Severe mental illness tied to higher rates of substance use

People with severe mental illness such as schizophrenia or bipolar disorder have a higher risk for substance use, especially cigarette smoking, and protective factors usually associated with lower rates of substance use do not exist in severe mental illness, according to a new study funded by the National Institute on Drug Abuse (NIDA), part of the National Institutes of Health.

Estimates based on past studies suggest that people diagnosed with mood or anxiety disorders are about twice as likely as the general population to also suffer from a substance use disorder. Statistics from the 2012 National Survey on Drug Use and Health indicate close to 8.4 million adults in the United States have both a mental and substance use disorder. However, only 7.9 percent of people receive treatment for both conditions, and 53.7 percent receive no treatment at all, the statistics indicate.

Studies exploring the link between substance use disorders and other have typically not included people with severe psychotic illnesses.

"Drug use impacts many of the same brain circuits that are disrupted in severe mental disorders such as schizophrenia," said NIDA Director Dr. Nora D. Volkow. "While we cannot always prove a connection or causality, we do know that certain are risk factors for subsequent , and vice versa."

In the current study, 9,142 people diagnosed with schizophrenia, schizoaffective disorder, or with psychotic features, and 10,195 controls matched to participants according to geographic region, were selected using the Genomic Psychiatry Cohort program. Mental disorder diagnoses were confirmed using the Diagnostic Interview for Psychosis and Affective Disorder (DI-PAD), and controls were screened to verify the absence of schizophrenia or bipolar disorder in themselves or close family members. The DI-PAD was also used for all participants to determine substance use rates.

Compared to controls, people with severe mental illness were about 4 times more likely to be heavy alcohol users (four or more drinks per day); 3.5 times more likely to use marijuana regularly (21 times per year); and 4.6 times more likely to use other drugs at least 10 times in their lives. The greatest increases were seen with tobacco, with patients with severe mental illness 5.1 times more likely to be daily smokers. This is of concern because smoking is the leading cause of preventable death in the United States.

In addition, certain protective factors often associated with belonging to certain racial or ethnic groups – or being female – did not exist in participants with severe mental illness. "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 Dr. Sarah Hartz, from the Washington University School of Medicine in St. Louis and first author on the study. "We also saw that among young people with severe mental illness, the were as high as smoking rates in middle-aged adults, despite success in lowering smoking rates for young people in the general population."

Previous research has shown that people with schizophrenia have a shorter life expectancy than the , and chronic cigarette smoking has been suggested as a major contributing factor to higher morbidity and mortality from malignancy as well as cardiovascular and respiratory diseases. These new findings indicate that the rates of substance use in people with severe psychosis may be underestimated, highlighting the need to improve the understanding of the association between substance use and psychotic disorders so that both conditions can be treated effectively.

More information: JAMA Psychiatry. Published online January 01, 2014. DOI: 10.1001/jamapsychiatry.2013.3726

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Benni
2 / 5 (4) Jan 04, 2014
Well surprise, surprise. Now with Colorado allowing legal use of pot, just where do you think the statistics for dimentia will be be 10-30 years from now? Ten times the present day national average if other states follow suit?

I mean what the hell, this country has become so obsessed with the evils of legal tobacco use that whole state governments have gone on the warpath against it, they put up billboard ads & placed ads all over TV decrying its use. Now with marijuana legal in Colorado, will it be safe to drive anywhere at any time of the day?

Why are Colorado public health officials not jumping all over the use of an hallucinogenic substance that is far more deadly than tobacco. Even short term use as well as long term use will kill far more people than tobacco ever has at any end of the scale. This hallucinogenic substance causes the formation of plaque in brain cells upon very short term use, at least tobacco doesn't do that. Must have something to do with counting votes.
dogbert
not rated yet Jan 04, 2014
It has been well known for many years that people with mental illness self medicate, particularly with nicotine.

I suppose reexamining old knowledge is OK, but it would be better if it were noted that the results of the study confirmed prior knowledge.
aroc91
5 / 5 (2) Jan 04, 2014
Now with marijuana legal in Colorado, will it be safe to drive anywhere at any time of the day?


Now with alcohol legal in all states, will it be safe to drive anywhere at any time of the day?

far more deadly than tobacco


Now you're just lying.

This hallucinogenic substance causes the formation of plaque in brain cells upon very short term use


Evidence needed.
Benni
1 / 5 (2) Jan 04, 2014
far more deadly than tobacco


Now you're just lying.


Evidence needed.


Your denialist post calling me a liar........
Returners
1 / 5 (2) Jan 04, 2014
Now with alcohol legal in all states, will it be safe to drive anywhere at any time of the day?


