Dual Diagnosis

Dual Diagnosis in substance misuse means having an addiction as well as a mental health disorder such as depression, generalised anxiety disorder, bipolar disorder, obsessive compulsive disorder, post-traumatic stress disorder, phobias, schizophrenia or personality disorders, to name a few.

In such cases, it’s essential to treat both problems, not just one of them. A 7-14-day detox helps us remove the main addiction element and allows us to focus on relapse prevention and treatment of any mental health disorder through our outpatient programmes.
Finding the root cause of addiction is essential. It’s not just about a successful detox. The BONDS Clinic team are dedicated to making sure you have the best chance of being addiction-free now and in the future. Relapse Prevention is key.

How often do patients have dual diagnosis?

Dual diagnosis may occur in up to 70% of all addiction including behavioural addictions such as gambling, sex or porn addiction. Treating both disorders is essential to recovery.

How does it work? (a hypothetical patient)

During an assessment, a patient with a heroin addiction might is also found to suffer from recurrent bouts of anxiety and depression over several years, with periods of abstinence from heroin. Multiple detoxes have been undertaken but relapse has unfortunately occurred within a few months. During our assessment, we find that there were flare-ups of mixed anxiety and depression which triggered some of the relapses.

Our patient underwent a successful 7-day detox with The BONDS Clinic and moved onto our Consolidation and Relapse Prevention programme, received a naltrexone implant and solution-focused & integrated talking therapies looking at triggers and behaviours linked with addiction. A mental health treatment plan was initiated using non-addictive medication, psychological therapies and lifestyle and self-help strategies to optimise wellbeing through support networks, diet, exercise, sleep and additional resources.

Services involved

  • Individual therapy is integral to dual diagnosis treatment because it can specifically address not only the issues surrounding someone’s substance misuse but also the symptoms, they experience because of their mental health disorder.
  • Relapse prevention and psycho education supports an individual to understand and therefore alter their behaviours.
  • When necessary after a careful assessment and exploration of all options, medication management is often part of dual diagnosis treatment. Medication may help treat symptoms of the mental health disorder, but only as part of a holistic treatment plan, which should aim to promote better outcomes for the addiction treatment programme.
  • Family therapy can help the loved ones of someone struggling with dual diagnosis disorders to better understand what is happening
  • Holistic treatment approaches are often utilised within Dual Diagnosis programmes because they address the physical, psychological, social and spiritual needs of the client.

Find out more about Dual Diagnosis from Dr Amal Beaini

Who is involved in dual diagnosis treatment?

Our multi-disciplinary teams can draw upon:
Consultant psychiatrist, specialised GPs in addiction, mental health nurses, psychological therapists and dual diagnosis practitioners

How effective is it?

97% success rates of completion of initial detox, prior to moving onto the consolidation and relapse prevention phase with treatment of co-existing mental health or chronic pain. For opioid patients using the BONDS protocols*, internal audit data shows that 67% of patients reported abstinence at 12 months1. Prior to the use of implants from 2006 onwards, published data for opioid patients shows a 51% abstinence at 12 months for the BONDS protocols (historic data from BONDS protocol use at Detox5, not The BONDS Clinic at Broughton).

*Outcome measures recorded at a time in previous years when Dr Amal Beaini was previously providing the BONDS protocols from the Detox5 service, not The BONDS clinic at Broughton. We are very pleased to say that these BONDS protocols are now part of The BONDS Clinic at Broughton. Detox5(TM) has closed a few years ago. Abstinence data at 12 months did not include those patients who could not be contacted or lost to follow up.


  1. Beaini AY, (2019). BONDS Protocol, history and audit data. Unpublished internal document.
  2. Beaini AY et al (2000, October). A compressed opiate detoxification regime with naltrexone maintenance: patient tolerance, risk assessment and abstinence rates. Addiction Biology, 1;5(4):451-62. doi:10.1111/j.1369-1600.2000.tb00215.x.

What makes BONDS dual diagnosis treatment different to others

  • Dual Diagnosis is a clear focus in the assessment
  • One unified treatment team – often so-called ‘dual diagnosis’ services use separate teams and may not be led by a consultant psychiatrist for the mental health component
  • Shorter and streamlined detox from primary substance – in the majority of cases, this can be completed in 7 days. Some other programmes can take weeks to detox patients, especially from opioids such as co-codamol, morphine, tramadol, heroin, methadone or buprenorphine. Drops out rates in long detoxes can be high and annual rates of abstinence can be low. Costs for some private programmes can be significantly higher.
  • Simple aim for Abstinence. There is no use of substitution therapy at The BONDS clinic.

Dual Diagnosis Programme

  • 7-Day Detox

    Our inpatient facility within the Broughton Hall Estate in, North Yorkshire Skipton, is where your journey to recovery begins. Starting with a 7-14-day detox depending on polysubstance misuse, you’ll first meet the team at our purpose-built facility Hope House for a multi-disciplinary team (MDT) assessment and then your detox begins… The majority of detoxes are expected to be completed within 7 days, and those with more complex multiple addictions or significant mental health disorders may require 14 days (or possibly longer).

    Find out more
  • Consolidation and Relapse Prevention

    After a successful detox, we encourage our patients to undertake a consolidation and relapse prevention programme. At The BONDS Clinic, we see this as a 12-month programme tailored to you to ensure we provide you with the best route to recovery.

    Find out more

Know someone with an addiction?

The BONDS Clinic work with you and your family, offering a comprehensive Family Support Program.

It can be challenging if a loved one has an addiction, sometimes having a negative effect on relationships, home environment and family dynamics.

It may be difficult to spot the signs of addiction and how best to approach them in taking those first steps towards recovery.

The BONDS Clinic feel that we should all be empowered to support and seek treatment for our loved ones when they need it most but also remember we are here for you as well. If you think a loved one may have an addiction, we are here to help.

Find out more