Substance use disorders affect the brain and behavior, causing difficulties in work, school, or in relationships. These disorders involve patterns of behaviors that might include using more of the substance than planned, finding it difficult to stop, or continuing to use despite knowing it's causing harm.
Sometimes, people with substance use disorders may take risks while using, like driving under the influence. They can develop tolerance (needing more of the substance to feel the same effects) or withdrawal symptoms when they stop. Substance use disorders exist on a spectrum, ranging from mild to severe, but it's important to remember that substance use disorders are treatable.
The relationship between substance use and mental disorders is complex and often interconnected. Many people with substance use disorders also experience other mental disorders like depression, anxiety, or bipolar disorder. Similarly, people with mental disorders are at a higher risk of developing substance use problems.
For more information, please see the National Institute on Drug Abuse (NIDA) webpage on Co-Occurring Disorders and Health Conditions .
Why do substance use and other mental disorders occur together?
Research suggests possibilities that could explain why substance use disorders and other mental disorders may occur together:
- Certain environmental factors (like stress or trauma, and genetics) can contribute to developing both substance use disorders and other mental disorders.
- Mental disorders can lead to an increase in risky behaviors, including using substances to cope. Additionally, some mental disorders alter the brain in ways that can make substances feel more rewarding, further increasing the risk of substance use disorders.
- The reverse is also true: Substance use can contribute to brain changes that increase the risk of other mental disorders.
How are these co-occurring disorders diagnosed and treated?
Accurate diagnosis is key for treating co-occurring substance use and mental disorders, since symptoms may overlap. Health care providers with experience in both substance use disorders and mental disorders can use comprehensive assessment tools to reduce the chance of a missed diagnosis and create an effective treatment plan.
Talk to your health care provider to determine the best treatment for you. It is important to give any treatment plan a chance to work before deciding whether it is right for you.
- Integrated care combines mental health and substance use treatment so patients can receive more convenient, coordinated care in one place. Treatment can involve behavioral therapies, medications, care management services, or a combination. Care teams work with patients to help find evidence-supported treatments that work for the patient.
- Behavioral therapies such as cognitive behavioral therapy, contingency management, and motivational interviewing can help individuals build coping skills and learn to manage co-occurring substance use and mental disorders.
- Family-based interventions like Multisystemic Therapy and Functional Family Therapy, which focus on improving family dynamics and communication and addressing environmental factors that contribute to substance use and mental health issues, can be particularly effective.
- Medications can effectively treat addictions to opioids and alcohol and lessen the symptoms of many other mental disorders. Some medications may be useful in treating multiple disorders.
Federal resources on treatment
How can I find help for co-occurring substance use and mental disorders?
How is NIMH research addressing this critical topic?
NIMH is supporting research to expand therapeutic options for treating addiction, including overdose treatment and medication-assisted treatment for opioid use disorder. As part of the Helping to End Addiction Long-term® Initiative (NIH HEAL Initiative®), NIMH leads a research program that seeks to optimize the delivery of services for people with opioid use disorders, mental disorders, and suicide risk.
Explore clinical trials for co-occurring substance use and mental disorders
Clinical trials are research studies that look at new ways to prevent, detect, or treat diseases and conditions. To learn more or find a study, visit:
Additional federal resources
- MedlinePlus: Information, journal articles, and other resources collected by the National Library of Medicine. Many resources are also available in Spanish.
- National Institute on Drug Abuse (NIDA)
- DrugFacts : Plain and simple facts about drugs and addiction.
- Parents and Educators : Science-based information about drug use, health, and the developing brain for young people and their parents, guardians, teachers, and other educators
- Substance Use and Mental Health Services Administration (SAMHSA)
Last reviewed: March 2025
