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Substance Abuse ‘Significantly Higher’ Among Mentally Ill

Researchers have found that those with severe psychological illnesses are far more likely to abuse alcohol and drugs.

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By Shawn Dwyer

01/03/14

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A new study published in the online journal JAMA Psychiatry has revealed that the rates of alcohol, drug, and tobacco abuse are “significantly higher” among those suffering from mental illness as compared to the general public.

Conducted by the Washington University School of Medicine in St. Louis and the University of Southern California, the study claims to be the largest of its kind and analyzed the drinking, smoking, and drug taking habits of 20,000 people. That total contained 9,142 psychiatric patients diagnosed with a variety of mental illnesses, including schizophrenia, bipolar disorder, and depression. Researchers assessed the group’s intake of drugs, alcohol, and tobacco as compared to roughly 10,000 people without mental illness and found that 75 percent of those with psychiatric problems were smokers, while 33 percent of healthy subjects used tobacco regularly. Thirty percent of those with mental illness engaged in binge drinking, while eight percent of healthy people drank heavily. For marijuana, 50 percent of mentally ill people smoked pot regularly as compared to 18 percent of the general public. And the same rate of psychiatric patients used other illicit drugs, while 12 percent of those without mental problems used such substances.

The study’s lead author, Sarah M. Hartz, an assistant professor of psychiatry at Washington University, wasn’t particularly surprised with the results. “I take care of a lot of patients with severe mental illness, many of whom are sick enough that they are on disability,” she said. “And it’s always surprising when I encounter a patient who doesn’t smoke or hasn’t used drugs or had alcohol problems.” One thing that did surprise Hartz was the discovery that once a person develops a mental illness, neither race nor gender has any discernible influence on the rates of substance abuse. “We see protective effects in these subpopulations,” Hartz said. “But once a person has a severe mental illness, that seems to trump everything.”

The results of the study prompted Hartz and her fellow researchers to conclude that more can be done on the treatment side once someone has been diagnosed with a mental illness. “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,” Hartz said.

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