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Substance Use Dual Diagnosis

Substance Use Disorders

Medically reviewed: February 10, 2026 Updated: February 10, 2026

Substance use disorders (SUDs) are treatable medical conditions involving continued use of alcohol or drugs despite harm. Advanced Health and Education in Eatontown, NJ provides comprehensive addiction treatment from medical detox through outpatient care, including specialized dual diagnosis programming.

Substance Use Disorders

Key Facts About Substance Use Disorders

  • Substance use disorder is a medical condition that affects the brain and behavior, not a moral failure. 1
  • Cravings, tolerance, and withdrawal can make stopping difficult—especially without support. 1
  • Co-occurring mental health conditions are common; integrated treatment often improves outcomes. 1-3
  • Medications for opioid use disorder (buprenorphine, methadone, naltrexone) are evidence-based treatments. 2,3
  • Naloxone can reverse opioid overdose and is a key harm-reduction tool. 4

Substance use disorder (SUD) is a medical condition that affects the brain and behavior. It involves continued use of alcohol or drugs despite problems in health, relationships, work, or safety. SUD can range from mild to severe and can involve substances such as alcohol, opioids, stimulants, benzodiazepines, cannabis, and others.1

A key point that many people don’t realize: addiction is not just “lack of willpower.” Repeated substance use can change brain circuits involved in reward, stress, and self-control. Those changes can make cravings stronger and quitting harder—even when someone truly wants to stop.1

Why people keep using—even when they know it’s hurting them

SUD often follows a cycle:

  • Craving and preoccupation with the substance
  • Loss of control (using more than intended, difficulty cutting down)
  • Short-term relief (numbing emotions, stress relief, feeling “normal”)
  • Consequences (health problems, conflict, legal issues, work/school problems)
  • Withdrawal or rebound symptoms that push use again1

SUD and mental health often overlap

Many people use substances to cope with anxiety, depression, trauma symptoms, ADHD, or sleep problems. Over time, substances can worsen the very symptoms they were used to manage (for example, alcohol worsening depression or sleep, stimulants worsening anxiety, or cannabis worsening motivation). Integrated treatment that addresses both mental health and substance use is often essential for lasting recovery.1-3

Recovery is possible—and treatment works

Effective treatment often combines behavioral therapies (skills, relapse prevention, coping strategies), supportive services, and—when appropriate—medications. For opioid use disorder, FDA-approved medications such as buprenorphine, methadone, and naltrexone are evidence-based treatments that can reduce overdose risk and support recovery.2,3

Harm-reduction strategies (like overdose education and naloxone access) can save lives while people work toward change.4

At Advanced Health and Education in Eatontown, New Jersey, we treat substance use disorders through a full continuum of care—from medical detox through partial hospitalization (PHP) and intensive outpatient (IOP). Our dual diagnosis treatment program addresses addiction alongside co-occurring mental health conditions like depression, anxiety, and PTSD using evidence-based therapies including CBT, DBT, and motivational interviewing.

Types of Substance Use Disorders

Substance use disorder can involve many different substances. Each may have unique withdrawal patterns, risks, and treatment considerations.

  • Alcohol Use Disorder
  • Opioid Use Disorder
  • Stimulant Use Disorder (includes cocaine, methamphetamine, and prescription stimulants like Adderall)
  • Benzodiazepine Use Disorder (includes Xanax, Valium, Klonopin, etc.)
  • Cannabis (Marijuana) Use Disorder
  • Inhalant Use Disorder

Signs & Symptoms of Substance Use Disorders

SUD is diagnosed based on patterns of behavior and impact—not just how often someone uses. Signs can show up in health, mood, relationships, and daily functioning. The severity of SUD is determined by the number of diagnostic criteria (specified in the DSM-5) met over a 12-month period.

  • Using more than intended

    Taking larger amounts or using for longer than planned.

  • Unsuccessful attempts to cut down

    Wanting to stop but repeatedly returning to use.

  • Cravings

    Strong urges to use, often triggered by stress, emotions, people, places, or routines.

  • Spending a lot of time using or recovering

    Time devoted to obtaining, using, or recovering from substance effects.

  • Neglecting responsibilities

    Work, school, parenting, or other responsibilities suffer.

  • Relationship conflict

    Ongoing arguments, secrecy, or loss of trust related to substance use.

  • Risky use

    Using in unsafe situations (driving, mixing substances) or continuing despite physical danger.

  • Continuing despite harm

    Use continues despite health problems, mental health worsening, or social/legal consequences.

  • Tolerance

    Needing more to get the same effect (not always present, especially if use has been intermittent).

