This page provides an overview of the main considerations when planning and delivering health and social responses for people experiencing co‑occurring mental health and substance use disorders. It examines the availability and effectiveness of these responses and explores the implications for policy and practice.

In a nutshell

What are dual disorders? 

• Dual disorders refer to the co-occurrence of mental health disorders and substance use disorders in the same individual.

Why are they relevant? 

• They are very common among people with substance use problems.
• They increase the risk of poor health outcomes and social marginalisation.
• They are associated with complex, cyclical interactions, where each condition can exacerbate the other, complicating diagnosis, treatment and recovery.

What are the main responses?

• Integrated care: treating mental health and substance use disorders together.
• Coordinated services: combining psychiatric care, medication, addiction treatment and social support.
• Comprehensive approach: early detection, assessment, personalised plans and ongoing support to prevent relapse.
• Psychosocial interventions: cognitive behavioural therapy, motivational interviewing, contingency management, family-based and digital therapies.
• Pharmacological care: management of possible pharmacological interactions with other ongoing substance use treatments, and use of other substances.
• Professional training: equipping staff for the integrated care of dual disorders.

The European picture

• Overall, there are considerable differences in the approaches used across European countries to respond to dual disorders.
• A majority of countries have some service providing integrated care, mostly in urban settings, although coverage remains limited.