The Complexity of Addiction: Why More Drug Abusers are Mentally Ill

Many may not understand how people become addicted to drugs or alcohol, but there's a certain science to this that some might not be aware of. Some may just shrug off addiction to lack of willpower, when in reality, it is a complex disease that involves the brain, genetics and compulsive behaviors. Often times, an individual suffering from a type of drug or alcohol addiction may need outside help in order to make a new life for themselves.

And a recent study by researchers at Washington University School of Medicine in St. Louis and the University of Southern California takes an in-depth look at how those suffering from mental illness may have a harder time coping with addictions that involve smoking, drinking and drug use.

"These patients tend to pass away much younger, with estimates ranging from 12 to 25 years earlier than individuals in the general population," said first author Sarah M. Hartz, MD, PhD, assistant professor of psychiatry at Washington University, via a press release. "They don't die from drug overdoses or commit suicide - the kinds of things you might suspect in severe psychiatric illness. They die from heart disease and cancer, problems caused by chronic alcohol and tobacco use."

For their study, researchers analyzed smoking, drinking and drug use in nearly 20,000 people that included 9,142 psychiatric patients diagnosed with schizophrenia, bipolar disorder or schizoaffective disorder. Researchers also assessed nicotine use, heavy marijuana use, heavy drinking and recreational drug use in more than 10,000 healthy people without mental illnesses.

The study showed that more than 30 percent of those suffering from severe psychiatric illnesses often engaged in binge drinking episodes, defined by the consumption of more than four servings of alcohol at one time compared to the rate of binge drinking in the general population at 8 percent.

The study also showed that more than 75 percent were regular smokers when compared to 33 percent of those in the control group who smoked regularly. For marijuana use, findings showed that 50 percent of people with psychotic disorders used marijuana regularly versus just 18 percent of the general population. And half of those with mental illness used other illicit drugs while only 12 percent of the general population did.

"I take care of a lot of patients with severe mental illness, many of whom are sick enough that they are on disability," said Hartz, via the release. "And it's always surprising when I encounter a patient who doesn't smoke or hasn't used drugs or had alcohol problems."

The researchers next goal is to help tackle addictive behaviors in those suffering from mental health issues. For those without these problems, Hartz notes that over the decades, medical officials have made great strides. But for those dealing with psychiatric disorders, they haven't made much progress. 

"Some studies have shown that although we psychiatrists know that smoking, drinking and substance use are major problems among the mentally ill, we often don't ask our patients about those things," she said, via the release. "We can do better, but we also need to develop new strategies because many interventions to reduce smoking, drinking and drug use that have worked in other patient populations don't seem to be very effective in these psychiatric patients." 

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More information regarding the study can be found via the journal JAMA Psychiatry.