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“Co-occurring substance use and mental health disorders often present with more severe mental health problems, earlier relapse, greater difficulty maintaining abstinence, more mental health hospitalizations, and greater risk for suicide attempts,” as well as more symptoms of each disorder (Reedy, 2020, p. Why does it matter? Co-occurring disorders and substance misuse/substance use disorders present exceptional life and intervention challenges. In other words, Problem A might influence Problem B, which then causes a change (worsening) in Problem A, which then changes Problem B, and so forth over time. The relationship between problems can be even more complex, including that they are iteratively interacting over time.

Conceptually, this situation exists when both problems (A and B) have shared, common risk or vulnerability factors contributing to their development or expression (NIDA, 2018). intimate partner violence, sexual assault, child maltreatment, or military combat). For example, both alcohol misuse and a mental disorder may be influenced by a common genetic thread or from experiencing violence (e.g. However, each may be caused or influenced by the same third factor. Yet, another possibility is that some third factor influences the emergence of both problems A and B-Problem A does not cause Problem B, nor does Problem B cause Problem A. For example, alcohol misuse (or other form of substance misuse) can contribute to the development or expression of mental disorders (NIDA, 2018). Or, the opposite may be true: Problem B may cause Problem A. For example, mental disorders can contribute to alcohol (or other substance) misuse and use disorder (NIDA, 2018). Quite possibly, Problem A causes Problem B, or at least increases the probability that Problem B will arise. Let’s consider examples where Problem A is a form of mental disorder and problem B is an alcohol use disorder. When two or more problems coincide like this (they co-occur or are concomitants), several possible models explain the possible relationship between them. These are issues, concerns, or problems that occur together, are associated with one another, and/or coincide closely in time or over the course of time.

infectious disease exposure and progression of diseaseĪs we progress through this module, consider what is meant by co-occurring or concomitant problems.

Second, we explore physical health and disability conditions that commonly co-occur with substance misuse, including:

multiple types of substance use disorder or addictive behaviors (e.g.

attention deficit disorder (ADD) with and without hyperactivity (ADHD).

mood disorders (e.g., depression, anxiety/panic).

The list about which there is available evidence includes: 1: Problems That Commonly Co-occur With Substance Misuseįirst, we explore mental/behavioral health challenges that commonly co-occur with substance misuse.

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