Substance Abuse and Mental Health in the World
- Introduction
Chronic use of drugs can lead to both short- and long-term effects on the brain. In most cases, the consequential impact is mental health issues. From a global perspective, drug use is responsible for at least 11.8 million death per year (Ritchie and Roser, 2019). In these numbers, alcohol, and smoking causes 11.4 million premature deaths while, over 350, 000 deaths are as a result of overdoses (Ritchie and Roser, 2019). Simultaneously, one in four people is reported to be affected by mental, neurological disorders at one point in their lives. Around 450 million people globally have mental conditions- placing mental disorders among the leading causes of deaths, and disabilities (“WHO | Mental disorders affect one in four people,” 2019). In the United States of America, the prevalence of drug abuse is estimated at 43.4 million (17.9%) in adults above the age of eighteen years (National Institute on Drug, 2019).
Of these numbers, 8.1 million are reported to have a co-occurrence of mental disorders and substance abuse (National Institute on Drug, 2019). The predisposition on mental health and substance abuse is based on the behavior of the user. In specific cases, the consumption of illegal drugs can result in addiction, consequently leading to mental health problems. Mental and substance abuse disorders share common underlying causation that ranges from brain composition, genetic variabilities, and early exposure to trauma or stress (“Mental Health and Substance Use Disorders | MentalHealth.gov,” 2019). According to the National Health Institute, people with severe mental illnesses such as bipolar disease have a higher risk of substance abuse (NIH, 2014). Accordingly, drug use has a direct impact on brain circuits that can disrupt mental disorders.
On the other hand, drug use can lead to severe brain dysfunction, which can result in mental health complications and problems. Mental health and substance abuse are co-dependent in most cases and in the world. The outcome of this report is to understand the connection behind this issue and the course of treatment, which includes how to identify/spot, deal, and even prevent it if possible.
- Background
- Mental Health
Mental health is the psychological, social, and emotional well-being of an individual. It regards how a person feels, thinks, and acts. In other words, it helps the person determines how they can handle their stress, relate with others, and make decisions. Thus, mental health is an essential aspect of everyone’s lives (“What Is Mental Health? | MentalHealth.gov,” 2020). Therefore, the inability of a person to effectively or have the capability of working, conducting their day to day activities, and engage with others is known as mental illness or disorder (Henthorne, 2013). Mental health is an essential facet in everyone’s life as it helps in the proper growth and development of an individual from childhood to adulthood. Numerous factors affect mental health. They include biological factors, life experiences (environmental), and family history (“Mental Health and Substance Use Disorders | MentalHealth.gov,” 2019). For instance, biological factors can include genes and brain chemistry, and life experiences encompass trauma and abuse, while family history includes hereditary mental health problems.
The signs and symptoms of mental health disorders span from emotional to behavioral. In specific scenarios, individuals can exhibit fears, worries, show signs of tiredness, detachment from reality, and inability to cope with others and daily stresses (“Mental illness – Symptoms and causes,” 2019). There are problems with alcohol abuse and other drug substances, change in sex drive, excessive anger, and suicidal thinking (“Mental illness – Symptoms and causes,” 2019). Mental health is a critical facet in a human’s life as it allows them to realize their full potential, work productively, make meaningful contributions to their societies and maintain a positive outlook on life (“What Is Mental Health? | MentalHealth.gov,” 2020). Without the capacity to develop coping skills and hardiness, individuals can find it difficult to relate with others and handle their normal stresses.
- Substance Abuse
The World Health Organization defines substance abuse as the consumption of harmful or illegal substances (“WHO | Substance abuse,” 2020). They encompass alcohol, cocaine, heroin, among others. Active use of substances deemed illicit or dangerous can result in dependence syndrome. Dependence syndrome is a conglomerate of behavioral, cognitive, and psychological phenomena that occur as a result of repeated substance abuse (“WHO | Substance abuse,” 2020). Drug abuse can start from an experimental phase that gradually progresses to the consumption of the drug for recreational purposes. Ultimately, if the individual pursues further consumption, they began using the substances more often (“Drug addiction (substance use disorder) – Symptoms and causes,” 2020). Drugs such as opioids can result in drug addiction. The initial use of substances originates from either a friend or a relative indulging the child is doing it (“Drug addiction (substance use disorder) – Symptoms and causes,” 2020). Soon the risk of drug addiction set in and the type of drug addiction depends on the preference of an individual. Some drugs are prescription, while others are standard such as alcohol and marijuana (“Drug addiction (substance use disorder) – Symptoms and causes,” 2020). The individual, therefore, requires the drug to feel better or for feeling ‘high.’
