Dual Diagnosis Enhanced Programs

In 2001, the American Society of Addiction Medicine Patient Placement Criteria, Second Edition, Revised (ASAM PPC-2R) (American Society of Addiction Medicine, 2001) introduced the concepts of dual diagnosis capability (DDC) and dual diagnosis enhanced (DDE) addiction programs into the national lexicon. The original definitions of DDC and DDE addiction programs were relatively brief. DDC programs “address co-occurring . . . disorders in their policies and procedures, assessment, treatment planning, program content, and discharge planning” (American Society of Addiction Medicine, 2001, p. 362; Center for Substance Abuse Treatment, 2005, p. 33) so that program staff are able to address co-occurring disorders routinely in relapse skills, recovery environment, and readiness to change “through individual and group program content.” DDE programs are able to provide primary substance abuse treatment to clients who are, as compared to those routinely treated in DDC programs, “more symptomatic and/or functionally impaired as a result of their cooccurring mental disorder” (American Society of Addiction Medicine, 2001, p. 10, Center for Substance Abuse Treatment, p. 33). Nonetheless, the fundamental message was very important: co-occurring disorder is an expectation in addiction treatment settings, and a continuum of addiction programs needs to incorporate routine DDC into its full array of services and plan for some DDE service components in order to provide access to episodes of addiction treatment for individuals who would be unable to receive treatment routinely in DDC programs. Further, fewer and