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Mental Health

People can experience mental health and substance use challenges at the same time. 

It’s common for people with a mental health condition to have a substance use disorder — or for someone who misuses drugs or alcohol to develop mental health issues. 

In fact, 17 million U.S. adults had co-occurring substance use and mental health issues — or a “dual diagnosis” — in 2020. 

The good news is both issues can be treated, and recovery is possible.

Behavioral health professionals today have a great understanding of the connection between these two conditions and ways to treat them together. Rehab providers and treatment specialists know to apply research-based “integrated interventions” that are more effective in jointly addressing mental health and substance use issues.

Are you or someone you know in crisis? 

Get help now by calling or texting 988.

Are you looking for ongoing mental health support?

  • Contact the National Alliance on Mental Illness (NAMI) HelpLine 10 a.m. – 10 p.m. ET, Monday – Friday. Connect with NAMI by phone 800-950-6264 or text“helpline” to 62640, or send a chat message.

  • Find a NAMI Connection support group.

  • Locate a nearby peer-run emotional support group via the NAMI Warmline directory.

Prevalence and common risk factors

An estimated 21.5 million Americans age 18 and over reported having both a mental health condition and substance use disorder (SUD) in the past year, according to the 2022 National Survey on Drug Use and Health. 

People with mental health conditions may use drugs or alcohol in an attempt to lessen their symptoms, but over time this makes them worse. Prolonged use of drugs can alter the brain in ways that cause or contribute to a mental health condition. 

When it comes to substance use and mental health disorders, it’s often hard to know which issue came first or caused the other condition. Most experts agree that SUDs and other mental health conditions share certain characteristics and risk factors, including: 

  • Impact on similar areas of the brain. These conditions target some of the same areas of the brain, making it easier for a person with one condition to develop the other.

  • Genetic vulnerability. Research shows that 40%–60% of people are genetically vulnerable to an SUD, which could then put them at greater risk of developing a co-occurring mental health issue.

  • Environmental stress. Various external factors put people at higher risk of SUD and mental health harm, including chronic stress and trauma. Experts are also exploring how environmental stress, trauma, and exposure to alcohol and drugs can impact behavior even at the molecular level. 
  • Past trauma. People who have experienced trauma in childhood or in their lives (e.g., service members on the battlefield) are at higher risk of co-occurring SUDs and mental health issues such as post-traumatic stress disorder.

Are you experiencing symptoms of a mental health condition? 

Online screening tools from Mental Health America (MHA) and the National Institute on Drug Abuse can help you determine if you’re experiencing symptoms of depression, substance misuse, or a related mental health condition. You can also use these online tools from MHA to boost your mental health and jump-start your or a loved one’s recovery.

Explore pathways of recovery from dual diagnosis disorders

Health care providers and counselors should work with you to understand the nature of your SUD and mental health condition and create a tailored treatment plan. Explore different treatment methods and pathways of recovery:

Withdrawal management

Withdrawal management or detoxification programs are programs that provide care for people experiencing symptoms of withdrawal from alcohol or other drugs.

Learn more about detox. 

Integrated treatment

In treating co-occurring disorders, health care providers consider the overlap in the causes and effects of substance use problems and mental health conditions and aim to explore, address, and heal them together. These integrated treatment approaches are used at many inpatient rehab centers and outpatient treatment programs. They are also used in aftercare as an ongoing or follow-up treatment for substance misuse to help people manage their daily lives without drugs or alcohol.

Integrated treatment programs help people with co-occurring disorders learn about substance use and mental health conditions in a safe and positive way and set goals for treatment. 

Learn if rehab is right for your needs, choose the right rehab program, and explore ways to pay for rehab.

Support groups

People in integrated care may also attend self-help groups to discuss their disorders and learn coping skills in a safe, supportive space.

Learn more about support groups. 


Integrated care programs may also offer medications to help people with mental health conditions:

  • Antipsychotics can help those who are experiencing symptoms of schizophrenia and related disorders.
  • Antidepressants help treat those who have depression that is not caused by their substance use.
  • Anticonvulsants may be beneficial for people with bipolar disorder and may help relieve drug or alcohol withdrawal symptoms.

By pairing medications for co-occurring mental health conditions with rehab treatment, patients get the benefits of stabilization while they work to develop coping skills and recover from their addiction. 

Learn more about medication treatment for SUD.


Medication treatment for SUD is most often successful when paired with evidence-based counseling and therapy tailored to specific needs and behaviors. 

Learn more about counseling.

If you or someone you know is experiencing co-occurring disorders, help is available. Discuss challenges and pathways of recovery with a health care professional.

Explore your treatment options using our treatment locator or through the Substance Abuse and Mental Health Services Administration’s National Helpline.

Find Support near You