Substance misuse typically presents a demanding array of challenges for affected individuals and families. But when patients contend with a substance use disorder and mental illness simultaneously, achieving recovery can be additionally challenging. Frequently, addiction and other mental health challenges can exacerbate each other or complicate diagnosis for professionals who seek to treat them. And although research suggests addressing both disorders simultaneously produces the best outcomes, many facilities are not equipped to provide this integrated treatment approach.
How many people with substance use also experience co-occurring mental health disorders? Past research has suggested a substantial percentage of substance users do – but we set out to investigate the most recent and comprehensive data available.
Using records from the most recent National Survey on Drug Use and Health conducted by the Substance Abuse and Mental Health Services Administration, we analyzed how often co-occurring disorders arise and how they might complicate a patient’s search for help. Read on to see how often people struggle with more than substance misuse alone.
Mental Health Struggles by Substance
If the connection between substance use and mental illness is quite evident in general terms, do certain substances correlate with co-occurring disorders more closely than others?
In the case of many substances, more than half of users reported a mental illness as well. That link was particularly pronounced for methamphetamine users, of who over 57 percent had a mental illness. Psychiatrists note extended meth use can cause psychotic episodes and more extended symptoms, in addition to exacerbating pre-existing disorders.
Users of opioids also experienced high rates of mental illness, which may relate to evidence that extended use of these drugs causes an increased risk of developing depression. Conversely, marijuana users had one of the lowest rates of mental illness among all substance users. This finding may encourage those who support the medicinal use of cannabis to treat a range of mental illnesses, including depression, anxiety, and bipolar disorder.
A Critical Need for Care
Among those with a mental illness who were classified as needing substance use treatment, only 8.9 percent felt a need for treatment for illicit drugs, while 5.4 percent felt a need for treatment for alcohol use. These percentages were substantially higher than in the cohort without a mental illness of any kind: Among those without a mental illness, for instance, fewer than 2 percent of individuals reported a perceived need for alcohol treatment.
Those with a mental illness, for example, were much more likely to say they did not know where to go for treatment or could not find a facility that offered the services they sought. They were also more frequently worried seeking treatment would affect their employment. Their fears may reflect a tragic reality: Mental illness is often harshly stigmatized in the workplace, despite legal protections against discrimination.
With or without co-occurring disorders, the most common cause for forgoing treatment was a lack of readiness to stop using. But on other motivations for delaying getting help, the differences between these groups were quite revealing.
Potential in Prescriptions?
While professionals debate the relative efficacy of therapy and medication in treating mental illnesses such as depression, most individuals benefit from some combination of both.
According to our data, more than a third of those with a mental illness were prescribed medication for their condition. The percentage was slightly greater for those with a mental illness and substance use disorder, and 11.5 percent of those with substance use issues alone received a prescription. According to experts, medications are underutilized in the treatment of substance use disorders, largely due to a lack of education among medical professionals. There may also be a reason for concern when prescribing medications to people with a known history of drug misuse.
More people with a mental illness who also misused psychotherapeutic drugs in the past year received prescriptions than those with a mental illness who did not misuse psychotherapeutic drugs. In particular, benzodiazepines prescribed to treat severe anxiety have generated concern within the medical community. With a high risk of tolerance and dependence, this type of drug has significant potential for misuse.
Optimism in Expert Care
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