Drug use disorders and mental illness go hand in hand, as people addicted to drugs have twice the risk of developing mood and anxiety disorders compared to people in general, and vice versa. According to the 2019 National Survey on Drug Use and Health (NSDUH), 24.5 percent (or 61.2 million adults) age 18 and older experienced a mental illness (AMI) or substance use disorder (SUD). ) in the last year. Additionally, 16.8 percent (or 42 million people) suffered an AMI but not a SUD. The survey also reported a 3.9 percent (or 9.7 million people) incidence of an SUD but not a MAI, while 3.8 percent (or 9.5 million people) found themselves struggling with both an MAI and a SUD.
Such a high co-prevalence of AMI and SUD makes it necessary to think that both are interrelated and, if so, why?
Co-occurrence: one match or more
The high incidence of co-occurring substance use disorders and mental illness is independent of a causal association between the two. Furthermore, it does not indicate any particular sequence at the start of the problem, simply because multiple factors can contribute to SUDs and AMI, and most of them are independent of each other.
For example, it is important to see if symptoms have progressed to a specific level (according to DSM) to confirm the diagnosis of any mental disorder. However, subclinical symptoms can also lead to drug use. Although it is always difficult to know which comes first between AMI and LDS. Nevertheless. there seem to be three possibilities.
- Drug use can lead to mental illness: The drug or drugs of use may be responsible for causing one or more symptoms of a mental illness in the user. The evidence supporting the possibility comes from the known association between an increased risk of psychosis and marijuana in some users.
- Mental illness leading to drug use: Researchers have been talking about the possible role of mental illness in causing drug use. People who report overt, mild, or even subclinical mental disorders are vulnerable to drug use as self-medication. Slowly, as the person becomes more empowered with the use of the drug, they become dependent on it, leading to addiction.
- Overlapping factors: There are certain factors, including genetic vulnerabilities, brain deficits, and / or early exposure to stress or trauma, that can cause AMI and SUD.
All of these three scenarios can be expressed (to different degrees for different individuals) by advocating for a concurrent IAM and SUD.
Exploring common factors
Genetics have a role to play in both an AMI and an SUD. Genetic factors can be an important common link between these two conditions, which are known to contribute to the development of addiction and other mental illnesses. According to the researchers, genetics contribute 40 to 60 percent of vulnerability to addiction. At the same time, genes can also act indirectly by contributing to the development of SUD by altering an individual’s response to stress or their tendency to develop risky behavior and search for novelties.
Similar brain regions are involved. It may be more than a coincidence that in both SUD and AMI, the same brain regions are affected. For example, addictive substances and mental illnesses such as depression and other psychiatric disorders affect dopamine, a chemical that carries messages from one neuron to another.
This overlapping of brain areas affected by AMI and SUD may indicate the possibility of some brain changes that can be caused by either of these and affect the other.
A report published in the National Institute on Drug Abuse (NIDA) suggests that the development of a mental disorder and subsequent changes in brain activity tend to increase susceptibility to substance use by reducing awareness of its negative effects, amplifying its effects positive or alleviate the unpleasant effects caused by the mental disorder.
Mental health is about timely treatment
Different behavioral therapies have been found to be effective in treating comorbid conditions. However, it is important to consider other associated factors, such as the patient’s age and the specific drug used, among other things, when proceeding with the planned treatment.