Understanding Co-Occurring Disorders for effective Substance Use Treatment

Substance use addiction is a complex and deeply personal mental health challenge, one that often coexists with other mental health conditions, known as co-occurring disorders. For many individuals, detox alone is not enough, and even comprehensive treatment programs may not lead to lasting recovery without a more holistic, long-term approach. Families and individuals often invest significant emotional and financial resources into care, only to face the discouraging reality that relapse can (and often does) occur. These moments can leave individuals feeling defeated, ashamed, and with fewer resources than when they began.

Detox is a step in the recovery process, and it is not always the first step. It helps clear the body of substances, providing physical stabilization and the mental clarity needed to engage in deeper therapeutic work. However, for most, detox marks only part of a much longer, more intricate journey toward healing, one that must address both substance use and the underlying mental health factors driving it.

Woman with her head in her hands

So why doesn’t detox, or even a full round of addiction treatment, always “stick”?

The answer, often, lies in co-occurring disorders. Co-occurring disorders are the presence of both a substance use disorder and one or more mental health conditions, such as depression, anxiety, PTSD, bipolar disorder, or trauma. These intertwined conditions require a comprehensive, long-term approach to treatment.

While detox and even extended residential treatment, such as a six-month stay, can be vital steps in recovery, they often represent just the beginning within a traditional recovery framework. It's important to understand that traditional approaches are not the only approaches. What works for one person may not work for another. Addressing both substance use and mental health disorders is a process that takes time, consistency, patience, and individualized care. For many, healing takes years. For others, recovery is a lifelong journey.

National data shows that nearly 50% of individuals with a substance use disorder also experience a co-occurring mental health disorder. These conditions do not exist in isolation. Anxiety may lead someone to use substances to cope; substance use may deepen depression. Trauma, especially when unaddressed, can fuel both substance use and mental health challenges.

Despite this, success in treatment is too often measured solely by abstinence. This narrow definition can be problematic and disheartening. For example, individuals utilizing medication-assisted treatment (MAT) with methadone or buprenorphine to manage opioid use are sometimes not considered "clean" in traditional recovery settings. In some circles, only complete abstinence from all substances and medications qualifies as recovery. While this belief may not always be explicitly stated, it remains pervasive in many recovery communities.

This perspective overlooks the critical importance of progress over perfection. It fails to honor the courage it takes to pursue recovery and the incremental steps that lead to stability and healing, especially for those managing co-occurring disorders. Recognizing and supporting these small but significant milestones is essential to truly compassionate and effective care.

When only one piece of the puzzle is treated, the whole system remains vulnerable.

If someone completes detox but their depression, anxiety, or unresolved trauma is left untreated, they’re far more likely to relapse, not due to a lack of willpower, but because the underlying causes of their substance use haven’t been addressed.

This is where experienced, dual-diagnosis-trained therapists are essential.

Find a therapist who understands the overlap between addiction and mental health.

A therapist trained to diagnose and treat co-occurring disorders will be able to:

  • Recognize when symptoms of a mental health disorder are driving substance use

  • Apply evidence-based, trauma-informed practices that treat both conditions together

  • Help clients identify root causes, triggers, and patterns in a safe, supportive space

  • Work collaboratively with medical providers, psychiatrists, and addiction specialists

  • Support long-term emotional regulation and resilience, not just short-term sobriety

Without this level of integrated care, people often find themselves in a frustrating cycle: detox, relapse, shame, repeat. Not because they’ve failed, but because their treatment didn’t go deep enough.

Healing requires more than abstinence. It requires understanding, safety, and support.

That’s why it’s so important to seek out substance use treatment centers and therapists who specialize in co-occurring disorders. They don’t just focus on stopping the behavior. They help clients build the inner resources, clarity, and healing needed to change their lives.

Integrated Care at Fountain Wellness

At Fountain Wellness, we have a small but mighty clinical team that brings multiple licenses in mental healthcare and addiction therapy, and we have a vested interest in our mission to help others struggling with substance use. Each of us at Fountain Wellness has personally felt the wounds of addiction. We pride ourselves on being a private, family-owned company, managed and led with empathy and integrity.

Our approach focuses on treating the whole person, not just the symptoms, and getting to the root causes of their substance-use addiction. Our addiction recovery program in Colorado integrates peer support, family therapy, and personalized, evidence-based treatment modalities for underlying mental health disorders.

Fountain Wellness understands that recovery is a lifelong journey, and we support and recognize medication-assisted treatment as part of many individuals' recovery process.

Clients being seen weekly for substance use recovery have free access to our weekly virtual support group, as well as our monthly group outings. Graduates of our recovery treatment program receive continued, lasting support by remaining engaged in support groups and wellness outings, free of charge.

If you or a loved one is struggling with addiction and mental health challenges, know this: there is a path forward. It starts with treating the whole person, not just the symptoms.