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

For Pompano Beach residents managing co-occurring substance use and psychiatric conditions, RECO Health offers integrated dual diagnosis treatment 18 miles north in Delray Beach — one in-house psychiatrist managing MAT and psychotropic medication, one therapist trained in both domains, one treatment plan. On-site rTMS and ketamine services extend the program's reach for treatment-resistant depression and PTSD. Admissions from Cresthaven, Lighthouse Point, Sea Ranch Lakes, and Hillsboro Shores are typically same-day or next-day when clinically indicated.

Pompano Beach sits 18 miles south of RECO Health’s Delray Beach campus — a 28-minute run up I-95 outside rush hour. That distance carries clinical weight: it separates a client from the local triggers, contacts, and routines that surround an active substance use disorder while keeping them inside the South Florida community they will return to. For residents of Cresthaven, Lighthouse Point, Sea Ranch Lakes, and Hillsboro Shores who are managing a substance use disorder alongside depression, PTSD, bipolar disorder, anxiety, or ADHD, an integrated dual diagnosis program a half-hour up the coast is often the difference between fragmented care and one team treating both diagnoses on one plan.

Why sequential treatment fails for co-occurring disorders

The old sequential model — “get sober first, then we’ll address the mental health” — is not supported by outcome data. Sequential care produces worse retention, higher relapse rates, and worse psychiatric outcomes than integrated care. The mechanism is straightforward: an untreated diagnosis destabilizes the treated one. Major depressive disorder that goes untouched during the first 30 days of sobriety drives early relapse; ongoing substance use blocks antidepressant response and confounds any psychiatric assessment attempted around it.

SAMHSA and the ASAM Criteria have named integrated treatment the standard of care for co-occurring disorders since the early 2000s. What that standard actually requires is not two parallel programs stitched together but a single clinical team — psychiatrist, primary therapist, case manager — trained to treat both domains and operating from one shared treatment plan. A referral to an “outside psychiatrist” while addiction treatment happens elsewhere is exactly the pattern integrated care was designed to replace.

At RECO, the psychiatrist prescribing buprenorphine also prescribes the sertraline or aripiprazole, the therapist running relapse prevention also delivers CPT for PTSD, and the treatment plan tracks progress on both diagnoses in the same weekly review.

The high-prevalence co-occurring diagnoses

The psychiatric conditions most commonly co-occurring with substance use disorder are major depressive disorder, PTSD, generalized anxiety disorder, bipolar disorder, and ADHD. Every RECO intake screens for all five with validated instruments: the PHQ-9 for depression, the PCL-5 for PTSD, the GAD-7 for anxiety, the MDQ for bipolar spectrum illness, and the ASRS for adult ADHD. A positive screen routes the client to a full psychiatric evaluation before treatment planning is finalized.

Each diagnosis carries a defined evidence-based pathway. Depression is treated with an SSRI (sertraline, escitalopram) or SNRI paired with CBT and behavioral activation; treatment-resistant presentations are evaluated for rTMS or ketamine augmentation. PTSD is treated with cognitive processing therapy, prolonged exposure, or EMDR, with prazosin used adjunctively for trauma-related nightmares. Bipolar disorder is stabilized on lithium, valproate, or lamotrigine — often with quetiapine or aripiprazole augmentation — before deeper trauma processing begins.

ADHD is more nuanced in a substance-using population. RECO’s protocol favors non-stimulant options — atomoxetine, bupropion, guanfacine — as first-line during active recovery, reserving carefully monitored stimulant trials for stable clients with clear diagnostic clarity and no history of stimulant misuse.

MAT and psychotropic medication managed by one psychiatrist

Fragmented prescribing is one of the most common and most preventable relapse pathways in dual diagnosis care. A client leaves detox on buprenorphine from an addictionologist, sees a primary care physician for a benzodiazepine refill, and picks up an SSRI from an outside psychiatrist who was never told about the buprenorphine. Interactions get missed, dosing gets guessed at, and the client ends up managing three prescribers who do not talk to each other.

