The Chicken or the Egg? Treating co-occurring disorders

Which came first, the Chicken or the Egg? Many have pondered that existential question without a consensus answer. A similar question exists about co-occurring mental illness and substance use disorders (also referred to as dual-diagnosis).

Did the mental illness create the substance use disorder or vice versa?

pexels-photo-195226.jpegWhile we don’t have a consensus answer about this question either, we do know mental illness and substance use disorders influence each other greatly. More importantly, there is a way to treat them successfully at the same time.

The Substance Abuse and Mental Health Administration’s most recent national survey on drug use and health (2016) provides important statistics and insight about co-occurring mental illness and substance use disorders.  The numbers are staggering. There are 8.2 million adults experiencing both mental illness and substance use disorders simultanously.

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These statistics highlight the need for substance use disorder and mental illness practitioners to work collaboratively to treat both disorders simultaneously.  There is great risk of relapse from substances as well as increased severity of mental illness if both areas are not addressed. Treating co-occurring disorders simultaneously using evidence-based practices like 12-Step and Cognitive Behavioral Therapy greatly increase the chances for long-term successful recovery.  The good news is, we don’t have to know which came first to treat them both successfully.

Adapted from remarks by Dr. John Dakin to the Collin County Psychological Association 4/27/18. 

For information on the SAMHSA nation survey results, visit

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