The Multiple Dimensions of Substance Abuse Treatment: Addressing Comorbidities

When someone enters treatment for substance abuse, there is much more to their story than their addiction. A wide variety of environments and circumstances surround an individual’s substance use disorder (SUD). Causes and symptoms vary from person to person, making it necessary to truly get to know clients as individuals. 

One element that greatly affects the development, trajectory, and treatment of substance use disorder is the presence of comorbidities.

How Prevalent Are Comorbidities?

Comorbidities are conditions that occur alongside addiction. These conditions can precede addiction or develop during or after it. They can take the form of mental health conditions or chronic physical ailments. Common physical comorbidities include: 

  • Infectious diseases like HIV and hepatitis C
  • Cancer
  • Hypertension
  • Heart disease
  • Chronic pain

It is incredibly common to have at least one comorbid mental health condition. About half of those with SUD also have another mental health condition at some point. This is also true in the opposite direction. Half of those with a mental health disorder will experience substance abuse or misuse at some point.

Some mental health conditions are more common than others in those struggling with addiction. Severe mental health and SUDs are especially related. Someone with a severe mental health disorder — such as schizophrenia, bipolar disorder, or major depressive disorder — has difficulty functioning in critical areas of their life. 

Mental Health and Substance Abuse Affect Each Other

Substance abuse is as much of a mental health condition as it is a physical health condition. The brain and body are each thoroughly affected, causing widespread effects. This mental component contributes to the connection between addiction and other mental health issues. As mentioned previously, half of those living with addiction have a co-occurring condition, and half of those with a mental health disorder also struggle with substance abuse. This relationship shows that sometimes mental health conditions can lead to addiction, just as addiction can trigger mental health concerns.

Poorly managed mental health can lead to unhealthy coping strategies that pave the way for substance abuse. For example, those living with anxiety may turn to alcohol to quiet distressing thoughts or participate in social activities. Others may try to distract themselves from the sadness or apathy of depression by misusing prescription medications. These behaviors can quickly get out of control, leading to an emotional and physical dependence on substances.

Risk Factors 

Mental health conditions can also be initiated by problematic substance use, particularly when someone is predisposed to developing a mental health condition. Several brain regions are disrupted by both addiction and mental health. Systems in the brain that control the rewarding and reinforcing of certain behaviors, the inhibition and control of dangerous impulses, and the processing and regulation of emotions are sensitive and can be altered as a result of substance use. 

These same regions change when someone is experiencing mental health distress, indicating a link at the neurological level. Additionally, the amount of certain neurotransmitters, which are chemical messengers in the brain, fluctuates when someone is experiencing substance abuse or mental illness.

Substance abuse and mental health are related regarding their risk factors as well. In addition to the biological factors, a person’s environment plays a major role in whether someone will develop a mental health condition or addiction. Adverse childhood experiences are one example of negative environmental exposure. If someone experiences a traumatic event or stressful extenuating situation in childhood or adolescence, their risk of poor mental and physical health outcomes increases. 

Examples of adverse childhood events include:

  • Experiencing abuse
  • Witnessing violence
  • Having family members with mental health disorders
  • Living in a household where substances are abused

The more of these events a person endures, the greater their risk of developing physical, mental, emotional, and social issues later in life. Even stress, in general, that is caused by daily life, interpersonal relationships, and work can increase the risk of SUD and co-occurring conditions.

The Importance of Treating Comorbidities

Often, when someone starts treatment for their addiction, that is the most pressing concern in their life. They may have just experienced a medical crisis, such as an overdose. Their family may have gotten involved through an intervention. There may have been other serious repercussions, such as being arrested. These circumstances can make treatment one of the last opportunities for individuals to get their lives back from addiction.

While substance abuse can push a person into dire straits, it is not the only area of their life that will need to be addressed. In order for treatment to be effective, comorbidities should be properly assessed and treated. Studies show that improving depression symptoms even slightly is linked to positive outcomes in addiction recovery. Substance abuse does not exist in a vacuum, and addressing the exacerbating factors that surround it can improve success in recovery and overall well-being.

 

The decision to enter treatment is often preceded by tremendous mental, emotional, and social pain. When someone has been living with mental illness and addiction and reaches out for help, it is important to get them that help as soon as possible. It is also important to ensure that the whole spectrum of their needs is being met effectively. Lightning Step Technologies wants to help your team help clients in a meaningful and comprehensive way. Our All-In-One system seamlessly combines an EMR, CRM, and RCM in one effortless interface, saving your team time and stress. We take care of the basics so you can provide exemplary care. To learn more, schedule a demo today!

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