HOUGHTON — Nobody intentionally contracts a substance use disorder (SUD). Research has found that many who develop SUDs are also diagnosed with mental disorders, and vice versa, according to the National Institute on Drug Abuse (NIDA) in its Aug.1, 2018, NIDA report, Comorbidity: Substance Use Disorders and Other Mental Illnesses DrugFacts.

The NIDA is the leading federal agency supporting scientific research on drug use and its consequences.

The institute states that research suggests that adolescents with substance use disorders also have high rates of co-occurring mental illness; over 60 percent of adolescents in community-based substance use disorder treatment programs, also meet diagnostic criteria for another mental illness.

“It is remarkably common for people who misuse substances to have additional mental health issues that occur at the same time,” states the American Addiction Centers.

In many instances, SUDs occur as a result of someone misusing substances as a means of trying to manage or cope with a mental disorder, which is often undiagnosed, a term often referred to self-medicating.

The Substance Abuse and Mental Health Services Administration (SAMHSA) concurs. Its Substance Use Disorder Treatment for People with Co-occurring Disorders, Updated 2020: Treatment Improvement Protocol (IP) 42, states:

“People with SUDs are more likely than those without SUDs to have co-occurring mental disorders. Addiction counselors encounter clients with Co-occurring Disorders (CODs) as a rule, not an exception. Mental disorders likely to co-occur with addiction include depressive disorders, bipolar I disorder, post-traumatic stress disorder (PTSD), personality disorders (PDs), anxiety disorders, schizophrenia and other psychotic disorders, ADHD, and eating and feeding disorders.”

Although many people who self-medicate may have a concurrently-diagnosed health condition, such as a mental illness, cancer, injury or chronic pain, states the Addiction Centers, it is imperative to remember that a person does not have to a formal clinical diagnosis to have already started the act of self-medication.

“Although many people (who) self-medicate may have a concurrently diagnosed health condition, such as a mental illness, cancer, injury, or chronic pain,” states the Addiction Centers.

During an interview last week, Prevention Specialist and Drug Counselor from the Western U.P. Health Department Gail Ploe said that the Facing Addiction through Community Engagement (FACE) program was begun in order to take a look at what is missing in the local communities and what can be done to bridge those gaps.

Ploe said that one of the things receiving focus is learning about Adverse Childhood Experiences, or ACEs. Adverse childhood experiences (ACEs) are potentially traumatic events that occur before a child reaches the age of 18. Such experiences can interfere with a person’s health, opportunities and stability throughout his or her lifetime-and can even affect future generations. The NIDA report also addressed that issue.

Physically or emotionally traumatized people are at much higher risk for drug use and SUDs, the report states, and the co-occurrence of these disorders is associated with inferior treatment outcomes.

“People with PTSD may use substances in an attempt to reduce their anxiety and to avoid dealing with trauma and its consequences, the report went on to state.

To make matters even more complex, it is estimated that 40-60 percent of an individual’s vulnerability to substance use disorders is attributable to genetics. Most of this vulnerability arises from complex interactions among multiple genes and genetic interactions with environmental influences.

The point in this article is to establish the complexities of mental illness and SUDs that far exceed the social stigma associated with them. What is at point is: although co-occurring diagnoses are more complicated to treat, there still is hope for those who want to break the cycle and live normal, productive and happy lives.

The high rate of co-occurrence (comorbidity) between substance use disorders and other mental illnesses calls for a comprehensive approach that identifies and evaluates both the NIDA reports. Accordingly, anyone seeking help for either substance use, misuse, or addiction or another mental disorder should be evaluated for both and treated accordingly.

Several behavioral therapies have shown promise for treating comorbid conditions. These approaches can be tailored to patients according to age, the specific drug misused, and other factors. They can be used alone or in combinations with medications. Some effective behavioral therapies for treating comorbid conditions include:

– Cognitive behavioral therapy (CBT) helps to change harmful beliefs and behaviors.

– Dialectical behavioral therapy (DBT) was designed specifically to reduce self-harm behaviors including suicide attempts, thoughts, or urges; cutting; and drug use.

– Assertive community treatment (ACT) emphasizes outreach to the community and an individualized approach to treatment.

– Therapeutic communities (TC) are a common form of long-term residential treatment that focus on the “resocialization” of the person.

– Contingency management (CM) gives vouchers or rewards to people who practice healthy behaviors.