Editorial - The status of addiction treatment research with co-occurring substance use and psychiatric disorders
Journal of Substance Abuse Treatment Volume 34, Issue 1, January 2008, Pages 1-2

If you “Google” the term “dual disorder patient,” you will see pages of references to the treatment of hypertension and diabetes! Most of us do not think of that combination when we hear the term, but this is just the most common of the many “comorbid” or “co-occurring” combinations of health problems found in contemporary treatment settings. Although the dual disorders of hypertension and diabetes combine to create a very serious condition, the individuals who seek treatment for this combination have some advantages over individuals who seek treatment for a substance use combined with a mental health disorder.

Both hypertension and diabetes are unarguably health conditions—neither is considered a sin, a sign of moral weakness, or a lifestyle. Those seeking treatment may feel reasonably confident that their primary care physician has received training in both of the conditions, that (in most cases) the same providers will be able to diagnose and treat both conditions, and that however problematic the health care coverage may be, it will be reasonably comparable for both conditions. These rather basic aspects of care delivery cannot be assumed when substance use and mental illnesses combine. Yet, these “dual disorders” do combine with great regularity, producing significant debilitation for the individuals affected and their families, significant costs to the health care system, and regular confounding of efforts for those who try to treat either condition without addressing the other. Despite the problems created by the trifurcated research, treatment, and insurance systems in this country (general medical, mental health, and substance use), there have been significant advances in the research and treatment—but not in the insurance coverage—of various combinations of mental and substance use disorders. This special issue of the Journal of Substance Abuse Treatment pays tribute to those clinical researchers who have overcome these systemic impediments to advance our knowledge about these “co-occurring” disorders.
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