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Substance Abuse Among People With a Psychiatric Disorder

Updated: Aug 11, 2023

The rate of coexisting substance abuse and mental health problems is high, yet the cause of substance abuse among people with mental illness remains not clear. In this article I will explore problem of substance abuse among people with a psychiatric disorder.


Is there a link between mental health and substance abuse?


People with coexisting substance abuse and mental disorders have a greater tendency to get depressed, suicidal or violent. They are more vulnerable to hospitalisation.

The study conducted by Laudet et al. (2004) sought to explore reasons for initiation of substance use, cessation and relapse, and to examine a link between substance use and mental health problems among dually diagnosed people. Findings show that the initiation of substance use was mostly motivated by peer influence and the desire to “fit in”. It has been acknowledged that the role of peers has probably the strongest influence on adolescents in the initiation of substance use. The need for peer acceptance may be especially strong during a difficult time of adolescence. This is likely to be true of adolescents who experience prodromal symptoms of mental illness. As a consequence of such symptoms, a person may feel alienated and different from their peers.

Difficulties with accessing social groups may push adolescents towards network of drug users who may be more accepting than other social networks. A sense of belonging to the group fulfils the need for an identity. A person can also discover that substance use lessen social anxiety and facilitate social interaction.


The common motivations to cease substance use were the negative outcomes and the desire for a better life. Although the long-term negative consequences may not be recognised immediately, especially among people with cognitive impairments, over time, as the negative outcomes increase, the long-term consequences may be acknowledged and many users will decrease their use or quit it completely.


Most common reported reasons for relapse included boredom, loneliness, lack of structured activities and cravings. Social isolation has been associated with substance use among people with serious mental illness. Negative emotional states like sadness or anger could be even more challenging for dually diagnosed people who also experience psychiatric symptoms or side effects of medications.


The study suggests there is a strong association between these two disorders. More that two thirds of participants reported wanting to use when they experience symptoms. Many reasons given for substance use such as boredom, stress or loneliness may be a result of mental illness or derive from the double social stigma of mental illness and chemical dependency.


What are the risk factors for substance use?


Risk factors for substance use disorder involve social isolation, poor interpersonal and cognitive skills, parental substance use, childhood trauma, school or job failure, association with risky groups and lack of structured activities.


The importance of education and prevention strategies targeted at both, vulnerable adolescents and their families is undeniable. Prevention strategies should go beyond highlighting the negative outcomes of substance use. Creating opportunities for pleasurable and meaningful activities, cultivating good relationships with families and peers, and learning how to cope with adversities will enhance the likelihood of stable abstinence among people with mental health disorders.



Substance abuse among people with psychiatric disorder. Iremia Counselling

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