Another Look at Comorbid Substance Abuse

comorbid substance abuse treatment

Mental health and drug addiction are two “taboo” topics that we often leave out of everyday conversation. Yet all around us, people – neighbors, friends, loved ones – are battling these disorders, often together, at the same time.

If you or a loved one is struggling with co-occurring substance abuse and mental health disorders, know that you are not alone. Millions of people are fighting a similar fight. And there is help available to you. It’s time we face the facts and understand the truth behind comorbid substance abuse.

Just last month, the National Institute on Drug Abuse published a new infographic about comorbidity as it pertains to substance abuse. Below, Turnbridge discusses what comorbid substance abuse means, and what we – as clinicians, educators, friends, family members, even sufferers – should know about it.

What is Comorbidity?

By definition, comorbidity is the co-existence of two or more chronic diseases or conditions within a single patient – for example, depression and substance addiction. Also called co-occurring disorders, these multiple disorders can affect a patient simultaneously or sequentially, at the same time or one after the other. Comorbidity also implies that co-occurring illnesses interact with one another in the same regions of the brain, which, according to the National Institutes of Health, can worsen the progression and the prognosis of both.

Comorbidity can pertain to any illness, but is used most frequently in relation to substance abuse and addiction. Substance abuse and addiction, in millions of cases, present themselves alongside other co-occurring mental health disorders, such as: depression, post-traumatic stress disorder (PTSD), obsessive-compulsive disorder, anxiety disorders, bipolar disorder, eating disorders, attention-deficit disorder (ADD), schizophrenia, even antisocial personality or conduct disorders.

Unfortunately, for patients with comorbid substance abuse and mental health disorders, it can be very difficult to determine which disorder came first. On one hand, the stress and symptoms of mental illness can steer a person towards drug use, often as a means of self-medication. Yet because of how drugs affect the brain, users may start to develop symptoms of mental illness only after their drug use begins.

Who is Affected by Co-Occurring Disorders?

As stigmatized as these topics may be, co-occurring substance abuse and mental health disorders exist all around us. New research cites that 7.7 million adults are suffering from co-occurring mental and substance use disorders. About 38 percent of people with a drug problem also suffer from a co-occurring mental illness, while 18 percent of people with mental illness also battle substance addiction.

When we talk about these disorders, remember that these include more than just the extreme cases. A substance use disorder can involve anything from alcoholism to dangerous, incessant opioid abuse. Mental illness can include anything from schizophrenia to major depressive disorder, social anxiety to even attention-deficit-hyperactivity disorder (ADHD). Data shows that those with mood or anxiety disorders are twice as likely to suffer from drug abuse or addiction, compared to the general public. Similarly, people diagnosed with drug disorders are about twice as likely to suffer from mood and anxiety disorders, at the same time or at some point in their lives.

Comorbid substance abuse disorders can affect anyone, no matter their age, upbringing, or background. In fact, most drug use starts in adolescence, when a young person’s brain is still developing. The NIH reports that early drug use in the teenage years may be a risk factor for later substance abuse problems as well as the later occurrence of other mental illnesses. In addition, having a mental disorder in childhood or adolescence can increase the risk of later drug abuse problems. However, other causal factors should also be considered. Drug use and mental illness can both be triggered by underlying brain deficits, genetic vulnerabilities, and/or exposure to stress or trauma at a young age.

How to Treat Comorbid Substance Abuse Disorders

Historically, mental health and substance abuse disorders were treated separately, as though they did not correlate with one another. Over the years, evidence has shown that this is not an effective approach to treating comorbid substance abuse, and that addressing just one disorder will not cause the other to consequentially improve. Co-occurring disorders must be treated together simultaneously, using a more integrated dual-diagnosis approach.

Integrated, dual diagnosis treatment allows clinicians to understand how the multiple, comorbid disorders interact with one another. This is an important distinction, as mental health and substance abuse disorders affect the same regions of the brain, and therefore increase their likelihood of worsening one another. If one disorder is left untreated, both comorbid disorders are likely to exacerbate. As an example, addictive substances and psychiatric disorders like depression directly affect our brain’s dopamine levels. If a person’s depression is left unaddressed, they are more likely to increase their substance abuse in efforts to relieve depressive symptoms. As their substance intake increases, new or harsher depressive symptoms are more likely arise.

All that said, long-term, inpatient dual diagnosis treatment is needed to address co-occurring disorders – at the same time, in the same place. In this type of setting, counselors can identify and help clients work through any underlying problems contributing to their drug use – negative feelings, history of trauma or abuse, anxiety or low self-esteem. Treatment professionals can then work with clients to develop coping skills, as well as foster positive, alternate strategies for handling mental and emotional stress.

The unfortunate reality is – the majority of people battling comorbid substance abuse and mental health conditions do not receive the integrated treatment they need – only 9 percent of people do. Over 50 percent of people with co-occurring disorders receive neither mental health care nor substance use treatment, while about 35 percent of those afflicted receive only mental health care. There are many barriers to proper treatment, including fear of commitment or what others may think, an unreadiness to stop using, and simply not knowing where to go for dual diagnosis treatment.

Know that there is always help available for you, your patients, and your loved ones. Turnbridge is a recognized inpatient, dual diagnosis treatment center helping both young men and young women work through co-occurring mental and substance abuse disorders. For information about our programs, or for more insight on comorbid substance abuse, please call 877-581-1793 today.