Some people are more
sensitive to the effects and frequent use of substances and the impact this leaves on their
lives.
When people experience relief from the body and mind’s dependency on alcohol or other
drugs, positive effects can be seen in job performance, careers, personal ambitions, physical
and mental health, not to mention goals, hopes, dreams and values. On the other hand, a person
with a substance use issue may develop or experience symptoms of a psychiatric diagnosis which
may become compounded over time. For some, this may become clear only after attempting to stop
or cut down on substances that were often used to mask the emotional, physical or mental pain
of past and present experiences.
