Home Mental Health & Well-Being Why Do Mental Health Issues Coexist with Drug Abuse?

Why Do Mental Health Issues Coexist with Drug Abuse?

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Drug abuse is classified as a mental health issue since it leads to various mental health problems, including anxiety, depression, etc. There is no age specification where drug abuse is concerned. Drug abusers can be adolescents, middle-aged or old-aged people. 

Many of these people also suffer from other chronic mental illnesses like eating disorders and personality disorders. According to research, out of 10 people who abuse an illicit drug, 6 of them suffer from another mental illness. 

What is comorbidity?

In medical terms, comorbidity is when one health condition gives rise to another health condition in the body. This term can be used to describe how drug abusers suffer from mental health issues and vice versa. Although they impose a certain influence on each other, this does not mean that one causes the other. According to the NIH National Institute of Drug Abuse (NIDA), 37.9% of drug abusers battle various types of mental illness. In contrast, 18.2% of mental health patients abuse some illicit drug.

How do we approach treatment?

Treatment for comorbidity can be tricky. We cannot treat one without the other. Drug abusers have more chances of relapse if their mental health disorder is treated side-by-side and vice versa. 

There has been extensive research and study going on for some time to treat both of these conditions simultaneously. The following mental illnesses are commonly associated with drug abuse, and treatments are tailored accordingly.

Depression, anxiety, and PTSD

Studies have shown that people who suffer from depression, anxiety, and PTSD also suffer from alcohol abuse and addiction and vice versa. However, combining ketamine and psychotherapy to treat addiction has proven useful in recent clinical trials.

Ketamine is a drug that was manufactured as anesthesia during the mid-1900s. As mental health issues started to gain recognition, this drug was used against depression and PTSD. After acknowledging the success of this drug, researchers combined it with psychotherapy to treat drug abusers who seemed to relapse after rehab. It helped them gain perspective on their mental health condition and modify destructive thought patterns. Moreover, ketamine is administered to lower their anxiety and depression symptoms and keep their heads clear.

Antisocial personality disorder

People with antisocial personality disorder are unable to bond with others. This inability, combined with impulsive behavior, makes them the most difficult people to treat. Antisocial personality disorder (APD) is seen in people who abuse opiates. Statistically speaking, one out of every four opiate-dependent people suffers from APD. 

People who suffer from APD respond well in high reward conditions. The standard therapy procedure doesn’t work well on them. Therapists consider an approach where the patients are rewarded right after producing a urine sample free of the traces of illicit drugs. This approach is combined with a methadone treatment programme to minimise their craving.

Bipolar disorder

Bipolar disorder is characterised by constant mood switches from depression to mania. One minute you are depressed, and the next minute you feel euphoric. This disorder is diagnosed mostly in teenagers.

Drugs that contain lithium are highly effective against bipolar disorders. And this, combined with behavioral therapy, has proven to treat comorbid substance abuse.

Research suggests that lithium also proves useful to treat substance abuse in bipolar teens. So, to study this, 25 bipolar teens with substance abuse were given lithium capsules twice a day for six months. After the study, illicit drug traces in their urine samples dropped from 40% to 10%. 

Why does it occur?

Several factors explain why comorbid substance abuse occurs. Some of these factors are mentioned as follows.

  • Genetic factors. Many mental illnesses like schizophrenia and depression run in families. Similarly, genetics also play a role in drug abuse. Children of alcohol abusers are four times more likely to become alcoholics than children of non-alcoholics. Combining these two factors, if your family history indicates drug abuse and mental illnesses, you are more prone to suffer from comorbid substance abuse. But this does not necessarily mean that it is inevitable. Nonetheless, you have to work extra hard to stay healthy and sober.
  • Emotional changes in adolescence. Teenagers go through several hormonal changes at various stages of adolescence. Sometimes, these changes can spark aggressive behavior and disturbing thought processes. Many teenagers find solace in drugs recreationally, which could also be due to peer pressure. Such behavior can lead to substance abuse problems if left unsupervised.
  • Common risk factors. Many mental illnesses are caused by extreme stress and trauma. These risk factors also contribute to drug abuse. A traumatic life-changing event can cause anxiety and depression, pushing people to use drugs excessively. Genetics is another common risk factor.
  • Is it difficult to diagnose? Diagnosing comorbidity can be highly challenging. Because the symptoms of drug abuse and certain mental disorders are the same, one of these problems often gets overlooked by doctors. Statistics show that 34% of the individuals suffering from comorbidity only receive treatment for mental health disorders. If drug abuse is left untreated, patients usually revert to destructive thought patterns regardless of therapy. Similarly, if a person goes to rehab without seeking help for their mental illness, chances of relapse significantly increase.


Comorbidity is a prevalent problem, especially among drug abusers. It’s imperative to recognise the signs and seek treatment as soon as possible. Advancements in healthcare have allowed doctors and therapists to work together and find a solution that best suits the needs of the patients. Now, we can say that drug abuse leads to mental health issues, and the same applies the other way around. Nonetheless, by approaching reliable healthcare professionals, one can get rid of such issues once and for all.

Dennis Relojo-Howell is the managing director of Psychreg.


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