The signs and symptoms of substance abuse disorder range from continued use of drug, drug addiction, and drug dependence (“WHO | Substance abuse,” 2020).
- Substance Abuse and Mental Illness
There is evidence that suggests the development of substance abuse disorders correlate with a diagnosis of mental health disorders and vice versa (Abuse.gov, 2018). In the United States of America, the correlation between the two disorders is supported by national population surveys and epidemiological reports. In these surveys, as reported by Abuse.gov (2018), half of those who experience mental illness(es) during their lives report of experienced substance abuse disorders and the other way around. In youth, the incidences are higher compared to adults. Abuse.gov (2018) reports that comorbidity of substance use disorders has a high rate of co-occurrence with mental illness. It is estimated that 60% of adolescents in America who partake in community-based consumption of illegal substances seek treatment for mental health illnesses (Abuse.gov, 2018).
In particular, national survey data indicate high comorbidity between substance use illnesses and anxiety disorders. Anxiety disorders are generalized into panic, post-traumatic stress, and anxiety disorders. Additionally, Abuse.gov (2018) reports of increased incidences of substance use disorders and co-occurrence of mental illness at high prevalence, including depression and bipolar disorders (Blanco et al., 2015). Other diseases include borderline personality, anti-social personality disorder, and schizophrenia (Abuse.gov, 2018). According to the Federal level diagnosis of mental illness in adults above the age of eighteen years, the incidence of psychological, behavioral, and or emotional disorders causes impairment that interferes with or limits significant life occurrences (Abuse.gov, 2018). The statistics estimate that one in four individuals have substance abuse disorders and mental illness.
Figure 1: Data on Occurrences of Mental Illness and Substance Abuse Disorders in Adults above the Ages of 18 in America. Source: https://www.drugabuse.gov/publications/research-reports/common-comorbidities-substance-use-disorders/part-1-connection-between-substance-use-disorders-mental-illness
Statistics in the above figure suggest that individuals in America diagnosed with mental, personality, and substance abuse disorder have a high risk of co-morbidities with mental illness.
- Serious Mental Illness
Severe mental health is usually dilapidating to the brain functionalities, change in behavior, and effect on the normal functioning of an individual. Signs of severe mental illness include major depression, bipolar disorders, and psychotic diseases (Han et al., 2017). It is estimated that 5.8% of the general population at any one time may have severe mental problems. Shockingly, this can develop as early as 25 years of age (Dewa et al., 2018). The progression of mental illness can occur as a result of the transition from one comfort zone to another (Dewa et al., 2018). For instance, the change from one city to another can lead to increased psychotic episodes in individuals. In particular, the deterioration in mental health can be severe for the younger generation (Dewa et al., 2018). Thus, deterioration in mental health can progressively get worse in time. Reports on mental health illness indicate that health deterioration can occur through or across several severe mental disorders (Dewa et al., 2018).
Symptoms of severe mental illness include increased incidences of mania, psychosis, aggressive behavior, suicidal thought as well as behavioral changes that are risky to the health of the patient (Dewa et al., 2018). The control of people who have severe mental illness show increased risks of asphyxiation during restraining and rapid tranquilization. There are incidences of increased weight gain and conditions (Dewa et al., 2018). Research on co-morbidity in substance abuse and mental illness suggests an increased incidence of gastrointestinal diseases, respiratory disorders, and physical health deterioration. However, it is also reported that it is difficult to recognize early signs of mental health deterioration in severe mental illness patients (Dewa et al., 2018). The only mitigation strategies in identifying mental health problems are treated and therapy-based interventions.
