SAFE Glen Cove Coalition: On Opioid Use and Mental Illness

The term “comorbidity” in the addictions treatment field refers to the presence of one or more other mental illnesses that make the addiction worse.

According to the Substance Abuse and Mental Health Services Administration (SAMHSA), if an individual is diagnosed with a comorbid illness, addiction becomes even more complex, thus making it more difficult to address. In many cases, the problem is that other illnesses (such as depression or anxiety) usually aren’t as obvious as the addiction so when a patient seeks opiate addiction treatment and are not open and honest about other mental illnesses they may have, doctors and therapists may fail to make the dual diagnosis. As a result, patients may receive treatment for their addiction only. The other mental illness will go untreated, which greatly increases the chances of relapse.

While there are high rates of comorbidity and substance use disorder, opiate addicts are set apart by the severe mental and physical effects of their drug of choice. Heroin is not only the most addictive drug but it’s also illegal, highly socially stigmatized and incredibly risky. Serious heroin addiction makes it almost impossible to be a functioning member of society, and seriously impairs the addicts personal life. Having an underlying mental illnesses further exacerbates the situation.

Comorbid disorders that are most commonly associated with an addiction to opiates are Anxiety and panic disorders, Depression, Alcoholism, Sleep disorders, Bipolar disorder (Manic Depression) Adult Attention Deficit Hyperactivity Disorder, Post-Traumatic Stress Disorder and Schizophrenia.

Each of these illnesses on its own warrants extensive treatment. Many require long-term medication, along with therapy. And more serious illnesses such as prolonged depression, bipolar disorder and schizophrenia can even be chronic issues. That’s why, when the individual also has substance abuse problems that stem from or are closely associated with the other illness, there’s a perpetual danger of relapse.

In the most severe cases, the two comorbid disorders can dangerously feed off of each other. For instance, say an individual takes prescription medications for schizophrenia or bipolar disorder, but falls into an extended bout of substance abuse and thus fails to regularly take his medication. In this scenario, the underlying mental disorder goes untreated while the addiction rages unchecked.

The problem may become even worse in cases where the individual is incapable of seeking treatment due to poverty or homelessness. For some people, particularly those who lack insurance, getting access to drugs such as heroin can be easier and cheaper than seeking medical care.

Ideally, treatment of the comorbid illness should begin as early as the detox stage of treatment. This way, while the patient begins transitioning from heroin or prescription painkillers to replacement drugs like Suboxone or methadone, their treatment professionals will be aware of any additional mental problems that may come up as a result of the change.

In the best of circumstances, the patient will have all problems diagnosed, and treatment will begin as early as possible. With an all-encompassing combination of opioid replacement therapy, drug therapy to address the mental illness, psychotherapy and ongoing participation in a support group, the recovering addict will have the best possible chance of success.

The Substance Abuse and Mental Health Services Administration (SAMHSA) is a branch of the U.S. Department of Health and Human Services. It is charged with improving the quality and availability of treatment and rehabilitative services in order to reduce illness, death, disability, and the cost to society resulting from substance abuse and mental illnesses. For more information about SAMHSA please visit www.samhsa.gov.

The SAFE Glen Cove Coalition is conducting an opioid prevention awareness campaign entitled "Keeping Glen Cove SAFE" to educate and update the community regarding opioid use and its consequences. To learn more about the SAFE Glen Cove Coalition please follow us on www.facebook.com/safeglencovecoalition or visit SAFE’s website to learn more about the Opioid Epidemic at www.safeglencove.org.