Dual Diagnosis

Dual diagnosis describes co-occurring substance use and mental health disorders that interact and require integrated care.

Someone can need help with substance use and mental health at the same time. Drinking or taking drugs may bring temporary relief, worsen an existing condition, or produce symptoms that resemble another illness. Shared influences can also contribute to both difficulties. There is no single sequence that explains everyone.

Good care considers both concerns together. A person should not have to solve one completely before their other needs are taken seriously. Assessment may develop over time, but uncertainty about a diagnosis is a reason to keep looking, not to dismiss distress or postpone necessary help.

New difficulties recognising what is real, marked changes in mood or behaviour, or thoughts of suicide or self-harm need prompt professional attention. Thoughts of suicide or self-harm warrant immediate professional or crisis support; immediate danger or being unable to stay safe requires emergency help. Sudden confusion needs immediate medical help. Urgent help is especially important if someone cannot be woken, is breathing abnormally, has a seizure, becomes severely confused or delirious, or shows other signs of major deterioration. Someone does not need to know exactly what was taken before recognising that something is seriously wrong.

Alcohol withdrawal can be medically dangerous. Someone who may be physically dependent should not assume that abruptly stopping alcohol alone is automatically the safest course. Medical assessment can determine whether withdrawal needs monitoring, medication or a more supported setting. Seizures, severe confusion, hallucinations or other signs of severe alcohol withdrawal require urgent medical attention.

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