Defining Concurrent Disorders

Excerpted from the Preface to Treating Concurrent Disorders: A Guide for Counsellors - Approaching Concurrent Disorders

In Ontario, “concurrent disorders” is the term used to refer to co-occurring addiction and mental health problems (see “Defining the Terms,” below). The term covers a wide array of combinations of problems, such as anxiety disorder and alcohol abuse, schizophrenia and cannabis dependence, borderline personality disorder and heroin dependence, and bipolar disorder and problem gambling. These problems can co-occur in a variety of ways. They may be active at the same time or at different times, in the present or in the past, and their symptoms may vary in intensity and form over time.

Note that the term “concurrent disorders” as we define it here does not include co-occurring mental health problems without substance use problems, or co-occurring substance use problems without mental health problems. Such co-occurrences do of course exist, but are not the subject of this book.

Also, our primary focus in this book is on co-occurring mental health and substance use problems, although other behavioural addictions, such as problem gambling, may also be associated with mental health problems.

Defining the terms

Here in Ontario, the Ministry of Health and Long-Term Care uses the term Concurrent Disorders to describe co-occurring addiction and mental health problems. Other terms are used in other places and by different groups. The following list should help to clarify the confusion.

Dual Diagnosis/Dual Disorders: outside of Ontario, these terms are often used to describe what we call concurrent disorders. Much of the literature that comes from the U.S. uses these terms, and focuses on severe mental illness and co-occurring substance use problems. In Ontario, dual diagnosis is used to describe co-occurring developmental delay and mental illness.

Co-morbid Disorders: Co-morbid is a medical term used to describe the presence of more than one significant health problem in a person.

Mentally Ill Chemical Abusers (MICA) and Chemically Abusing Mentally Ill (CAMI): MICA is used to describe people whose primary problem is mental illness, who have co-occurring substance use problems; CAMI refers to people whose primary problem is substance use, who also have mental health problems. Both terms originate in the U.S. literature.

Substance-Abusing Mentally Ill (SAMI): SAMI is used to describe people with serious and persistent substance use and mental health problems.

Double Trouble and Double Jeopardy: These terms are sometimes used by people with co-occurring substance use and mental health problems to refer to their own struggles.

Co-occurring Disorders: This is the term used by the Substance Abuse and Mental Health Services Association (SAMHSA) in their 2002 report to the U.S. Congress.

In the Preface: Approaching Concurrent Disorders:

Defining Concurrent Disorders

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