Addiction Treatment and Dual Diagnosis Care in Portland, OR
Addiction rarely shows up alone. Most people struggling with substance use are also carrying depression, anxiety, trauma, or another mental health condition that played a role in how the addiction started and what keeps it going. Treating one without the other tends to fail, which is why dual diagnosis care exists and why it matters who is providing it. Caroline Thiongo PMHNP-BC at Thrive Psychological Wellness provides psychiatric evaluation, medication-assisted treatment where appropriate, and ongoing support for people dealing with substance use and the conditions that accompany it, with appointments available at our Portland and Multnomah Village offices and through telehealth for patients anywhere in Oregon. Inpatient detox and residential treatment are referred to appropriate providers, but outpatient psychiatric evaluation and medication management are provided directly.
What We Provide
Why Treating Addiction Alone Rarely Works
Addiction is a medical condition that changes how the brain processes reward, stress, and decision-making. It is not a matter of willpower, and treating it as a moral failing rather than a clinical issue is part of why so many people struggle to access effective help even when they are actively trying to get better. The goal of treatment is to build genuine insight, support abstinence and recovery, and develop the practical skills needed to maintain sobriety once someone is back in their community and the structure of treatment is no longer there.
Dual diagnosis refers to the presence of a substance use disorder alongside one or more mental health conditions. Depression, anxiety, PTSD, ADHD, and bipolar disorder are among the most common. Research consistently shows that roughly half of people with a substance use disorder also have a co-occurring mental health condition, and treating one without addressing the other significantly increases the likelihood of relapse. In many cases the mental health condition preceded the substance use and needs to be treated as a primary concern rather than a secondary one.
Caroline Thiongo PMHNP-BC treats both conditions at the same time rather than sequencing them. A psychiatric evaluation identifies what conditions are present and how they interact. Medication is used where clinically appropriate for both the addiction and any co-occurring conditions. Thrive Psychological Wellness coordinates with group counselling, family support, and community resources to build a complete treatment picture that extends beyond the clinical appointment.
Common Co-Occurring Conditions With Addiction
- Often present before substance use begins or develops as a result of it. Treating the depression directly reduces the likelihood of using substances to self-medicate.
- Many people use alcohol or other substances to manage anxiety symptoms. Treating the anxiety reduces the underlying drive to self-medicate.
- Trauma history is extremely common in people with substance use disorders. Addressing trauma symptoms directly is often necessary for lasting recovery.
- Untreated ADHD increases the risk of substance use, particularly with stimulants. Treating ADHD appropriately can reduce that risk significantly.
- Substance use is common during both depressive and manic phases of bipolar disorder. Mood stabilization is a key part of addressing the addiction.
Psychiatric and Medication Support for Addiction Recovery
Thrive Psychological Wellness focuses on the psychiatric and medication side of addiction treatment. Caroline Thiongo PMHNP-BC works alongside group counselling, family support programmes, and community recovery resources rather than trying to replace them, because effective addiction treatment is almost always a coordinated effort across multiple types of support rather than something any single provider can deliver alone.
Step 1: Full Evaluation
We assess substance use history, patterns, prior treatment attempts, and screen carefully for co-occurring mental health conditions. We ask directly and without judgment.
Step 2: Diagnosis and Planning
We identify which substance use disorder is present and which co-occurring conditions need to be addressed. We build a treatment plan that covers both.
Step 3: Medication-Assisted Treatment
For opioid and alcohol use disorders, medications can significantly reduce cravings and support recovery. We discuss options and prescribe when appropriate.
Step 4: Coordinated Ongoing Care
We connect patients to weekly group meetings, family drug and alcohol counseling when relevant, and refer to higher levels of care including detox and residential treatment when needed.
Medications Reference Card
Blocks the rewarding effects of opioids and reduces alcohol cravings. Available as a daily pill or monthly injection. Useful for both opioid and alcohol use disorders.
Reduces opioid cravings and withdrawal symptoms. Often combined with naloxone (Suboxone) to reduce misuse potential. Requires a specific waiver to prescribe, which our PMHNP holds.
Helps reduce alcohol cravings and supports abstinence by restoring some chemical balance disrupted by long-term alcohol use. Taken three times daily.
Creates an unpleasant reaction if alcohol is consumed, acting as a deterrent. Requires strong patient motivation and is not appropriate for everyone.
Antidepressants, anti-anxiety medications, and mood stabilizers are used as appropriate for any co-occurring condition identified during evaluation.
Addiction and Dual Diagnosis Care by Telehealth Across Oregon
Thrive Psychological Wellness offers secure, HIPAA-compliant telehealth appointments for addiction psychiatric evaluation and ongoing medication management to patients anywhere in Oregon. Telehealth works well for outpatient care and is particularly suited to ongoing medication-assisted treatment follow-up appointments where consistency of access matters. When detox or a higher level of care is needed, Caroline Thiongo PMHNP-BC helps coordinate that referral so patients are not left to navigate the system on their own.
📍 Locations Served
In-Person Offices
Multnomah Village, OR (Primary)
Portland, OR (Secondary)
Regional Areas
SW Portland, Lake Oswego, Beaverton
Gresham, Milwaukie, Clackamas
What is dual diagnosis treatment?
Dual diagnosis treatment addresses both a substance use disorder and a co-occurring mental health condition at the same time rather than treating one and hoping the other resolves on its own. Roughly half of people with a substance use disorder also have a condition such as depression, anxiety, PTSD, or bipolar disorder contributing to the pattern. Treating both together produces significantly better outcomes than addressing either in isolation, and in many cases the mental health condition needs to be treated as a primary concern rather than something to deal with after sobriety is established.
Do you provide inpatient detox or residential treatment?
No. Thrive Psychological Wellness provides outpatient psychiatric evaluation and medication management. When detox or residential treatment is clinically needed, Caroline Thiongo PMHNP-BC refers to appropriate inpatient services and coordinates care once you return to outpatient treatment so the transition back is supported rather than left to manage alone.
What is medication-assisted treatment?
Medication-assisted treatment uses FDA-approved medications to reduce cravings and withdrawal symptoms, making it significantly easier to sustain recovery. Naltrexone is used for both opioid and alcohol use disorders. Buprenorphine is used for opioid use disorder. Acamprosate supports abstinence from alcohol. Medication-assisted treatment is most effective when combined with counselling, peer support, and treatment of any co-occurring mental health conditions.
Can addiction treatment be done through telehealth in Oregon?
Yes for outpatient psychiatric evaluation and ongoing medication management. Thrive Psychological Wellness offers secure, HIPAA-compliant telehealth appointments for addiction care to patients anywhere in Oregon. When a higher level of care is needed, Caroline Thiongo PMHNP-BC helps arrange that referral and coordinates the transition so you are not navigating it alone.
Does insurance cover addiction treatment in Oregon?
Yes. Most major Oregon insurance plans cover psychiatric evaluation and medication management for substance use disorders, including Oregon Health Plan. Thrive Psychological Wellness verifies your coverage before your first appointment so you know what to expect before care begins.
Accepting New Patients for Addiction and Dual Diagnosis Care in Portland
If substance use has been part of your life alongside depression, anxiety, or another mental health condition, a combined evaluation can identify what is actually going on and what treatment will help. Book a time and we will start from there.
Crisis note below buttons: If you are in crisis, call or text 988. Cascadia Crisis Line: (503) 988-4888.