Published on August 10, 2026
Written by Charlie Health Editorial Team
What it means when substance use and mental health conditions overlap, and how integrated treatment addresses both at once.
For most people entering substance use treatment, addiction isn’t the only thing they’re managing. Depression, anxiety, trauma, and other mental health conditions usually show up alongside substance use, and treating one while referring out for the other can perpetuate a cycle of fragmented, incomplete healing.
That gap in care is most dangerous in the weeks right after a client leaves a higher level of care. Tolerance drops during a residential or inpatient stay, and overdose risk spikes in the days and weeks following discharge. Those are the losses International Overdose Awareness Day marks each August 31. For a client with acute co-occurring needs, that handoff to the next level of care often matters just as much as the treatment that came before it.
What does it mean to be co-occurring?
A co-occurring condition is when a person has both a mental health condition and a substance use concern at the same time. The conditions interact: untreated anxiety can drive alcohol use, and heavy drinking can deepen depression. Substance use commonly co-occurs with mood disorders, anxiety, and PTSD. Because each can worsen the other, addressing them separately often means neither fully resolves.
Why substance use and mental health should be treated together
Integrated treatment addresses substance use and mental health needs in one coordinated plan instead of in separate tracks, and it’s the approach SAMHSA recommends for co-occurring conditions. When care is split across separate providers without a shared plan, clients can fall into the gaps between them, and the way the conditions feed each other goes unaddressed.
Know someone struggling with substance use or co-occurring conditions?
Our virtual IOP can help.
What level of care is right after inpatient or detox?
Substance use treatment runs on a continuum, and most clients step down as they stabilize. The question after detox, inpatient, or residential care usually isn’t whether a client still needs support, but rather how much. An intensive outpatient program (IOP) is often the right next step: several hours of structured treatment a few days a week while the client lives at home and gets back into a routine.
Many providers and payors use the ASAM Criteria to assess a client across multiple dimensions before making a level-of-care decision. Placing someone in the wrong level or into a program that treats the substance use but not the co-occurring mental health condition, is exactly where post-discharge recovery can break down.
9 min read
The ASAM Criteria, Explained: Why It's the Standard for Substance Use Treatment
How we treat substance use and mental health together
Charlie Health’s Addiction Program for Teens (ages 13-17) and Adults (ages 18-64) is built for clients who need more than weekly therapy but not residential care. Many of them are stepping down from a higher level of care, managing both substance use and mental health concerns. The program runs 6-12 weeks, with 10+ hours of treatment each week.
What the program includes:
- Harm reduction and abstinence-based pathways: Clients choose the group that best fits their recovery goals. Group sessions run 3 times per week for 3 hours, covering processing, skills-building, and experiential therapy. Cohorts are kept separate so those goals aren’t mixed, and a client can switch if their goals change.
- Integrated clinical care: Each client meets weekly with a dedicated licensed Primary Therapist who treats the substance use and co-occurring mental health conditions in one care plan, drawing on evidence-based approaches like CBT, DBT, ACT, and Motivational Interviewing. When clinically indicated, psychiatric care is also available by board-certified psychiatrists.
- Family support: Optional sessions with family members explore relational dynamics and help families heal together.
- Medication-assisted treatment: For clients 16 and older, Charlie Health can start or continue FDA-approved medications to treat alcohol and opioid use disorder, with symptom management support for other substances. Availability of some medications depends on the state.
- Structure and safety between sessions: Between group sessions and individual and family therapy, clients have access to certified peer recovery coaches, a 24/7 crisis line staffed by master’s-level clinicians, and at-home drug testing as needed.
- Placement matched to need: The Clinical Admissions Team uses an ASAM-informed intake assessment to confirm that an IOP is the right level of care and connects clients to a different program or provider when it isn’t.
- Care that continues after discharge: Discharge planning, care navigation, and a free Alumni Program help clients hold their progress beyond IOP.
If you’re weighing whether a client is ready to step down or whether they need more support than weekly therapy can provide, Charlie Health’s Admissions Team can help determine the right next step and coordinate a warm handoff.
After an intake form is submitted or faxed, a client can expect a call in as little as 24 hours, followed by a biopsychosocial intake assessment that informs cohort placement. You can also reach the Admissions Team directly at (986) 206-0414 to learn more about the program.
