Users report depression and injuries - Substance Abuse - researchers find high incidence of comorbidity among substance abusers

USA Today (Society for the Advancement of Education), Feb, 2004

People with substance abuse disorders often have accompanying medical or psychiatric conditions that can include bone fractures, muscle injuries, pain disorders, depression, anxiety, and even psychoses, maintain two studies by the National Institute on Drug Abuse, Bethesda, Md. "The findings ... highlight the need for medical screening and treatment of comorbid conditions," advises NIDA Director Nora D. Volkow. "These studies provide more evidence that substance abuse does not occur in a vacuum, but rather often exists together with a number of conditions that have serious health consequences and may influence the success of substance abuse interventions provided alone. Physicians and ether health care providers need to keep in mind that a diagnosis of substance abuse should be all important warning signal to look for coexisting medical or psychiatric conditions."

Research by Jennifer Mertens and her colleagues at Kaiser Permanente health maintenance organization and the University of California, San Francisco, demonstrates that people undergoing treatment for substance abuse have a significantly higher prevalence of injuries (such as fractures, sprains, strains, and burns), depression, and anxiety disorders. Substance abuse patients also are more likely to require treatment for lower back pain, headache, and arthritis. About one-third of the medical conditions described during the study period are significantly more common in people undergoing substance abuse rehabilitation.

In the second study, Karen Abram, A. Linda Teplin, and their colleagues at Northwestern University Feinberg School of Medicine and Children's Memorial Hospital, Chicago, Ill., conclude that more then 10% of males and almost 14% of females at the Cook County Juvenile Temporary Detention Center have a substance abuse problem and a major mental disorder. Approximately 600 of these 1,829 young people have substance abuse and behavioral complications.

"As members of the medical community, we need to be aware of the high prevalence of comorbidity with substance abuse, and adjust our focus to include treating all of a persons health problems," warns Volkow. "We need to recognize that these problems can be severe and can include physical injuries and serious mental disorders. Effectively addressing these concerns will be key to breaking the cycle of those disorders and substance abuse."