Week 5 assignment
kin2tu
WK4AssgnP.King.docxRunning head: and connection to substance abuse 1
comorbidity and connection to substance abuse 6
Literature Review Comorbidity and Its Connection to Substance Abuse, Treatment, and Relapse
Paula King
Walden University
Capstone
Dr. Jane Lyons
June 23, 2019
Comorbidity and Its Connection to Substance Abuse, Treatment, and Relapse
Comorbidity is considered as two or more conditions that occur in one person. These disorders can happen one after another or at the same time. Comorbidity has a strong connection with substance abuse, treatment, as well as relapse (Kelly & Daley, 2013). It is essential to note that many of those who suffer from substance use disorder usually develop other mental disorders, which is a similar case to many of those diagnosed with mental disorders. Research indicates that about half of those experiencing mental illnesses have a high probability of experiencing substance abuse disorders at some time in their life. Some few research have been conducted on children, and the result indicates that youths with substance abuse disorder typically have a high rate of co-occurring mental diseases like anxiety and depression (Child, 2012). Clinicians must find an effective way to treat individuals with substance use and addictions mental health disorders. To be effective they need to prescribe the right medication to treat alcohol, opioid, and nicotine addiction and there are also medications to alleviate symptoms of mental disorders. There are some behavioral therapies that have promise in treating comorbid conditions. The programs are tailored for the clients according to age, drug misused, and other factors, which can be used alone or with medication. Some effective therapies for treating comorbid conditions: cognitive behavioral therapy, Dialectical therapy, assertive community treatment, therapeutic communities, and contingency management (Kelly & Daley, 2013).
According to Woody and Blaine (1979) for over 25 years there has been a correlation between substance abuse illnesses and other mental disorders is not a visible indication that one resulted in another, albeit one came after another. Understanding the directionality or causality can sometimes be difficult because of different reasons. For instance, emotional or behavior issues may not be severe enough to raise the alarm for diagnosis. However, sub-clinical mental health concerns may prompt abuse of drugs. The main factors that contribute to comorbidity between mental illnesses and drug abuse disorders include the aspect of conventional risk factors, the possibility of mental diseases contributing to addiction and drug abuse, and the possibility of drug abuse and addiction contributing to the growth of mental health disorders (Bukstein & Horner, 2015). Drug use and mental health illnesses can result from coinciding aspects such as epigenetic and genetic exposures, concerns with related parts of the brain, and environmental factors like the early experience of trauma or stress. Most of the vulnerabilities come from composite connections with several genes and genetic relations with environmental factors. For instance, regular use of marijuana during the youthful stage may cause various complications during adulthood, especially among those carrying a given gene variant. Environmental aspects such as trauma, stress, and unfavorable childhood experience increase the risk of both mental illnesses and disorders associated with drug use (Ouimette & Brown, 2016). Treatment patients with substance use and psychiatric comorbidity is a challenge because they may resist psychiatric or additional treatment. They could relapse or stop treatment entirely, and placing those with substance abuse and mental disorders rehabilitation facilities (Bukstein & Horner, 2015).
Research has established that those with mild, severe, or sub-clinical mental disorders may tend to use drugs for self-medication. Even though drugs can reduce the symptoms of mental illnesses temporarily, they can as well worsen the symptoms, both in the long run and acutely. For instance, proof indicates that the use of cocaine can aggravate bipolar disorder symptoms and lead to the advancement of the disorder (Ross & Peselow, 2014). When one develops a mental disorder, the resultant changes in the brain may intensify the susceptibility for challenging substance abuse use by increasing their positive impacts, lowering awareness of the harmful effects, or lessening the unfavorable signs of the mental illness and the side effect of the medications utilized in its treatment. For instance, neuroimaging connects ADHD with the neurobiological alterations in the circuit of the brain which are linked with drug yearnings, and this can partially explain why those with substance abuse disorders experience higher cravings when they have comorbid ADHD (Ross & Peselow, 2014). It is also essential to note that substance abuse and addiction has the capability of causing the development of mental illnesses. The use of drugs can cause alterations in certain parts of the brain, which are affected by other mental illnesses like anxiety, impulse control, or mood illnesses (Ross & Peselow, 2014).
Treatment for comorbidity normally entails collaboration between clinicians and organizations that offer supportive care. Treatment of the problem should focus on substance abuse and mental illness disorder together instead of focusing on one. There are effective medications and behavioral therapies to deal with addiction and mental illnesses. Relapse usually happens 70% of the time for substance use, identifying the characteristics associated with the patient relapsing and adjust the treatment program (Andersson, Wenaas, & Nordfjaern, 2018).
References
Andersson, Helle Wessel, Wenaas, Merethe, & Nordfjaern, Trond (2018). Relapse after inpatient substance use treatment: A prospective cohort study among users of illicit substances. https://reader.elsevier.com/reader/pii/SO30640318308542?token=4D108E6999079029E
Bukstein OG & Horner MS. (2015) Management of the adolescent with substance use disorders and comorbid psychopathology. Child Adolescent Psychiatric Clinics North America 19(3):609-623. doi:10.1016/j.chc.2010.03.011.
Child, J. (2012). Adolescent Substance Abuse. 2012 Jul 1; 21(4): 310–322. doi:10.1080/1067828X.2012.709453/ https://www.ncbi.nlm.nih.gov/pmc/articles/PMC3923628/ Kelly, TM, Daley, DC. Integrated Treatment of Substance Use and Psychiatric Disorders. Soc Work Public Health. 2013; 28(0): 388-406. doi: 10.1080/19371918.2013.774673
Ouimette, P. E., & Brown, P. J. (2016). Trauma and substance abuse: Causes, consequences, and treatment of comorbid disorders. American Psychological Association.
Woody GE, Blaine J. Depression in narcotic addicts: Quite possibly more than a chance association. In: Dupont RL, Goldstein A, O’Donnell J, Brown B, editors. Handbook on Drug Abuse. Washington, DC: U.S. Government Printing Office; 1979. pp. 277–285
