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Abuse, addiction and mental illness: A dangerous trap

“Dual diagnosis.” Spend any amount of time reading treatment literature – or browsing a treatment company’s website – and it’s only a matter of time before the phrase “dual diagnosis” makes an appearance. What is a dual diagnosis? According to the National Alliance on Mental Illness (NAMI), a dual diagnosis is when someone has both a mental illness and a substance use disorder simultaneously.

Although not everyone with a mental illness develops a substance use disorder – and vice-versa – those who do often face a long, complex recovery. How do dual diagnoses develop? The National Institute on Drug Addiction (NIDA) offers three possible reasons why:

  • Some drugs can create the symptoms of mental illness in users. For example, studies have shown some marijuana users run a risk of experiencing psychotic symptoms.
  • The symptoms of mental illness cause some patients to self-medicate with drugs and alcohol for relief. In 2006, a study found links between a lack of mental health care and increased substance abuse in some patients.
  • Mental illness and substance use disorders often have complex mental and biological causes behind them. Exposure to trauma in childhood can create major problems in later life, according to the National Child Traumatic Stress Network.

However, a new study – the first of its kind – recently published in the journal Frontiers in Genetics examined a potential genetic link between a patient’s genes and the person’s risk for both mental health and substance abuse issues.

A hereditary risk found?

In the study, researchers from Washington University’s BRAINLab examined data from over 2,500 people who participated in the latest Study of Addiction: Genetics and Environment, funded by the National Human Genome Research Institute. The study analyzed the participants’ substance habits and drug dependencies.

Washington University’s team then examined the participants’ genetic data, looking for susceptibilities toward mental disorders. “Our research shows that if someone is genetically predisposed towards having mental illness, they are also prone to use licit and illicit substances and develop problematic usage patterns,” said Catlin Carey, M.S., a study co-author in a Frontiers Science blog post.

The study also found links between specific substances and mental health. “We were fortunate to work with data from individuals recruited for various forms of substance dependence. In addition to evaluating the full spectrum of substance use and misuse, from never-using and non-problem use to severe dependence, this also allowed us to evaluate specific psychiatric disorder-substance relationships,” said study senior author and BRAINLab director Ryan Bodgdan, Ph.D. “For example, we found that genetic risk for both schizophrenia and depression are associated with cannabis and cocaine involvement.”

Other studies have established links between addiction and mental disorders – particularly severe disorders.

Severe mental illness comes with high risks for substance abuse

In 2014, NIDA conducted a study, which examined over 9,000 patients diagnosed with schizophrenia, bipolar disorder with psychotic features and schizoaffective disorder. Using the Genomic Psychiatry Cohort program, the patients were geographically matched to 10,195 control subjects.

According to the data, severely mentally ill patients were:

  • Three and a half times more likely to be regular marijuana users – the study classed regular use as 21 times per year
  • Four times more likely to be heavy alcohol users – which the study classed as four or more drinks per day
  • Nearly five times more likely to use other drugs at least 10 times during their lives

The study also found severely mentally ill people did not have the same protective factors seen in other racial, ethnic and gender groups. “In the general population, women have lower substance use rates than men, and Asian-Americans have lower substance use rates than white Americans, but we do not see these differences among people with severe mental illness,” said study lead author Sarah Hartz, M.D., of the Washington University School of Medicine in a National Institutes of Health press release. Previous studies on patients with severe mental disorders have found they often have a dramatically lower life expectancy than people without the disorder.

The combination of mental illness and substance abuse is a complex medical condition which benefits from professional treatment. Sovereign Health provides expert help for substance abuse and dual diagnosis at our El Paso treatment center. A healthier life can begin today. Please call our 24/7 helpline.

Brian Moore is a staff writer and graphic designer for Sovereign Health. A 20-year veteran of the newspaper industry, he writes articles and creates graphics across Sovereign’s portfolio of marketing and content products. Brian enjoys music, bicycling and playing the tuba, which he’s done with varying degrees of success for over 25 years. For more information and other inquiries about this media, contact the author and designer at

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