  • Withdrawal

    Physical or emotional symptoms when stopping or reducing use (varies by substance).

Causes & Risk Factors

SUD usually develops through a combination of biology, environment, and learning.

Brain reward and stress systems

Repeated use can shift the brain toward stronger cravings and stress sensitivity.

Genetics and family history

Inherited vulnerability can increase risk.

Mental health conditions

Anxiety, depression, PTSD, ADHD, and chronic insomnia can increase risk—especially when untreated.

Trauma and chronic stress

Trauma exposure and ongoing stress can drive substance use as a coping strategy.

Social environment

Peer use, availability, and cultural norms can influence initiation and continued use.

Early onset use

Starting substance use in adolescence is linked with higher risk of developing SUD later.

Medical exposure

Prescription exposure (for example, opioids after injury) can be a risk factor for some people.

How Substance Use Disorders Are Diagnosed

Diagnosis involves a structured assessment of substance use patterns, safety, and impact on functioning.

  1. Substance use assessment - Type of substance(s), frequency, amount, route, and history of attempts to cut down.
  2. Screening tools - Clinicians may use validated screening questionnaires to assess severity and risks.
  3. Medical evaluation - Lab tests may be used to evaluate health effects (for example, liver function or infectious disease risk) and guide care.
  4. Withdrawal and overdose risk assessment - Some substances require medically supervised withdrawal; opioids carry overdose risk—especially after periods of abstinence.
  5. Mental health assessment - Evaluation for depression, anxiety, trauma symptoms, and other co-occurring conditions.
  6. Treatment planning and level-of-care matching - Care level is matched to medical/safety needs, severity, and recovery environment.

Treatment Options

Addiction is a medical condition, and recovery starts with the right level of support. At our Eatontown, NJ facility, we use CBT, DBT, motivational interviewing, and family therapy alongside medication-assisted treatment (MAT) when appropriate. Our dual diagnosis program ensures co-occurring mental health conditions are treated simultaneously—not as an afterthought.

Cognitive Behavioral Therapy (CBT)

Cognitive Behavioral Therapy (CBT) is one of the most extensively researched forms of psychotherapy, helping people identify and change the distorted thinking patterns and unhealthy behaviors that contribute to mental health conditions and substance use disorders. At Advanced Health and Education in Eatontown, NJ, CBT is a core component of both our mental health and dual diagnosis programs.

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Dialectical Behavior Therapy (DBT)

Dialectical Behavior Therapy (DBT) is a comprehensive, evidence-based treatment that combines cognitive-behavioral techniques with mindfulness principles to help people who experience intense emotions develop skills in distress tolerance, emotion regulation, and interpersonal effectiveness. At Advanced Health and Education in Eatontown, NJ, DBT skills are integrated across our treatment programs.

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Motivational Interviewing

Motivational interviewing (MI) is a collaborative counseling style that helps you resolve ambivalence and strengthen your own motivation for change—without pressure or judgment. At Advanced Health and Education in Eatontown, NJ, motivational interviewing helps clients build readiness for change across all levels of care.

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Family Therapy

Family therapy is an evidence-based approach that involves family members in the treatment process, recognizing that mental health conditions and substance use disorders affect — and are affected by — the entire family system. By improving communication, resolving conflicts, and strengthening relationships, family therapy supports lasting recovery for everyone involved. At Advanced Health and Education in Eatontown, NJ, family therapy is a key component of our treatment approach.

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Behavioral Activation

Behavioral activation is a structured therapy that helps you break the cycle of depression by reducing avoidance and increasing meaningful, rewarding activities—even when motivation is low. At Advanced Health and Education in Eatontown, NJ, behavioral activation is used to help clients rebuild structure and motivation during treatment.

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Narrative Therapy

Narrative therapy helps you separate yourself from the problem and “re-author” your story by identifying values, strengths, and alternative ways of making meaning. At Advanced Health and Education in Eatontown, NJ, narrative therapy helps clients build a preferred story grounded in their values and strengths.

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Levels of Care at Advanced Health and Education

The right level of care depends on substance type, withdrawal risk, co-occurring conditions, and prior treatment history. Our Monmouth County facility offers a full continuum—from medical detox and stabilization to PHP and IOP—so clients can step down through care as they build stability.

Frequently Asked Questions

Is addiction really a “brain disease”?

Research shows that repeated substance use can change brain circuits involved in reward, stress, decision-making, and self-control. Those changes can make cravings stronger and quitting harder, which is why treatment often needs more than willpower alone.1

Do I have to “hit rock bottom” to get help?

