According to recent epidemiologic studies, approximately 50 percent of people with a diagnosis of severe mental illness also meet lifetime criteria for a diagnosis of substance use disorder. Some researchers believe that substance abuse may precipitate mental illness in vulnerable individuals, while others believe that people with psychiatric disorders use alcohol and other drugs in a misguided attempt to alleviate symptoms of their illnesses or side effects from their medications. One further point about vulnerability is clear. Accordingly, researchers often recommend abstinence from alcohol and other drugs for people with severe mental illness. Substance abuse also appears to worsen health and social problems by contributing to poor nutrition, unstable relationships, inability to manage finances, disruptive behavior, and unstable housing.
Substance abuse interferes with treatment as well.
Perhaps due to their poor treatment compliance and psychosocial instability, people with both mental illness and substance abuse are highly vulnerable to homelessness, hospitalization, and incarceration. The problems related to combined substance abuse and mental illness pose a substantial burden to the families of people with dual disorders. Surveys show that family members identify substance abuse and its attendant secretiveness, disruptive behavior, and violence as among the behaviors that are most disturbing. Even though relationships are strained by problems related to dual diagnoses, our research shows that families expend a great deal of time and money helping out in a variety of areas, from providing direct care to attempting to structure leisure time and increase participation in treatment. Furthermore, they are often unaware that their relative is abusing drugs or confused about how to respond to substance abuse, so education is greatly needed.