Key Researchers


Overview of Substance Abuse and Co-occurring Disorders


Mark P. McGovern, Ph.D., Dartmouth Medical School

Review Panel: Ron Claus, Ph.D., Missouri Institute of Mental Health, University of Missouri School of Medicine, Joseph E. Comaty, PhD, M.P., ABMP, Office of Mental Health, Louisiana Department of Health & Hospitals, Heather J. Gotham, Ph.D., Mid-America Addiction Technology Transfer Center, University of Missouri-Kansas City
Introduction: In health care, the term "co-occurring disorder" has imprecise meaning. Diabetes and hypertension commonly co-occur, complicate the treatment of one another, and, if both are present, lead to less favorable outcomes. The medical care system recognizes the common nature of this co-morbidity, so treating both in an integrated way is standard care.

In the field of substance abuse, "co-occurring disorder" has come to mean co-occurring substance use and psychiatric disorders (McGovern and McLellan, 2008). The detection, diagnosis, and treatment for substance use disorders and psychiatric disorders have become increasingly sophisticated within the parallel and separate mental health and addiction treatment systems that currently exist in the United States. However, when the two disorders co-occur in the same individual, these systems of care do not intersect as well as they do for other medical diseases like hypertension and diabetes.

Epidemiological and clinical studies have revealed that co-occurring psychiatric problems in the context of a substance use disorder are (1) prevalent; (2) associated with negative treatment and life outcomes; and (3) not typically treated using an integrated approach, despite the evidence that integrated treatments are most effective. The most recent estimates from SAMHSA are that 5.4 million adults in the United States have a co-occurring disorder. Most (53.5%) do not receive treatment, and of those who do, only about 10% receive care for both at the same time. Even fewer receive services that are integrated, i.e., delivered by the same person or program (SAMHSA, 2008).

Date Updated :
Original Date: Mar. 2010

Mark P. McGovern, Ph.D.; Substance Abuse and Co-occurring Disorders Knowledge Asset, Web site created by the Robert Wood Johnson Foundation's Substance Abuse Policy Research Program; March 2010.,

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