What Is the Relationship Between Mental Illness & Drug Abuse?

Drug abuse among the mentally ill is a common and growing problem, according to E. Fuller Torrey, M.D. in "Surviving Schizophrenia." Torrey states that those with mental illness are twice as likely to abuse substances, compared to the general population. Cause-and-effect relationships are complex and include several possible scenarios.

Cause and Effect

• According to the National Institute on Drug Abuse (NIDA), there are three possible relationships between mental illness and drug abuse:

  1. Mental illness can lead to drug abuse, when the ill person self-medicates with drugs in order to alleviate symptoms or ease medication side effects.
  2. Drug abuse can cause or exacerbate mental illness.
  3. There may be a common origin for both disorders.

Common Origins

• When there is a single cause for both disorders, according to NIDA, it can be one (or more) of the following:

  1. An individual can be genetically predisposed to both mental illness and substance abuse disorders.
  2. Some people are more vulnerable to both mental illness and drug abuse due to environmental factors, such as family problems and other stressors in early life.
  3. Certain areas of the brain have been linked to both mental illness and drug abuse.

Consequences

• Comorbid substance abuse and mental illness can lead to consequences that the National Alliance on Mental Illness (NAMI) calls "numerous and harsh," including medication noncompliance, failure to respond to treatment, episodes of psychosis and damage to relationships with family and friends.

Treatment

• NAMI recommends an integrated approach to recovery, including intensive case management, counseling, motivational interventions and social support. Treatment should also be comprehensive, taking all aspects of the client's life into account, including stress management, socialization, jobs, housing and activities.

Problems

• Substance abuse increases the risk of homelessness and jail and adds to societal stigma against the mentally ill. And, writes Torrey, although people with psychiatric disorders are not generally violent, the few who do act assaultively are usually abusing drugs, not taking their medications or both.

Warning

• Because drug abuse can cause such serious problems for the mentally ill, it may be necessary to monitor compliance or to use the services of an Assertive Community Treatment (ACT) team.