Mental Health and Substance Abuse: Integrated Approaches to Treatment
Substance abuse and mental health disorders often coexist. The affected people may find recovery more challenging when dealing with several problems. These conditions call for integrated treatment approaches, i.e., measures that address both substance abuse and mental health at the same time. Since it’s not uncommon for people to have both mental illness and substance abuse problems, it’s important to shed more light on this subject. Keep reading to learn more about the connection between mental health and substance abuse and get more information about integrated approaches to treatment.
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Connection between Mental Health and Substance Abuse
Estimates show that more than one in five U.S. adults live with a mental illness, which accounts for 59.3 million people. The prevalence of mental illnesses was higher in women than in men, 26.4% vs. 19.7%, respectively, the National Institute on Mental Health reported.
The 2023 United States National Survey on Drug Use and Health (NSDUH) reported that 48.5 million, or 16.7%, of Americans aged 12 and older battled substance use disorder in the past year. Substance abuse is also considered a form of mental disorder that affects a person’s brain and behavior.
Substance abuse often co-occurs with other mental health disorders and vice versa. More precisely, people with a mental illness often develop substance abuse problems.
Mental illnesses that may coexist with substance abuse include anxiety disorders, depression, schizophrenia, personality disorders, bipolar disorder, and attention-deficit hyperactivity disorder (ADHD).
The coexistence between mental illness and substance abuse requires further research. One potential explanation is that both have common risk factors. In other words, mental illnesses and substance abuse tend to run in families, implying that genes could play a role in their development. Stress and trauma may influence genetic genes that are passed down through generations and contribute to the development of substance abuse and mental illness. Moreover, genes can also directly influence how a person responds to stress, which could play a role in the initiation of substance abuse and mental disorders.
Another explanation is that mental illness could contribute to substance use because people often turn to alcohol and drugs to self-medicate. In this case, the specific substance acts as an escape from the symptoms they’re experiencing. Brain changes that occur due to mental illnesses could amplify the rewarding effects of substances.
These problems have a bidirectional relationship, and their complexity further worsens a person’s physical, mental, and emotional well-being. Quality of life declines even more when mental illness and substance abuse occur together.
Integrated Approaches to Treatment
An integrated approach is a strategy to treat mental illness and substance abuse at the same time. It also includes the use of multiple treatments, such as a combination of psychotherapy and pharmacotherapy. Since mental health and substance abuse are connected in many ways, the treatment protocol aims to address both and thereby improve a person’s overall well-being.
Treating dual disorders via an integrated approach often involves interdisciplinary teams, including social workers, psychotherapists, student counselors, and case managers. The most important aspect of integrated approaches to the treatment of mental illness and substance abuse is to understand how comorbid disorders interact.
Evidence shows that the longer patients stay in treatment, the more they’re likely to remain in recovery from substance abuse and have decreased psychiatric symptoms. That said, patients with dual disorders tend to be less compliant with the treatment and may drop out before patients who aren’t comorbid. For that reason, treating comorbid psychiatric disorders and substance abuse requires high-intensity and integrated interventions. Effective treatment should combine different therapeutic approaches such as psychotherapy (cognitive-behavioral therapy or CBT, motivational interviewing), behavioral treatments, and pharmacotherapy.
Below are the most important aspects of integrated approaches to the treatment of mental illness and substance abuse:
Coordinated Care Models: Refer to a multidisciplinary approach where addiction specialists, therapists, psychiatrists, and primary care providers collaborate to create an individualized care plan. That means the exact approach may vary from one patient to another, depending on the severity of their mental illness and substance abuse, and their overall health.
CBT and Motivational Interviewing (MI): As mentioned above, CBT and MI are both important parts of integrated approaches to treat dual disorders. Studies show that CBT is effective in the management of substance abuse both as a monotherapy and in combination with other approaches. The role of CBT is to help people identify irrational or negative thoughts that influence their emotions and behaviors. After that, patients learn to adopt more rational alternatives that lead to a healthier thought pattern. Motivational interviewing encourages self-reflection and commitment to change.
Medication-Assisted Treatment (MAT): In addition to therapy, patients often need medications such as buprenorphine, methadone, and naltrexone to manage withdrawal symptoms and reduce cravings. The doctor decides whether or not to prescribe or administer medications depending on the severity of the condition and the exact type of substance a person is using. Patients may also receive medications to treat underlying mental illness (e.g., antidepressants to manage depression).
Group Therapy: Peer support plays an important role in the treatment of mental illness and substance abuse. In this case, groups such as Alcoholics Anonymous (AA), Narcotics Anonymous (NA), and similar programs offer peer support and promote emotional healing and a sense of accountability. These groups function by sharing stories of personal recovery, ups and downs, and potentially inspiring others while being inspired by their stories.
Lifestyle Changes and Other Approaches: Regular exercise, yoga, mindfulness practices, and nutritional counseling may contribute to overall well-being and support the efficacy of other approaches. A healthy lifestyle is all about self-care, physical and mental well-being, and staying sober. Depending on the person, an integrated approach may also include workshops, family therapy, and occupational therapy.
Conclusion
Mental health and substance abuse are strongly connected, which is why a well-structured treatment protocol is necessary to manage them. Integrated approaches include a combination of psychotherapy and medications, but support groups also play a role. The exact integrated treatment protocol depends on every patient and their specific needs.