So, the solution to over-intoxication is to...add more intoxication?

Now we can have drunk driving accidents plus stoned driving accidents, not to mention drunk and stoned driving accidents.

Not to mention more "sick days" that are actually hung-over days, and lost productivity for people showing up to work intoxicated or late.

Does Colorado and Washington want to increase their accidental death rate, and cancer death rate for some reason?
Zephir_fan
Jan 04, 2014
This comment has been removed by a moderator.
full_disclosure
4 / 5 (4) Jan 04, 2014
Zipperhead_fan must be Vendicar, Fagness or Nom Nuts....or all three! Behavior is identical....
Whydening Gyre
5 / 5 (3) Jan 04, 2014
Well surprise, surprise. Now with Colorado allowing legal use of pot, just where do you think the statistics for dimentia will be be 10-30 years from now? Ten times the present day national average if other states follow suit?

Well, they didn't say harmful drug use was a risk factor for mental illness, Benni. The opposite, actually - crazy people at risk for using drugs which are LEGAL, BTW...
I mean what the hell, this country has become so obsessed with the evils of legal tobacco use that whole state governments have gone on the warpath against it, they put up billboard ads & placed ads all over TV decrying its use.

You sound like a smoker. No prob, me too - (must be crazy...)
Now with marijuana legal in Colorado, will it be safe to drive anywhere at any time of the day?
Sure it will - They'll just get (not too) high and throw a barbecue. No travel needed.
When are you gonna get down on excessive coffee use? You think people are safe when they're over adrenalized?
Zephir_fan
Jan 04, 2014
This comment has been removed by a moderator.
Whydening Gyre
5 / 5 (2) Jan 04, 2014
It has been well known for many years that people with mental illness self medicate, particularly with nicotine.

Yea, but - does giving them a smoke work to calm them down? Yep...
I suppose reexamining old knowledge is OK, but it would be better if it were noted that the results of the study confirmed prior knowledge.

It more appears to me that the study was designed to confirm prior "knowledge".
But, what do I know - I'm a crazy person that is starting to need a smoke, right now...
Whydening Gyre
3 / 5 (2) Jan 04, 2014
Zipperhead_fan must be Vendicar, Fagness or Nom Nuts....or all three! Behavior is identical....


I thank you for your endorsement Skippy, but that is all you get, my thanks. I can't afford to pay you no. But I will award you the occasional good karma points. Please keep the fan mails coming, it lets the higher ups know that I am on my toes and doing my dutys.

See? I nailed it - what you're REAL function is here.... You sneaky Google employee, you.
Benni
1 / 5 (1) Jan 05, 2014
Does Colorado and Washington want to increase their accidental death rate, and cancer death rate for some reason?


The politicians who aid & abet public use of hallucinogenic substances are themselves using it. Look at the voting records of those State Representatives & Senators inside these state legislatures who want approval of this stuff, then do a background check of their personal life's history & in most cases it will be revealing.

Just within the town in which I live there has been a recent incident in which a local politician was interfering with an investigation of a person illegally growing marijuana. The grower had a greenhouse fitted with lights, & heaters for winter growth, the outside was completely housed in a barred cage with a locked entrance monitored by survellience cameras from the house 50 feet away. This practice was defended by a local politician who himself is a self proclaimed Libertarian type, but who always votes as a partisan Democrat.

skippy_skippys
3.7 / 5 (3) Jan 05, 2014
Zipperhead_fan must be Vendicar, Fagness or Nom Nuts....or all three! Behavior is identical....


I thank you for your endorsement Skippy, but that is all you get, my thanks. I can't afford to pay you no. But I will award you the occasional good karma points. Please keep the fan mails coming, it lets the higher ups know that I am on my toes and doing my dutys.


What higher up's the wardens of the psycho ward?
full_disclosure
3 / 5 (2) Jan 06, 2014
Zipperhead_fan….so soooo insecure….feel free to threaten me with decapitaion if it makes you feel better Herr Vendicar….soooo insecure….
full_disclosure
1 / 5 (1) Jan 06, 2014
Zipperhead_fan must be Vendicar, Fagness or Nom Nuts....or all three! Behavior is identical....


I thank you for your endorsement Skippy, but that is all you get, my thanks. I can't afford to pay you no. But I will award you the occasional good karma points. Please keep the fan mails coming, it lets the higher ups know that I am on my toes and doing my dutys.

See? I nailed it - what you're REAL function is here.... You sneaky Google employee, you.


Wrong again mook! Keep trying....