- Therapy Interventions for Mental Illness and Associated Substance Abuse
There is a broad spectrum of strategies that identify, treat, and manage substance abuse problems disorders. Identification of mental disorders and substance abuse disorders depends on the severity or mildness of the conditions. For mild and common diseases, it is advisable to identify signs and symptoms from a self-diagnosis perspective (Abuse.gov et al., 2016). Early strategies of detection include self-report subjective evaluation to either family or friends who notice mood changes or behavioral alterations (Dewa et al., 2018). Other options include general practitioner assessment and technology-based assessment methods (Abuse.gov et al., 2016). Doctors, for instance, are regarded as the best in the evaluation of young people since the majority of mental health disorders can go unnoticed (McHugh et al., 2015). For severe and complex signs and symptoms, specialized treatment identification strategies are often recommended (Abuse.gov et al., 2016). From these options, there are two types of treatments that are provided. They are substance use disorder treatment and continuum of care (Abuse.gov et al., 2016).
Substance Abuse Disorder Treatment is a type of service or set of services that include medication, counseling, and supportive services designed to establish a patient’s problems to reduce or eliminate drug use (Mir et al., 2015). It addresses, therefore, the associated physical or mental health problems, and aims to restore the patient to maximum full functionality (Abuse.gov et al., 2016). Another type of treatment is continuum care. It is a type of integrated care system that guides and tracks a person over some time through a comprehensive array of health services appropriate for the patient’s needs (Vasconcelos et al., 2015). Therefore, it includes prevention, early intervention, treatment, continuing care, and recovery support (Abuse.gov et al., 2016).
For continuum care, there are different types of care treatments. They include inpatient drug abuse treatment. In this, the patients are allowed to focus on their recovery in an intense treatment environment (“Drug Abuse Treatment,” 2012). The treatment is best for those with severe drug addiction and may not have a good support system at home. They also have co-occurring incidences of mental illness such as depression and personality disorder (“Drug Abuse Treatment,” 2012). Inpatient treatment therapy includes group therapy and a mixture of individuals with different types of illnesses (Weiss et al., 2015). The purpose of group therapy is to provide a concerted effort in healing, which also provides motivational and educational opportunities (“Drug Abuse Treatment,” 2012).
Another continuum care is a long-term treatment. Long-term care is ideal for preparation into re-introduction into daily lives (“Drug Abuse Treatment,” 2012). The long-term is for individuals with a drug addiction history, have recovered and have relapsed. It is advised for them since it is hoped to improve the therapeutic process (Bronson et al., 2017). The program often lasts between 6 to 12 months. It aims to aid addicts to re-socialize by developing socially productive lives and maintain self-accountability (“Drug Abuse Treatment,” 2012).
Another option is outpatient drug abuse treatment. The treatment protocol addresses all the stages of recovery (“Drug Abuse Treatment,” 2012). The treatment process is ideal for patients who have been in-patient programs and may prefer continuing with the program outside the medical facility (“Drug Abuse Treatment,” 2012). Under the National Institute on Drug Abuse determines that drug treatment programs have to last more than 90 days since limited times below ninety days are less effective (“Drug Abuse Treatment,” 2012).
- Therapy Options for Substance Abuse Disorders
A variety of treatment is provided on drug abuse disorders with co-morbidities to mental illness. They include cognitive-behavioral therapy (CBT). CBT is shown to be effective in treating substance abuse disorders (“Drug Abuse Treatment,” 2012). CBT aids in managing thought processes and controlling negative thought patterns noted to lead to substance abuse or destructive behavior. Often, the identification of triggers in patients can help in reduced drug abuse. Another form of therapy is Motivational Enhancement Therapy (“Drug Abuse Treatment,” 2012). It is a type of therapy employed in drug abuse therapy. The therapist aids the patient to improve their coping skills and capabilities to resist drug use. It is shown to be the most effective in drug abuse patients (Feng et al., 2018). Family therapy is another form of drug abuse therapy. It allows family members to participate in the recovery process. Rehabilitation programs are ideal for drug addicts and drug-dependent individuals. The effectiveness of the program ensures that the individuals can understand and expose any underlying familial issues that may contribute to their substance abuse as well as repair their relationships (Kieres-Salomoński and Wojnar, 2015). Another program is the twelve-step program ideal for narcotics, cocaine, and alcohol-related drug abuse disorders. It is regarded as one of the most successful programs in the country (“Drug Abuse Treatment,” 2012).
