CO-OCCURRING DISORDERS IN ADDICTION 1

Co-Occurring Disorders in Addiction

Justin PR Cilvik

Lackawanna College
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Co-Occurring Disorders in Addiction

For me one of the most interesting co-occurring disorders is the combination of addiction

and mental illness. They are both entwined and separate. Each a potential symptom of the other,

but often linked.

Mental health services in the U.S. are insufficient despite more than half of Americans

(56%) seeking help (CVN, 2022) is the opening line of the National Council for Mental

Wellbeing’s review of Cohen Veterans Network’s study of mental illness in the United States.

It’s beyond a common anecdote that mental health services in the United States are not as

available as they should be, it’s a clear fact.

In the absence of services many people self medicate. It commonly starts with cigarettes,

alcohol, marijuana, prescription painkillers, or even household products with an intoxicating

smell. For some their mental illness proves to be their main issue and drug use exists on the

sideline. The connections between mental illness and substances has a mirror as well. Drug use

can also induce mental illness.

Some people rarely experience psychosis when trying to use drugs. There is also potential

for brain damage, which also can induce a long term or permanent mental illness. I worked with

a poly drug user and mainly used psychedelics. Schizophrenia ran in his family and it did not

occur on its own. It was when he took excessive doses of multiple drugs that he had his first

psychotic break. While he did learn how to function afterwards, he never fully recovered and

was left in a permanently delusional state from that day on.

At the same time though, both can be interlinked and have a more complex relationship.

In addiction there are often cycles of behavior. These cycles involve having an unwanted feeling,
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using drugs (or other addictions) to remove the feeling, feeling shame over one’s use, and then

wanting to remove that unwanted shameful feeling. Mental illness can become part of this. The

unwanted feeling can be symptoms of one’s illness. The lack of feeling or intense feelings one

can have with drug use are powerful tools to control how one thinks and feels. This can link the

two and make the addict more ill from dealing with their addiction and making their addiction

harder to deal with as it helps them with their mental illness.

I have worked with a schizophrenic man that experiences strong manic episodes. When

those happen he experiences delusions and has poor impulse control. When his symptoms

become too strong he will seek THC to ease his mania. The problem is this exacerbates his other

symptoms and often plunges him into a full psychotic episode. I have seen him finish this cycle

more than once now and I am unsure if the circle has been broken for him.

In the end while addiction and mental illness are both serious problems on their own, the

connections between the two are vital to understand and knowing when someone is dual

diagnosis can greatly improve the outcomes of their care if managed correctly. It’s a vital

distinction that has an important place in addiction and mental health treatment.
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References

Wormer, V. K., & Davis, D. R. (2017). Addiction Treatment (4th ed.). Cengage Learning.

CVN, C. V. N. (2022, November 17). Study reveals lack of access as root cause for

mental health crisis in America. National Council for Mental Wellbeing. Retrieved November

27, 2022, from https://www.thenationalcouncil.org/news/lack-of-access-root-cause-mental-

health-crisis-in-america/#:~:text=Mental%20health%20services%20in%20the,as%20important

%20as%20physical%20health.

Buckley, P. F. (2007). Dual diagnosis of substance abuse and severe mental illness: The

scope of the problem. Journal of Dual Diagnosis, 3(2), 59–62.

https://doi.org/10.1300/j374v03n02_07