Dual diagnosis treatment for Highland Beach — one team, both diagnoses, together.

For Highland Beach residents in Bel Lido Isle, Toscana, or Boca Cove, RECO Health's Delray campus sits about twelve minutes up A1A. Dual diagnosis care runs on a single treatment plan under one addiction psychiatrist — MAT (buprenorphine, naltrexone, acamprosate) and psychotropic medication managed on the same chart, with trauma-focused therapy (CPT, PE, EMDR) integrated rather than sequenced. Full ASAM levels of care, from medical detox through IOP, and adjunctive rTMS and ketamine services are on the same campus.

Highland Beach occupies the narrow oceanfront strip along A1A between Delray Beach and Boca Raton, roughly a 12-minute drive from RECO Health’s Delray campus. For residents of Bel Lido Isle, Toscana, Boca Cove, Ocean Cove, or Penthouse weighing options for concurrent substance use and psychiatric treatment, the difference between a general behavioral-health office and a specialty program shows up in the clinical density: full ASAM levels of care, in-house addiction psychiatry, and integrated protocols on a single treatment plan. RECO’s dual diagnosis treatment program is built for exactly this presentation.

Why sequential treatment fails for co-occurring disorders

The evidence base on co-occurring disorders is unambiguous: sequential treatment — the older model of “get sober first, then we’ll address the mental health” — produces worse outcomes than integrated treatment across every measurable dimension, including relapse rates, psychiatric symptom burden, treatment retention, and long-term function. The untreated diagnosis destabilizes the treated one. A patient in an abstinence-based program whose major depressive disorder is left unmanaged is materially more likely to relapse in the first ninety days; a patient in outpatient psychiatric care whose alcohol use disorder is not concurrently addressed will show blunted response to SSRIs and elevated suicide risk.

Integrated care is the SAMHSA and ASAM standard, and it requires more than a shared address. It requires clinical staff dually trained in substance use and psychiatric disorders, unified assessment, and a single treatment plan that sequences interventions across both domains. Medication management, individual therapy, and group programming all reference the same case formulation. At RECO Health, that structure is the default, not a special track.

The high-prevalence co-occurring diagnoses

The psychiatric diagnoses most commonly co-occurring with substance use disorder are major depressive disorder, PTSD, generalized anxiety disorder, bipolar disorder, and ADHD. Each is screened at intake with a validated instrument — PHQ-9 for depression, PCL-5 for PTSD, GAD-7 for anxiety, MDQ for bipolar spectrum illness, and ASRS for ADHD — and confirmed diagnostically by the treating psychiatrist. Substance use severity is assessed against the ASAM Criteria across its six dimensions; withdrawal risk is quantified with CIWA-Ar for alcohol and COWS for opioids.

Each confirmed diagnosis carries a defined evidence-based pathway inside the program. Depression is treated with SSRIs such as sertraline or escitalopram, augmented as clinically indicated with aripiprazole or, for treatment-resistant presentations, rTMS or intravenous ketamine. PTSD is treated with trauma-focused psychotherapy — CPT, prolonged exposure, or EMDR — supported by prazosin for nightmares where appropriate. Bipolar disorder is stabilized with lithium, lamotrigine, or quetiapine before deeper work proceeds. ADHD is treated with a non-stimulant such as atomoxetine or, when clinically appropriate and closely monitored, a stimulant with abuse-deterrent considerations written into the plan.

MAT and psychotropic medication managed by one psychiatrist

Fragmented prescribing across a primary care physician, an outside psychiatrist, and a separate MAT provider is one of the most common relapse pathways in dual diagnosis populations. Interactions get missed. Doses drift. When a patient decompensates, no single prescriber owns the full picture. RECO’s in-house addiction psychiatry team closes that gap by managing medication-assisted treatment and psychotropic medication under one chart.

Opioid use disorder is treated with buprenorphine or extended-release naltrexone; alcohol use disorder with naltrexone, acamprosate, or disulfiram where appropriate. These are coordinated with the antidepressant, mood stabilizer, anxiolytic, or ADHD medication the patient requires. Buspirone is generally preferred over benzodiazepines for co-occurring anxiety. When a mood stabilizer and MAT are both indicated, dosing is sequenced to minimize sedation and preserve daytime function. For severe treatment-resistant depression alongside substance use, on-site rTMS (3,000 pulses per session at 120% of motor threshold) and supervised intranasal esketamine or IV ketamine are available — prescribed by the same team managing the MAT.

Trauma is often the through-line

For a substantial share of dual diagnosis patients, unprocessed trauma sits upstream of both the substance use and the mood disorder. The substance use often began as self-medication; the depressive or anxious symptoms are downstream manifestations of the same unresolved event or developmental context. Treating either diagnosis in isolation, without addressing what the patient is actually medicating, tends to work short-term and fail long-term.

The RECO protocol screens for trauma at intake using the PCL-5 and a structured clinical interview. Early treatment prioritizes stabilization — sleep restoration, containment and distress-tolerance skills from DBT, motivational interviewing to reinforce engagement — before trauma processing begins. Once the patient’s window of tolerance supports it, evidence-based trauma work proceeds: Cognitive Processing Therapy, Prolonged Exposure, or EMDR, delivered by clinicians credentialed in the modality. ACT and CBT for co-occurring depressive, anxious, and craving-related symptoms run in parallel.

What to expect at the first visit

Admissions from Highland Beach typically begin with a phone screen and insurance verification, followed by an in-person or telehealth intake at the Delray campus. The intake includes a full biopsychosocial history, a psychiatric evaluation by an addiction psychiatrist, medical screening, and ASAM Criteria assessment to determine the appropriate level of care — medical detox, residential, PHP, IOP, or standard outpatient.

Level-of-care decisions are grounded in withdrawal risk (CIWA-Ar or COWS scoring where indicated), medical stability, psychiatric acuity, and the social supports available at home. Patients leave the first appointment with a written summary of findings, a recommended level of care, and defined next steps — not a vague referral loop. Family members are typically included in the admissions conversation with the patient’s consent, and a discharge trajectory is sketched at intake rather than at the end of treatment.

Insurance and admissions from Highland Beach

RECO Health is in-network with Florida Blue, Aetna, Cigna, UnitedHealthcare, Humana, and Blue Cross Blue Shield plans. Benefits are verified before admission and out-of-pocket exposure is quantified in writing. From Bel Lido Isle or Toscana, the drive to the Delray campus is roughly seven miles up A1A or Federal Highway, about twelve minutes in typical traffic. Admissions is available seven days a week; when medical detox is clinically indicated, direct admission avoids the waitlist gap that puts patients at risk. Local proximity also keeps family involvement — often a formal component of the treatment plan — logistically realistic.

Serving residents of: Bel Lido Isle, Boca Cove, Ocean Cove, Toscana, Penthouse.