- Therapy Options for Mental Illness
For mental illnesses, diagnosis requires a physical examination, laboratory tests, and psychological examination. A physical examination includes an assessment of physical problems by the general practitioner (“Mental illness – Diagnosis and treatment – Mayo Clinic,” 2020). A consequential laboratory test assesses thyroid function, for instance, and screening for alcohol and drug use (Krauth and Apollonio, 2015). A psychological test, on the other hand, evaluates for symptoms, thought-process, and behavioral and feeling patterns in patients (“Mental illness – Diagnosis and treatment – Mayo Clinic,” 2020). In most cases, questionnaires are used. For instance, psychological test tools include Willoughby Social Anxiety Scale for anxiety disorder, CES for depression, Perceived Control Scale for cognitive disorders, and others (“Mental illness – Diagnosis and treatment – Mayo Clinic,” 2020).
Psychotherapy is among the leading types of therapy for mental illness. It is regarded as a treatment done by trained officials. Psychotherapy addresses thoughts, feelings, and behaviors. Overall, the main idea is to improve an individual’s well-being (Singh et al., 2016). Psychotherapy is combined with medication. For instance, cognitive behavioral therapy or dialectical behavioral therapy (“Mental Health Treatments,” 2019). Another option is medication. Medication is used to treat mental illness and help in alleviating symptoms (“Mental Health Treatments,” 2019). It is often paired with psychotherapy, which is determined as the most effective way of promoting recovery (“Mental Health Treatments,” 2019).
Other programs include case management and hospitalization. Hospitalization is for minority cases that require the close monitoring of a patient who is accurately diagnosed for mental illness in association with substance abuse disorder. In most cases, it is used for individuals with temporary mental illness that has worsened (“Mental Health Treatments,” 2019). Case management requires the coordination of services for an individual with the help of cse management. A case manager in this scenario helps to assist in the planning and implementation of several strategies for recovery (“Mental Health Treatments,” 2019).
- How to Prevent Drug Abuse
Prevention of drug abuse and consequential addiction and dependence is variant. For teenagers, it is advised that caregivers need to pay more attention to their activities and friends they keep. Additionally, it advised that teenagers need to discuss drug abuse and its short- and long-term effects (“Teen drug abuse,” 2018). The process can include a campaign against drug abuse on social media and discussion on ways that teenagers can reduce peer pressure (“Teen drug abuse,” 2018). The other preventative strategies are the knowledge needed in understanding any signs and symptoms of drug abuse in teenagers (“Teen drug abuse,” 2018). They encompass talking to them, encouraging honesty, and checking on them regularly (“Teen drug abuse,” 2018).
Programs that institute drug prevention in schools and community settings are regarded as among the most effective. They include Family-based drug prevention. Prevention of drug abuse begins within the family unit (“Drug Prevention | Abuse,” 2011). It includes education on drug use prevention, improved parent-child communication, and child bonding. Another program is school-based drug abuse prevention programs. Schools are required to invest in drug prevention programs that address learning about signs and symptoms, dangers of drug abuse, and how to avoid peer pressures on drug abuse indulgence (“Drug Prevention | Abuse,” 2011). Community-based is another form of program in which communities unite in educating their teenagers and others about drug abuse and mental illness (“Drug Prevention | Abuse,” 2011). They are incorporated in schools, community-based projects, and churches.
- Conclusion
Drug abuse is associated with mental illness. Throughout the report, empirical evidence suggests that incidences of mental illness are linked to the history of substance abuse. Contributing factors to substance abuse range from peer pressure to the experimental use of recreational drugs, including prescription and illegal drugs such as marijuana and heroin and cocaine. Simultaneously increased incidences of drug abuse are linked to incidences of mental illness. Illnesses of mental capacity include anxiety disorder, schizophrenia, and post-traumatic stress disorder, among others (Turner et al., 2017). As noted throughout the report, increased occurrence of severe mental illness is common among continuous drug users. It can lead to physical health deterioration, which can be perilous. Therefore, early interventions are necessary to reduce instances of drug abuse. It includes rehabilitation, psychotherapy, medication, hospitalization, and family-based care, among others. The therapy interventions intend to ensure that there are reduced chances of relapse. In cases where management of drug abuse increases, case management is often utilized. Interventions that include reduced drug use are often considered for complex substance abuse disorders.
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