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May 15, 2019

Mental Awareness: The Link Between Substance Abuse and Mental Illness

It is common for individuals suffering from substance abuse to have mental health issues, as well. The statistics provided by the National Bureau of Economic Research (NBER) provided a definitive link between these two conditions.

According to NBER, people with mental illness consume about 40 percent of cigarettes, 38 percent of alcohol, and 44 percent of cocaine. In the same research, it was found that individuals who have been diagnosed with any kind of mental health disorder consume 68 percent cigarettes, 69 percent of alcohol, and 84 percent of cocaine.

The numbers clearly show the connection between substance abuse and mental illness. The existence of both is referred to as dual diagnosis or a co-occurring disorder. Dealing with substance abuse alone is already challenging as it is, and having to deal with mental health disorders as well can make it even more difficult.

This is where drug and rehab facilities come in. They have the knowledge, skill, and competence to deal with the issue at hand.

What is Alcohol Abuse Disorder?

People may equate it with alcoholism, but the latter is just one of the many levels of AUD. If you have this disorder you have:

  1. Issues controlling your drinking problem

  2. You are obsessed with alcohol

  3. Inability to stop even at the risk of losing your health, job or family

  4. Withdrawal symptoms when you stop drinking for a certain period

According to the latest statistics, there were more than 21 million drug dependents in the United States alone. And 5.4 percent of the world’s population is plagued by the epidemic. Young adults from the age of 12 years old are included in these stats.

However, the study is not clear how many of them have a dual diagnosis.

No Causal Connection

Substance abuse and mental illness may be connected but researchers still have to find the smoking gun, so to speak, to determine if one condition directly causes the other. This is not to say that there’s no link, however, because countless documentations and studies have established that connection. However, it was found that individuals turn to alcohol or drugs or both to help ease the symptoms of an undiagnosed mental illness. They do this to deal with their grueling emotions or to momentarily alter their mood.

Mental illness is caused by a complex interplay of several factors. These include the environment, genetics, and other external factors. If an individual is at risk of mental illness, abusing drugs or alcohol can push a person over the edge.

According to the American Medical Association, dual diagnosis is much more common than we think. Based on their estimates:

  • Almost half of patients suffering from mental health disorders are also having problems with drug or alcohol abuse

  • Almost 3 in 10 of people with mental health problems are found to abuse drugs or alcohol

  • More than 5 in 10 of people who abuse drugs are also diagnosed with one “serious mental illness.” For alcohol, doctors diagnose mental illness in 37% of the cases

The Problem of Self-Medication

Historically, researchers have found that people with anxiety problems more often than not turn to alcohol or drugs as a coping mechanism.

Joshua P. Smith, PhD and Sarah W. Book, MD in their paper titled, “Anxiety and Substance Use Disorders: A Review,” pointed out that the number of cases where anxiety disorder and substance abuse occur together is too many to be denied.

And when the patient is suffering from dual diagnosis, the disorder feeds on the other. Even if you treat the addiction without addressing the mental illness, relapse is almost always a guarantee. In the same manner, treating the anxiety disorder doesn’t mean that the patient will immediately become sober.

Feeding Another Problem

It should be noted, however, that there’s little evidence that indicates that substance abuse will create long-term anxiety. The risk factor of dual diagnosis is when the individuals attempt to self-medicate their anxiety problems with alcohol or drugs.

A social phobia can be debilitating, so it’s understandable that individuals will drink a beer or two just to give them a fighting’s chance of going out their door to face the world. Unfortunately, they don’t see the danger that they are actually jumping from the frying pan and into the fire.

According to the National Institute on Alcohol Abuse and Alcoholism, there are 15. 1 million people ages 18 years old and above are dealing with alcohol abuse disorder. Of that total, 9.8 million are men.

 Untangling the Gordian Knot 

 Even today, with all the sophisticated technologies and advanced research that rehab centers have access to, doctors still couldn’t untangle the Gordian knot of mental illness and addiction. It’s hard to determine where one ends and another begins.

This is why people with dual diagnosis stay in the rehab centers longer than those who are only dealing with substance abuse. Not only do doctors have to make sure the patients are sober, but they also have to treat any of the mental issues they face.

Prioritizing, however, easy as they have to focus on which is life-threatening first, which is usually the substance abuse.

Length of Treatment

Most drug and rehab facilities offer a 30-day, 60-day, and 90-day treatment. You can choose from inpatient to outpatient programs. It’s impossible to make an approximation of how much time a dual diagnosis patient must stay there. Nevertheless, in four weeks, you would have finished the detox treatment, which is crucial to rid your body of the toxic chemicals present in drugs and alcohol.

paper published on US National Library of Medicine National Institutes of Health revealed that 18 percent of the drug rehab facilities in the country are equipped to treat dual diagnosis. The same goes for nine percent of the mental health centers.

The 2009 National Survey on Drug Use and Health: Mental Health Findings, on the other hand, revealed that people suffering from dual diagnosis don’t really get the treatment that they need. The programs are geared to addressing one disorder at a time.

 Treating the Dual Diagnosis 

While the assessment for drug and alcohol dependent remains the same, drug and rehab facilities have to take into account the co-occurring mental diseases as well. The lists down the most common mental issues that face Americans today. These are:

  1. Anxiety disorder

  2. Eating disorder

  3. Behavioral disorder

  4. Obsessive-compulsive disorder

  5. Mood disorder

  6. Personality disorder

  7. Psychotic disorders

  8. PTSD

Depression and suicidal tendencies may be present in almost all disorders listed above.

In terms of therapy options, the drug and rehab facilities typically employ:

  1. Dialectic Behavioral Therapy

  2. Cognitive Behavioral Therapy

  3. Medical Detox

  4. Interpersonal Therapy

  5. Contingency Management

  6. Eye Movement Desensitization and Reprocessing Therapy

  7. Pharmacological Therapy

  8. Matrix Model

  9. Rational Emotive Behavior Therapy

  10. Community Reinforcement and Family Training

  11. Multidimensional Family Therapy

  12. Person-Centered Therapy

  13. Motivational Interviewing

These are all options for the rehab centers, but there’s no one-size-fits-all treatment. Each individual will pass through the screening process, the outcome of which will form as a basis for the addiction counselors to craft a treatment plant that is personalized for you own unique sets of circumstances and challenges.


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