RECO’s integrated model closes that gap. The same in-house addiction psychiatrist manages MAT and psychotropic medication: buprenorphine or naltrexone for opioid use disorder, naltrexone or acamprosate for alcohol use disorder, and the client’s full psychiatric regimen — SSRIs, mood stabilizers, atypical antipsychotics, and non-stimulant ADHD medications. One prescriber, one chart, one set of interaction checks.

That coordination matters most at the edges. Benzodiazepines are almost always tapered rather than continued; stimulants require deliberate evaluation; ketamine and esketamine (Spravato) protocols for treatment-resistant depression are timed against the client’s MAT status and recovery stage. The psychiatrist owns those decisions rather than deferring them to a prescriber who does not know the recovery context.

Trauma is often the through-line

For a substantial share of dual diagnosis clients, unprocessed trauma sits upstream of both the substance use and the mood disorder. Treat the depression and the drinking without addressing the trauma and the pattern tends to repeat: short-term stability, followed by a triggering event that reopens the underlying wound and drives relapse.

RECO’s protocol screens for trauma at intake with the PCL-5 and, where indicated, the ACE questionnaire. Trauma processing does not begin on day one — stabilization comes first, and the client’s window of tolerance must support exposure-based work before it is attempted. Once stabilization is in place, evidence-based trauma modalities — cognitive processing therapy, prolonged exposure, and EMDR — are delivered by clinicians trained in the specific protocol rather than adapted from general talk therapy.

DBT skills for affect regulation, ACT for values-based recovery, and mindfulness-based relapse prevention surround the trauma work rather than replace it. For clients whose PTSD or depressive symptoms remain refractory after adequate trials, rTMS — typically 3,000 pulses per session at 120% of motor threshold across a six-week course — and ketamine-assisted therapy are available on-site.

What to expect at intake and through the first two weeks

The first contact is a phone assessment: substance use history, current use, prior treatment episodes, psychiatric history, medications, and a brief risk screen. If medical detox is indicated — alcohol, benzodiazepines, high-dose opioids, or polysubstance use — the client is admitted directly to the detox unit, where CIWA-Ar and COWS scales guide symptom-driven medication.

Within 72 hours, a full biopsychosocial and psychiatric evaluation is completed. DSM-5-TR diagnoses are entered, and the ASAM Criteria six dimensions — acute withdrawal, biomedical, emotional/behavioral/cognitive, readiness to change, relapse potential, and recovery environment — guide level-of-care placement across detox, residential, PHP, IOP, and outpatient. The initial treatment plan is signed by the client and reviewed at least weekly, with revisions documented against measurable clinical targets.

The first two weeks emphasize stabilization: medication initiation and titration, sleep and nutrition, motivational interviewing to consolidate ambivalence, and skills for acute craving management. Deeper trauma processing, family work, and long-horizon relapse prevention planning enter as the clinical picture stabilizes.

Insurance and admissions from Pompano Beach

RECO Health is in-network with the commercial carriers Pompano Beach residents most often carry — Florida Blue, Aetna, Cigna, UnitedHealthcare, Humana, and BCBS plans. Benefits verification is completed before admission so the client and family know covered levels of care, out-of-pocket estimates, and authorization status in advance rather than after the fact.

Admissions from Pompano Beach are typically same-day or next-day when clinically indicated. The 18-mile drive from Cresthaven, Lighthouse Point, Sea Ranch Lakes, or Hillsboro Shores up to the Delray Beach campus runs roughly 28 minutes outside rush hour, and transport can be coordinated for clients who cannot drive safely themselves.

For clients stepping down from residential or PHP, outpatient continuity remains at the Delray Beach campus — psychiatry, individual therapy, and MAT management with the same treating team. That continuity across levels of care is one of the strongest predictors of one-year outcomes in the co-occurring disorders literature and is a deliberate structural feature of the program rather than an afterthought.

Serving residents of: Cresthaven, Lighthouse Point, Sea Ranch Lakes, Hillsboro Shores.