Addiction & dual diagnosis

If you live with an addiction, you find it difficult to control or stop how much you use a substance or carry out a behavior.

Addictive disorders are very common, and often involve the overuse of alcohol and drugs. Without the right support, living with an addiction can have a negative impact on your life and the lives of your family and friends by changing how you feel and act and affecting your physical and emotional health.

However, addictive disorders are treatable; if you think you might be going through an addiction, there are treatments and supports available to help you in your recovery.

What are the signs of an addiction?

What are the signs of an addiction?

Alcohol addiction

The levels of alcohol use in Ireland are among the highest in Europe. Being dependent on alcohol means that you cannot physically or emotionally function properly without it; it is thought that about one in 20 adults in Ireland is dependent on alcohol. A further 7% of people in Ireland are estimated to abuse alcohol, which means they use alcohol in a range of ways which put health at risk. For example, there has been a rise in binge drinking, which is drinking a large amount of alcohol in a short space of time, especially among young men and women.

If you start feeling that you need alcohol to get through your day, it can become more difficult to control how much and how often you drink. Some symptoms and behaviours which could be a sign you have an alcohol addiction include:

  • Feeling strong urges or cravings to drink alcohol
  • Focusing a lot of energy or spending a lot of money on getting alcohol
  • Spending a lot of time drinking alcohol or recovering from using it
  • Being unable to limit the amount of alcohol you drink
  • Continuing to drink alcohol even when you know it's causing physical, social or relationship problems
  • Developing a tolerance to alcohol so you need more to feel its effect
  • Experiencing withdrawal symptoms when you don't drink, such as nausea, sweating and shaking
  • Drinking alcohol to avoid certain feelings or withdrawal symptoms
  • Failing to complete important responsibilities at home, work or college because of how you use alcohol
  • Giving up or reducing your hobbies or usual social and work activities
  • Using alcohol in unsafe situations, such as when driving or swimming
  • Wanting or trying unsuccessfully to cut down on how much you drink.

Drug addiction

A drug is a chemical substance which has a physical or psychological impact on your body or mind. Taking a drug can affect your thoughts, feelings and moods. Drugs come in different forms and have various effects. Some are legal, such as prescription medication, while others are illegal, such as cannabis or cocaine.

In Ireland, there has been a rise in the abuse of drugs, including marijuana and tranquillisers, in recent years.

Behaviours and symptoms relating to drug addiction include:

  • Having very strong urges to take the drug
  • Feeling that you have to use the drug regularly, such as every day or even a few times a day
  • Focusing growing amounts of time and energy on getting and using the drug
  • Needing to use more of the drug to get the same feeling
  • Making sure that you keep a supply of the drug
  • Spending a lot of money on the drug, even if you can't afford it
  • Doing things to get the drug, like stealing or lying, that you normally wouldn't do
  • Neglecting or missing obligations and responsibilities at home, work or college
  • Reducing your social activities or hobbies
  • Driving or doing other risky activities when you're using the drug
  • Feeling withdrawal symptoms when you stop taking the drug.
  • Failing when you try to stop using the drug.

What is dual diagnosis?

“Dual diagnosis” is the term used when two medical conditions are present at the same time. In mental health and psychiatry, dual diagnosis means that you are going through both a mental health disorder and an alcohol or drug problem.

It is important to treat the two conditions in a dual diagnosis. Regardless of how you are recovering from your addiction, the mental health condition you are living with will not go away without treatment. Evidence shows that, when you receive care and treatment for both the addiction and the underlying psychological problem, you can usually expect a good recovery.

Below, you can find more information about some mental health conditions which are often present in a dual diagnosis.

  • Mood disorders

    A mood disorder is a mental health condition that affects your emotional state. Mood disorders are very common. There are very significant links between alcohol dependence and other addictions and mood disorders.

    Drinking alcohol, even in moderate amounts, can cause a low mood on the same night, next day or even a few days later. Alcohol can also make suicidal ideas more intense if you have a history of depression. Alcohol and other addictive substances can lead to a heightened emotional state, called elation.

    If you are living with an addiction, avoiding or abstaining from alcohol or drugs for a number of weeks may be all that is required to lift your mood. In some cases, you may need treatment for a specific mood disorder.

    Risk factors which can cause or contribute to mood disorders include:

    • A strong family history
    • Significant traumatic life events
    • Childbirth
    • Childhood neglect
    • Childhood abuse
    • Some personality traits.
  • Depression

    Depression is a type of mood disorder. It is marked by a lowness in mood, which takes up a significant amount of your daily life. Current evidence suggests that 8% of women and 4% of men in Ireland go through depression.

    You can go through a depressive episode, or period of low mood and depression, even as you recover from an addiction. For example, some people can experience craving alcohol or drugs as a feeling of depression, while others can become depressed because of problems which become worse during a period of addiction.

    Symptoms of depression may include:

    • A feeling of being sad, unhappy or dull
    • A reduction in energy and/or activity
    • Loss of appetite and/or weight
    • Sleep disturbance
    • Poor concentration and poor memory
    • Feelings of guilt
    • Loss of pleasure (anhedonia)
    • Loss of motivation and interest
    • Feelings of pessimism and hopelessness
    • Thoughts of self-harm or suicide. 

    You can find out more about depression and its treatment here.

  • Bipolar disorder

    Bipolar disorder is a mood disorder which brings extreme changes in your mood, thinking and energy over a period of time. Between 0.5% and 1% of the population in Ireland are thought to live with bipolar disorder, with men and women affected equally.

    Bipolar disorder is marked by periods of an extreme feeling of wellbeing called elation or mania. These periods can be short-lasting but can include increased energy; increased rate of speech; significant insomnia or difficulty sleeping; racing thoughts; a state of distraction; irritability; lack of judgement; restlessness; over-spending; grandiose or extravagant ideas; and other changes in behavior.

    If you live with bipolar disorder, you can go through switches between episodes of elation and episodes of depression. You can also have episodes of mixed mood with features of both depression and elation at the same time.

    Find out more about bipolar disorder here.

How is addiction and dual diagnosis treated?

How is addiction and dual diagnosis treated?

If you are addicted to alcohol or drugs, there are lots of pathways of support. You may find that having information, knowledge and feedback about your addiction is enough for you to tackle it, or you may need to go through a treatment programme.

Treatment for drug and alcohol addictions usually involve a process of detoxification, which is a period of time to safely clear your body of alcohol and drugs under medical supervision. During and after this period, most treatment involves therapy and psychoeducation, or learning about a condition and how to stay well.

Useful resources

You can visit our Frequently Asked Questions page to see answers to some of the most common queries we are asked about mental health and our services.

More information and support is also available from the sources below.

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For general queries, please call us. For more on mental health and our services, see our frequently asked questions (FAQs).

01 249 3200 See our FAQs


Contact Referral and Assessment Service for queries regarding referrals to our services.

01 249 3635 See more from our referrals team