No. Earlier intervention is often easier and safer. Treatment can be helpful at mild, moderate, or severe stages—especially when mental health and substance use are treated together.

What are medications for opioid use disorder (MOUD)?

MOUD refers to FDA-approved medications used to treat opioid use disorder—buprenorphine, methadone, and naltrexone. These medications can reduce cravings, lower overdose risk, and support recovery when combined with counseling and services.2,3

What is naloxone and who should carry it?

Naloxone is a medication that can reverse an opioid overdose when given in time. It’s recommended for people at risk of opioid overdose and for friends/family who may be present during an emergency.4

Can someone have SUD and depression/anxiety at the same time?

Yes—co-occurring mental health conditions are common. Integrated treatment can help address both the substance use and the underlying symptoms that drive it.1-3

What levels of care are available for substance use disorder in New Jersey?

Treatment options range from medically supervised detox and residential care to partial hospitalization (PHP) and intensive outpatient programs (IOP), depending on severity and safety needs.

Is drug and alcohol rehab covered by insurance in New Jersey?

Yes, almost all insurance plans include coverage for some form of substance abuse treatment. To learn more specifics about your plan coverage, reach out to our admissions team for a free confidential insurance verification.

References

  1. National Institute on Drug Abuse. Drugs, Brains, and Behavior: The Science of Addiction. 2014 (revised). Accessed February 10, 2026. Source
  2. Substance Abuse and Mental Health Services Administration (SAMHSA). TIP 63: Medications for Opioid Use Disorder. Accessed February 10, 2026. Source
  3. American Society of Addiction Medicine (ASAM). National Practice Guideline for the Treatment of Opioid Use Disorder. Accessed February 10, 2026. Source
  4. Centers for Disease Control and Prevention. Lifesaving Naloxone. Accessed February 10, 2026. Source

Medically Reviewed By

Kelsey Blakeslee
Kelsey Blakeslee , LCSW

Clinical Director

Kelsey Blakeslee, LCSW, LCADC, is the Clinical Director at Advanced Health and Education, where she provides clinical oversight and leadership for complex mental health and substance use treatment programs. Dually licensed in social work and addiction counseling, she integrates CBT-based, skills-focused, and strengths-based approaches to promote high-quality, ethical care. Kelsey is committed to fostering a collaborative treatment culture centered on clinical excellence and client success.

If you’re in crisis, help is available

If you or someone you love is in immediate danger, call 911. If you’re having thoughts of suicide or self-harm, call or text 988 (Suicide & Crisis Lifeline) or chat at 988lifeline.org. If you are outside the U.S., contact your local emergency number.

Talk to a Clinician About Treatment Options

Advanced Health and Education (Eatontown, NJ) offers personalized care across levels of treatment—from inpatient support to outpatient therapy. Call to speak confidentially with our admissions team and learn what next steps may look like.

Call: (844) 302-8605 Verify Insurance

Related Conditions

Alcohol Use Disorder

Alcohol use disorder (AUD) is a medical condition defined by an inability to control drinking despite negative consequences. Advanced Health and Education in Eatontown, NJ provides comprehensive alcohol addiction treatment, from medical detox through outpatient care.

Learn more

Opioid Use Disorder

Opioid use disorder (OUD) is a chronic medical condition marked by compulsive opioid use despite harmful consequences. Advanced Health and Education in Eatontown, NJ provides comprehensive opioid addiction treatment, including medication-assisted treatment (MAT), medical detox, and residential care.

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Depression

Depression is more than feeling sad—it’s a treatable mental health condition that can affect mood, sleep, energy, and daily functioning.

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Anxiety

Anxiety disorders go beyond everyday worry. They involve persistent fear or worry that’s out of proportion to the situation and hard to control.

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Post-Traumatic Stress Disorder (PTSD)

PTSD develops after trauma and can include intrusive memories, avoidance, mood changes, and hypervigilance. At Advanced Health and Education in Eatontown, NJ, trauma-focused therapies like EMDR and CBT are central to our PTSD treatment approach.

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Bipolar Disorder

Bipolar disorder involves episodes of depression and mania or hypomania—high energy, reduced sleep, and impulsive behavior. At Advanced Health and Education in Eatontown, NJ, we provide structured bipolar disorder treatment to help you achieve long-term stability.

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Get Substance Use Disorder Treatment in Eatontown, NJ

Advanced Health and Education (Eatontown, NJ) offers personalized care across levels of treatment—from inpatient support to outpatient therapy. Call to speak confidentially with our admissions team and learn what next steps may look like.