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Comorbid Substance Abuse



Drug use is a serious issue that can have devastating consequences. Drug abuse can lead to physical and mental health problems, as well as legal issues. 

But drug abuse isn’t the only problem facing people who struggle with substance use disorders. 

Oftentimes, people with substance use disorders also have another mental health condition in addition to their drug or alcohol abuse. This is known as comorbidity or co-occurring disorder.


Table of Contents

What is comorbid substance use?

Comorbid substance use is the simultaneous or sequential use of two or more substances. 

For example, a person could be using alcohol and marijuana at the same time, or they could start drinking every day and then eventually begin smoking marijuana as well.

While comorbid substance use can be an issue for anyone who drinks alcohol or uses drugs, it’s particularly problematic when it involves teenagers who are still in school. 

When teens develop comorbid issues with alcohol and other drugs, they often experience negative consequences like getting into trouble with their parents or teachers; poor academic performance; poor physical health; unwanted pregnancy; sexually transmitted infections (STIs); etc. 

These consequences can lead to long-term problems like dropping out of high school before graduation or having trouble finding employment after graduation

—both of which could end up causing financial strain on families who would otherwise be able to support themselves without government assistance programs such as Medicaid coverage under Medicare Part D plans.”


The National Institute on Drug Abuse defines comorbid substance abuse

The National Institute on Drug Abuse defines comorbid substance abuse as “the co-occurrence of two or more diseases or conditions in the same person.” 

This is common in substance abuse cases, and it’s important to understand that these are not mutually exclusive—it’s not like you have one or the other. 

Instead, a person can have both a mental health disorder and a substance use disorder at once. 

Substance use disorders can also be considered chronic diseases that need treatment for patients to fully recover from their mental illness and/or drug addiction. 

In many cases, substance use disorder precedes the mental health condition; however, some people may develop a psychiatric illness after they’ve been abusing drugs or alcohol regularly over an extended period.


Comorbidity is common in substance abuse cases

When you think about the prevalence of comorbidity, it’s important to remember that the rate of substance abuse is higher in the general population than in other mental health issues. 

This means that there are more people with a mental illness who are not being treated for it than people with both a mental disorder and a substance abuse problem. 

And yet, according to research from 2014, 95% of drug users also meet the criteria for at least one other psychiatric disorder within 12 months of their first treatment compared with just 25% of people without drug problems.


What are the signs of comorbid substance use?

The signs of comorbid substance use can be similar to signs of mental illness, but may also differ significantly. For example, if your loved one exhibits symptoms like these:

  • Fear or paranoia
  • Mood swings
  • Hostility/aggression

Then they may have a dual diagnosis or struggle with both a mental illness and an addiction. 

However, other symptoms might indicate the presence of comorbid substance use alone. These include:

  • Disorganized thinking or speech patterns (i.e., rambling)
  • Trouble staying focused on tasks at hand.

How does comorbid substance use affect treatment?

If you have a substance use disorder, it can be challenging to determine what is causing your symptoms. 

This is especially true for people with comorbid mental illness who also have a substance use disorder. 

It may be hard to know if your symptoms are related to mental illness or substance use disorder and alcohol, drugs, and other substances (SUD).

It’s also hard to know what treatment works best for you because these types of disorders interact with each other in different ways. For example:

    • A person with depression could get better when they stop using drugs. But if they continue using drugs after starting treatment for depression, this could make their symptoms worse or even cause them to relapse into drug use. Similarly, someone who uses amphetamines (methamphetamine) might feel better when they’re taking antidepressant medication—but then start feeling depressed again if they stop taking the medications after several weeks or months of improvement; that’s because meth stimulates dopamine production while antidepressants block its reuptake by neurons in parts of the brain associated with pleasure and reward–which can lead some people back towards stimulant abuse once their prescribed dosage wears off.*
  • There are effective treatments for substance use disorders and mental health disorders
    • There are effective treatments for substance use disorders and mental health disorders. For example, cognitive behavioral therapy (CBT) is helpful for people with anxiety disorders and depression. CBT helps you identify the thoughts and behaviors that contribute to your problems, then teaches you how to change them in a way that works for your unique needs.
    • To get started on treatment, talk with your doctor about finding the right care provider who can help you find what works best for you. This could mean seeing a therapist or attending group sessions at a community center or hospital near you. If it’s too expensive or inconvenient to travel far from home, there are many free resources online where people share their experiences in recovery groups—you could join one of these groups by emailing them directly at [email protected]
  • Early intervention and treatment can prevent comorbidity from worsening.
  • It’s important to note that early intervention and treatment can prevent comorbidity from worsening. Comorbidity is a chronic disease, so it must be treated. Recovery from substance abuse requires a recovery plan that focuses on both substance use disorder and co-occurring mental health disorders. For individuals who are seeking help for addiction and/or mental health issues, treatment options include residential treatment, outpatient therapy, 12-step meetings, support groups (such as SMART Recovery), intensive outpatient programs (IOPs), self-help books, and other resources.


Comorbid substance use can complicate treatment for mental illness

Comorbid substance use can complicate treatment for mental illness.

People with comorbid substance use may not be able to stay in treatment long enough to benefit from it or may not find the treatment helpful because of their substance use. 

Substance use can also interfere with the effectiveness of medications prescribed by a psychiatrist or other mental health professional. 

It’s essential to be able to identify signs of comorbid substance use; this will help you navigate your recovery process carefully and support others who are struggling with mental illness and addiction simultaneously.


Takeaway: In conclusion, this study shows that comorbid substance abuse is a significant clinical problem that impacts the treatment of chronic pain

Substance abuse can lead to a higher risk of complications in patients with chronic pain, and it can impact long-term outcomes after surgery. 

A deeper understanding of these relationships will be essential to develop better strategies for treating comorbid substance abuse patients seeking pain management.



Comorbid substance abuse and mental health issues are serious problems that need to be addressed. 

A lot of people don’t know how to get help or where to start, so we encourage you to speak with your doctor today about treatment options.

There are many different types of treatment available for people who have comorbid substance abuse and mental health issues. 

If you or someone you know is struggling with this issue, don’t hesitate to reach out!


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