Substance Abuse & Mental Health

"What I’ve learned is that this illness is not something that disappears or fades with time. It is something I must continue to overcome and have not done yet. I want to thank God for keeping me alive and well."

- Demi Lovato

For years, singer and actress Demi Lovato struggled with substance abuse and mental illness. In July 2018, the 25-year-old overdosed at home in the Hollywood Hills and had to be revived with Narcan (an anti-Opioid overdose medication) [1]. Demi’s openness about sharing her story and seeking help is admirable and powerful, and she is not alone.

When you have both a substance abuse problem and a mental illness, it is called a co-occurring disorder or dual diagnosis (the terms can have similar but slightly distinct meanings, which you can learn more about here). According to helpguide, roughly 50 percent of individuals with severe mental disorders are affected by substance abuse [2]. As Demi stresses, dealing with substance abuse, alcoholism, or drug addiction is never easy, and it’s even more difficult when you’re also struggling with mental health problems.

But why do comorbidities occur? Well, like the name (co-) suggests, the relationship goes both ways. Substance abuse can be both a reason and a cause of mental health conditions. It may be the reason for someone’s severe anxiety, yet addiction can also be behind someone's trauma. Hence, the various conditions feed into each other, and it’s important to address both together when seeking help [3].

How does substance abuse happen in the first place? Reasons are complicated, from social pressures to threatened violence. But from a biochemical perspective, drinking alcohol can temporarily boost serotonin levels (a key chemical in depression), therefore making you feel happier. In the long term, however, excess alcohol can actually lower serotonin levels, and therefore either causing or increasing signs of depression [4].

Now, how would legalization of drugs affect substance abuse? Let's take the example of marijuana. Marijuana is currently the world’s most commonly-used illicit drug. The legalization of it in some places remains a controversial issue, and there continues to be a lot of debate about its effects. Some common reasons put forth by proponents of legalization include creating jobs, promoting consumer safety, etc. The flip side, however, often cites health concerns [5].

Specifically, when it comes to mental health, some studies have found that marijuana use is associated with psychotic illness, including schizophrenia in vulnerable adolescents, such as those exposed to child abuse. For a new user, it can cause severe anxiety and even panic attacks. However, many doctors prescribe marijuana to replace current medications being taken, citing calming effects. There is also controversy on whether or not marijuana is addictive [6]. Point being, legalization can allow a substance user to increase their access to a drug, but it also allows for broader, less stigmatized approaches to ensuring safe and moderate intake of any such chemicals.

While legalization occurs on a governmental level, many private organisations implement internal policies that outline the expectations they have concerning the misuse of drugs and/or alcohol in the workplace. This can often be referred to as a substance misuse policy. To ensure transparency of information, it is imperative that the policy is written in a clear, comprehensive manner. This should allow everyone to understand the consequences the organisation has in place for users who misuse substances, as well as how such misuse is defined. Of course, these things aren’t always clearly written, so like all policies, it’s worth taking a closer look at individual organisations on a one-on-one basis if you want to learn more.

With all that said, how do you treat a dual diagnosis? The key is for the patient to seek treatment for both substance abuse and mental illness [7]. This is because untreated symptoms of a mental health disorder can cause the patient to be unable to remain clean and sober, and untreated substance abuse issues can make mental health treatment ineffective.

For years, Demi Lovato has been open about addiction and how that’s affected her bipolar disorder and disordered eating [8]. For the pop singer, relapse has been a part of recovery – she relapsed after 6 years of sobriety last year – yet she pushes onward, sharing her journey with her fans and reminding us all that though these conditions can hurt and change us, they cannot doom us. There is hope, always.

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REFERENCES

[1] https://www.addictioncenter.com/community/celebrities-addiction-mental-illness/

[2] https://www.helpguide.org/articles/addictions/substance-abuse-and-mental-health.htm

[3] https://www.drugabuse.gov/publications/drugfacts/comorbidity-substance-use-disorders-other-mental-illnesses

[4] https://www.goodtherapy.org/blog/negative-effects-alcohol-anxiety/#:~:text=Drinking%20alcohol%20can%20temporarily%20boost,either%20causing%20or%20exacerbating%20depression.

[5] https://www.drugpolicy.org/issues/marijuana-legalization-and-regulation

[6] https://www.ncbi.nlm.nih.gov/books/NBK224396/

[7] https://www.helpguide.org/articles/addictions/substance-abuse-and-mental-health.htm

[8] https://www.addictioncenter.com/community/demi-lovato-relapse/