Substance Abuse Versus Substance Dependence

Individuals with a “dual diagnosis,” that is, with comorbid psychiatric and substance use disorders, are widely regarded as challenging to work with and often difficult to treat successfully. Besides the inherent difficulty oftreating two problems rather than one, treating “dual diagnosis” is further complicated by conflicts over which disorder is primary, uncertainty about establishing an accurate diagnosis, lack of staff and program integration for treating both disorders, and recurrent battles about treatment philosophy.