Dual diagnosis treatment for Fort Lauderdale — one team, both diagnoses, together.

RECO Health sits 40 minutes north on I-95 from Las Olas and Victoria Park — close enough to commute to PHP or IOP without relocating, far enough for genuine separation from active-use environments. In-house addiction psychiatry manages MAT and psychotropic medication on a single plan; therapists trained in both domains handle depression, PTSD, bipolar disorder, and anxiety alongside the substance use disorder rather than after it. TMS, ketamine, and esketamine are available in-house for treatment-resistant psychiatric presentations.

From Las Olas or Victoria Park, RECO Health sits 26 miles north on I-95 — roughly a 40-minute drive that lets Fort Lauderdale residents commute to partial hospitalization without uprooting work, housing, or family, while keeping enough distance from the people and places tied to active use. For clients with co-occurring substance use and psychiatric diagnoses, that middle distance is not incidental. The treatment container has to interrupt the pattern without severing the supports someone will need to lean on for the next five years.

Why sequential treatment fails for co-occurring disorders

The research on integrated versus sequential care has been unambiguous for two decades. Treating substance use in one setting and depression, PTSD, or bipolar disorder in another — or worse, telling a client to “get sober first, then we’ll address the mental health” — produces measurably worse outcomes than treating both diagnoses on a single plan, by a single team, in the same building. The untreated diagnosis destabilizes the treated one: untreated depression drives early relapse, and untreated substance use blunts antidepressant response and psychotherapy engagement.

At RECO Health, dual diagnosis treatment is structured around SAMHSA’s integrated care model. The same psychiatrist prescribes both the buprenorphine and the sertraline. The same therapist runs the CBT for depression and the relapse-prevention work for opioid use disorder. The treatment plan tracks both diagnoses in parallel, with shared measurement-based benchmarks — PHQ-9 every two weeks, cravings scored at each session, urine drug screens synchronized with medication management visits.

Fragmenting that care across a primary care physician in Fort Lauderdale, an outside psychiatrist, and a separate MAT provider is one of the most common pathways to early relapse. Integrated care closes that gap by design rather than by referral coordination.

The high-prevalence co-occurring diagnoses

Major depressive disorder, PTSD, generalized anxiety disorder, bipolar disorder, and ADHD are the five diagnoses most commonly co-occurring with substance use disorder in outpatient addiction populations. RECO screens for all five at intake using validated instruments: PHQ-9 for depression, PCL-5 for PTSD, GAD-7 for anxiety, MDQ for bipolar spectrum, and ASRS for adult ADHD. Positive screens trigger a structured psychiatric evaluation with an in-house addiction psychiatrist rather than a referral out.

Each diagnosis has a defined evidence-based pathway inside the program. Depression is treated with an SSRI or SNRI — commonly sertraline, escitalopram, or venlafaxine — paired with CBT or behavioral activation. Treatment-resistant presentations are candidates for adjunctive aripiprazole, rTMS delivered at 3,000 pulses per session at 120 percent of motor threshold, or ketamine and esketamine when clinically appropriate. PTSD is treated with CPT, prolonged exposure, or EMDR once the client has sufficient stabilization. Bipolar disorder is treated with mood stabilizer optimization — lithium, lamotrigine, valproate, or an atypical like quetiapine or olanzapine — never with antidepressant monotherapy, which risks manic switch.

ADHD is handled cautiously in this population. Adults with untreated ADHD and a stimulant use disorder in remission are often better started on atomoxetine or bupropion; when a stimulant is clinically indicated, it is prescribed only after the substance use disorder has been in stable remission, with pill counts, urine testing, and short-acting formulations avoided.

MAT and psychotropic medication managed by one psychiatrist

For opioid use disorder, RECO prescribes buprenorphine (Suboxone or Sublocade) or extended-release naltrexone (Vivitrol) based on the client’s history, prior treatment response, and preference. For alcohol use disorder, oral or injectable naltrexone, acamprosate, or disulfiram are matched to the individual case. These medications are not managed in isolation — the same in-house psychiatrist prescribing the buprenorphine is prescribing the sertraline, the lamotrigine, and the buspirone.

That single-prescriber model matters because psychiatric and addiction medications interact in ways that can quietly undermine care. Buprenorphine at high doses can prolong the QT interval; so can quetiapine and escitalopram. Gabapentin carries abuse potential in clients with sedative-use histories. Bupropion lowers the seizure threshold and is contraindicated in active alcohol withdrawal. Naltrexone precipitates opioid withdrawal if buprenorphine has not been fully cleared. A single psychiatrist holding the whole medication list catches these interactions before they become clinical problems.

Coordination with outside prescribers — a Fort Lauderdale primary care doctor, a longstanding therapist, an OB-GYN — is built into the plan. Records are requested at intake, communication is maintained during treatment, and a written handoff goes back to the outpatient team at discharge.

Trauma is often the through-line

For a substantial share of dual diagnosis clients, unprocessed trauma is upstream of both the substance use and the mood disorder. Depression, panic, and insomnia are frequently the felt experience of a nervous system that never resolved a discrete or chronic trauma; the substance use is the self-medication strategy that worked until it stopped working. Treating either diagnosis without addressing the trauma often produces short-term stabilization and long-term recurrence.

RECO’s protocol screens for trauma at intake with the PCL-5 and a structured trauma history, stabilizes the acute presentation first, and moves into evidence-based trauma processing only once the client’s window of tolerance can support it. That sequencing matters — running exposure work on a client who is still detoxing, actively suicidal, or sleeping four hours a night predictably destabilizes rather than heals. Stabilization draws on grounding skills from DBT, sleep restoration, medication optimization, and motivational interviewing on ambivalence about processing.

Once the client is stable, treatment moves into CPT, prolonged exposure, or EMDR depending on the clinical picture and clinician training. The trauma work is completed inside the same program, by therapists credentialed in both trauma and addiction, on the same treatment plan.

What intake and the first days look like

Admissions begins with a phone assessment covering substance use history, psychiatric history, medical comorbidities, and a preliminary review across the six ASAM Criteria dimensions — intoxication and withdrawal potential, biomedical conditions, emotional and cognitive conditions, readiness to change, relapse potential, and recovery environment. That review determines the appropriate level of care: medical detox, residential, PHP, IOP, or outpatient.

Clients arriving with active alcohol or benzodiazepine dependence are stratified with CIWA-Ar scores; opioid-dependent clients are assessed with COWS and started on symptom-targeted comfort medications and buprenorphine induction when appropriate. Medical clearance, a nursing assessment, a psychiatric evaluation, and a therapist biopsychosocial are completed in the first 24 to 48 hours. A dual-diagnosis treatment plan naming both conditions is signed within the first week, with measurable goals, medication decisions, and a family communication plan.

Insurance and admissions from Fort Lauderdale

RECO Health is in-network with Florida Blue, Aetna, Cigna, UnitedHealthcare, Humana, and most BCBS commercial plans, and works with out-of-network benefits for other carriers. Verification is completed in a single call — a benefits check, an estimate of client responsibility, and a clear picture of what a specific plan will and will not cover for detox, residential, PHP, and IOP.

For Fort Lauderdale clients, the logistics are straightforward. The Delray Beach campus is a 40-minute drive up I-95 from Las Olas, Victoria Park, Coral Ridge, Rio Vista, and Wilton Manors. PHP and IOP clients commute daily; residential and detox admissions are on-site, with transport from Fort Lauderdale coordinated by admissions when needed.

Serving residents of: Las Olas, Victoria Park, Coral Ridge, Rio Vista, Wilton Manors.