In the numerous potential challenges that drug addiction presents, one stands out as requiring particular attention: mental illness. Mental illness that occurs sequentially or concurrently with drug addiction indicates comorbidity. Comorbidity is the presence of two disorders occurring at the same time, which are often inexorably linked. When mental illness or drug addiction informs the experience or prognosis of either health problem, special consideration has to be taken to treat both. Comprehensive treatment and management procedures can provide the best outcomes for patients with comorbid addiction and mental illnesses.
Many medical professionals expect to find physical illnesses that occur in tandem with drug abuse. Cardiovascular disease, Hepatitis C, and HIV are some of the diseases and illnesses that they commonly see associated with the abuse of narcotics. Mental illnesses, however, can also be present. For many drug addicts, a craving for narcotics often includes a pronounced mental illness.
While scientists are still trying to understand the phenomenon of comorbidity, it is widely accepted that mental illness can influence or shape the experience of addiction. Brain scans of drug addicts have shown that the relationship between mental illness and addiction is a precipitous one: Many of the areas and structures of the brain affected by mental illness are also those that respond to drug use. For this reason, it should come as no surprise that many of the behaviors, compulsions, and cravings associated with drug abuse often have a psychological root. The intimate relationship between the brain and drug abuse also shows us that certain risk factors can help to predict the abuse of drugs or the emergence of mental illness.
Comorbidity of mental illness and drug use is fairly high. Six out of 10 addicts also experience mental illness, making both prevalent in sufferers. A wide range of factors can contribute to the presence of mental illness alongside drug abuse. Environmental, genetic, and neural frameworks can contribute to comorbidity. Individuals who suffer from mood, anxiety, or antisocial disorders are twice as likely to also have issues with addiction. Similarly, those who abuse drugs are twice as likely to suffer from some form of mental illness.
Attempting to determine whether drug abuse or mental illness occurred first in an individual can prove extremely challenging. Typically, there are three ways to look at comorbidity: Drug abuse can cause mental illness, mental illness can cause drug abuse, or both of these disorders have emerged as the result of common risk factors. Addiction can affect brain workings and give rise to psychological disorders, while addiction can also occur when those with mental illnesses choose to self-medicate with drugs. In addition, trauma or genetic predispositions can make certain people more vulnerable to mental illness and drug addiction than others.
Medical professionals often use comprehensive and broad diagnostic tools to try and identify the presence of comorbidity in patients. Screenings of drug addicts and mental patients for comorbid disorders can help pinpoint latent or pronounced symptoms. Patients may also undergo continued evaluation after a period of treatment to monitor and isolate the emergence of symptoms unrelated to the illness or disorder for which they are being treated. For example, negative behaviors that arise in drug addicts after a period of abstaining from substances can point towards a mental disorder. Those suffering from mental illnesses who rely on substances, even tobacco, to manage psychological or mood disturbances indicate a potential for comorbidity.
Providing adequate treatment for patients with comorbid disorders can be tricky for health professionals because of overlapping symptoms. Even firm diagnosis can be a challenging endeavor, as many of the signs and symptoms of mental illness can also be due to drug abuse and vice versa. The recognition and correct diagnosis of both health problems, however, is paramount to successful recovery for patients. Both disorders have to be correctly diagnosed and treated to reduce the probability for relapse. Treatment can include pharmacological responses, like medications, and behavioral therapies. Adults can respond well to dialectical behavioral therapy (DBT), exposure therapy, therapeutic communities (TCs), and assertive community treatment (ACT). Adolescents benefit from cognitive behavioral therapy (CBT), multisystemic therapy (MST), and brief strategic family therapy (BSFT). Each medication and therapeutic plan should be individualized to the patient’s particular needs for the highest potential for success.
Visit the following links for more information about comorbid addiction and mental illness:
- What is Comorbidity, and Why Does It Occur? (PDF)
- Comorbidity: Addiction and Other Mental Illnesses (PDF)
- Comorbid Drug Abuse and Mental Illness (PDF)
- Co-Occurring Mental Health and Substance Abuse Disorders (PDF)
- Mental Illness and Substance Abuse
- Severe Mental Illness Ups Risk for Substance Abuse
- Drug Abuse and Mental Illness Fast Facts (PDF)
- How Mental Illness and Addiction Influence Each Other
- Mental Illness: The Challenge of Dual Diagnosis
- Co-Occurring Disorders