Drug use problems and mental health: comorbidity explained


Drug use problems are often associated with
health harms. Infectious diseases such as HIV/AIDS and hepatitis
C, have clear links to drug use. But there are also links between drug use
and mental health problems that we need to consider: People with problematic forms of drug use
often suffer from both a substance use and a mental health disorder. The co-existence of a substance use and a
mental health disorder in the same person is usually called ‘psychiatric comorbidity
in substance users’ or “dual diagnosis” There aren’t many figures on the extent
of mental health disorders among drug users, but the numbers affected can be very high
– up to 80% in certain groups of drug treatment patients. Depression is the most common mental health
disorder associated with substance use, but anxiety is also often seen and comorbid substance
use disorders are more common in people with psychosis. Compared with people who have only a drug
use or a mental health problem, people with comorbidity have more emergency admissions
to general hospitals and to psychiatric hospitals, and more of them commit suicide. Substance use and mental health disorders
are interlinked in different ways, which are sometimes overlapping. In some cases, a mental health disorder can
be considered a risk factor for drug use, which may lead to the development of a substance
use disorder. In other cases, drug use can trigger the development
of a mental health disorder. Clinical practice has also shown that comorbid
disorders often interact to make each other worse. It is often difficult to diagnose comorbidity
among drug users. For example, in a person entering drug treatment,
acute psychiatric symptoms might be attributed to their drug use.
Or the effects of withdrawal or intoxication from drugs may be misinterpreted as psychiatric
illness. Patients need careful diagnosis and integrated
treatment, where the two disorders are treated at the same time, with professionals from
both fields working together. Providing this level of care is a major challenge
for policymakers, professionals and clinicians.

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