Comorbidity between substance abuse and other mental disorders

the term comorbidity O associated morbidity it is used to denote the diagnosis that the same person suffers from two or more disorders or diseases.

These disorders can occur simultaneously or in a chain. Comorbidity has the particularity of indicating an interaction between the two (or more than two) pathologies, which can worsen the prognosis of both.

Drug addiction and associated psychopathologies

When we talk about drug addiction, we need to be clear: in itself it is cataloged as a mental illness, As it interrupts and alters the normal categorization of needs and wants, replacing them with new priorities related to the acquisition and consumption of psychotropic drugs.

Compulsive behaviors decrease the ability to control impulses, causing gradual degradation in interaction with the environment. This image corresponds to a common symptomatology in psychopathologies.

Many drug addicts are also diagnosed with other mental illnesses, and vice versa. Without going any further, drug addicts are twice as likely to suffer from conditions related to their mood or type of anxiety, which also happens in reverse.

But, Why is there such a marked comorbidity between drug addiction and mental disorders? While substance abuse disorders occur at the same time as other psychopathologies, it does not mean that one causes the other, although one may appear before and the other after. Indeed, it is often difficult to decide which of the disorders occurs first and why. However, studies indicate the following as reasons why these diseases are common in co-morbidities:

  • Drug addiction usually causes symptoms of another psychopathology. For example, some cannabis smokers with certain underlying vulnerabilities may be at greater risk of developing psychotic symptoms.

  • Mental illness can lead to drug use, possibly as a means of self-medication. People who suffer from anxiety or depression are more prone to the use of alcohol, smoking, or other drugs or mind-altering drugs that can temporarily relieve their symptoms.

Risk factors in drug addicts

These psychopathologies can also be explained by common risk factors, such as:

  • The addition of genetic vulnerabilities. Certain genetic predispositions may increase susceptibility to both drug addiction and other psychopathologies, or may present an increased risk for a second condition once the first appears.

  • The addition of risk factors in the environment. Stress, substance use at a young age, or trauma in children and youth can lead to addiction and, in turn, to other mental disorders.

  • the activation of similar brain areas. For example, brain systems that are activated during gratification or stress are altered by substance use and may be abnormal in people with certain psychopathologies.

  • The pathologies of drug addiction and other mental disorders are developmental disorders. They usually appear during adolescence or even during puberty, just in times when the brain and nervous system undergo sudden changes due to their development. The use of drugs at this vital stage can change the structures of the brain so that the risk of suffering from psychopathologies will be greater in the future. So, when there is an early symptomatology of mental illness, it is usually linked to a higher risk of substance abuse in the future.

Studies carried out in the Community of Madrid between 2006 and 2008 indicated that the concordance of substance use disorders with mental illness occurred primarily in males (80%), With an average age of 37, single (58%) with a primary education (46%).

The most common mental illnesses in these people are personality disorders, risk of suicide, episodes of hypomania, anxiety disorders, and major depression.

55% of the subjects evaluated consumed at least two substances. cocaine (63%), alcohol (61%) and cannabis (23%) were the most reported drugs.

Bibliographical references:

  • Beck, A., Newman, C. and Wright, F. (1999), Cognitive addiction therapy. Barcelona: Paidós.
  • Cuatrocchi, I. (2009), Drug addiction. His recovery in the therapeutic community. Madrid: space.
  • García, J. (2008), Epidemiological study to determine the prevalence, diagnosis and therapeutic attitude of double pathology in the Community of Madrid. Department of Preventive Medicine and Public Health Faculty of Medicine (UAM).
  • Tejero, A. and Trujols, J. (2003). Clinical instruments for the assessment of cocaine dependence. Barcelona: Ars Mèdica.

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