Alcohol, Tobacco, Other Drugs and Mental Health

Alcohol and other drug (AOD) use is a barrier to accurate identification and effective treatment of those who suffer from psychiatric disorders. Such AOD use may conceal a psychiatric disorder, or accelerate its development and magnify its effects. AOD use can cause symptoms that resemble psychiatric syndromes and may inflate comorbidity rates (the presence of any two or more illnesses in the same person). Thus, an individual might be alcohol dependent and schizophrenic. Comorbid illnesses may occur at the same time, or one may follow the other. The fact that two illnesses are comorbid, however, does not necessarily imply a causal relationship, even if one illness occurs first.

Having either an alcohol or psychiatric disorder increases a person's risk of having the other diagnosis. Alcoholics, for example, are:

• 21 times more likely to have an antisocial personality disorder
• 3.9 times more likely to have a drug abuse disorder
• 6.2 times more likely to have manic depressive disorder
• 4 times more likely to have schizophrenia

In addition, approximately 10 percent of adult dementia in the United States is a result of alcohol-related brain damage.

In the Epidemiologic Catchment Area (ECA) survey of more than 20,000 people in households, group homes, and long-term institutions across the United States, 19.9 percent had psychiatric disorders and 13.5 percent had alcohol abuse/dependence. Of those with alcohol abuse/dependence, 36 percent had another psychiatric disorder. Another study, known as the National Comorbidity Survey, found that of more than 8,000 non-institutionalized civilian respondents, nearly half (48 percent) reported at least one lifetime psychiatric disorder and 26.6 percent reported a lifetime history of at least one substance use disorder.

Drug abuse appears to increase risks for psychiatric comorbidity. In about one-fifth of cases, alcohol disorders are complicated by abuse of other drugs. Of those with an alcohol-related diagnosis in the ECA sample, 18 percent had another drug use disorder, and at least 90 percent of alcoholics are nicotine dependent.

Preventing alcohol and other drug problems prevents comorbidity and increases opportunities for early, cost-effective, and successful interventions in psychiatric disorders. Prevention works where communities mobilize to discourage underage use of alcohol and other drugs, establish safe and healthy norms regarding these substances for all citizens, and counter risk factors in the environment.

Fact Sheet courtesy of:
The National Clearinghouse for Alcohol and Drug Information
P.O. Box 2345, Rockville, MD. 20847
www.health.org

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