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What are the Common Comorbidity in Substance Abuse?

Substance abuse is associated with common mental health conditions leading to a condition known as comorbidity. Learn more about comorbidities below.


Mental health and substance abuse disorders are common, and they often co-occur. The co-occurrence of these two conditions is medically referred to as comorbidity. One in four people with a substance use disorder has at least one co-occurring mental health disorder. These include disorders such as depression, anxiety, or post-traumatic stress.1
What are the Common Comorbidity in Substance Abuse?
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Relationship Between Mental Wellness and Substance Use

The relationship between mental health and substance use disorder is complex. Some people develop problems with alcohol or other drugs due to using them repeatedly to manage or self-medicate their mental health symptoms. Although this may make the person feel better in the short term, substance abuse can disguise the person’s symptoms and worsen some symptoms in the long term.
Once a person has both a mental and substance use disorder, the relationship between them becomes cyclical, with each disorder maintaining or making the other worse. This post looks at all you need about comorbidity, including some common comorbidity in substance abuse.

What Is Comorbidity?

Comorbidity is a medical term that refers to a chronic neurological or physical condition that occurs simultaneously but independently with substance use addiction. The disorder has a high mortality rate, especially among patients with one or two comorbidities with a 115% probability of death compared to patients without the disorder. 2
The Charlson comorbidity index is primarily used to predict a 10-year survival for individuals with multiple comorbidities. First developed in 1987 by Mary Charlson, the index predicts fatality risk with a year of hospitalization for individuals suffering from specific comorbid substance use disorder. The weighted index features 19 conditions, each assigned a weight from one to six depending on the estimated one-year mortality hazard ratio from a Cox proportional hazards model.

Understanding Comorbidities

There always seems to be confusion around comorbidities, co-occurring disorders, and dual diagnosis. Dual diagnosis or co-occurring disorders is a general term that defines the occurrence of two or more conditions affecting a person, whether mental or physical. On the other hand, comorbidity is the occurrence of mental health conditions and substance drug abuse, even if they are not co-occurring.

Comorbid Substance Abuse and Mental Illnesses

Substance use disorder is a form of mental health illness that affects an individual’s brain and behavior, consequently making them unable to control their use of controlled substances, whether legal or illegal.
Determining which of the two conditions precedes the other is a challenge among researchers. Some studies claim that mental health conditions may lead to substance abuse, while others show that substance use disorder and addiction contribute significantly to developing mental health conditions.

Most Abuse Substance Risk Factors

Some of the most abused substances that are a high risk for developing mental health disorders include:
  • Alcohol: As the most abused drug, 85.6% of American adults have reported consuming the drug at least once in their lifetime.3
  • Opioids: These are among the leading cause of overdose deaths, with nearly 500,000 American adults succumbing to opioid overdoses from 1999-2019.4
  • Stimulants: These drugs increase the activity of the central nervous systems and the body resulting in sympathomimetic effects. Approximately 900,000 American adults abuse prescription stimulants every month.

The Most Common Comorbidities in Substance Abuse

Most substance abuse sufferers are also diagnosed with one or two mental health conditions. However, the high prevalence of comorbidity between mental health disorders and substance abuse doesn’t necessarily mean that one condition caused the other, even if one of the conditions precedes the other.

Common Comorbidities

Some of the most common comorbidities in substance abuse include:
  • Anxiety disorders comorbidity 
  • Major depression comorbidity 
  • Bipolar disorder comorbidity 
  • Schizophrenia comorbidity 
  • Mood disorders comorbidity 
  • PTSD comorbidity 
  • ADHD comorbidity  
  • OCD comorbidity 

Signs and Symptoms of Comorbidity

Since comorbidity is the occurrence of two or more medical conditions, the signs and symptoms of the disorder will vary significantly depending on the mental condition and the type of drug being abused. This means signs and symptoms of the comorbid disorder are separated into two. Common signs of substance abuse include:
  • Issues with the law 
  • Anxiety and paranoia  
  • Aggression and irritability 
  • Withdrawal from friends and family  
  • Difficulty focusing 
  • Poor personal hygiene 
  • Mood swings  
  • Changes in sleep patterns and appetite 

Common Signs of Mental Illnesses

Common indicators of a mental illness include:
  • Excessive worrying and anxiety 
  • Suicidal tendencies  
  • Alterations in appetite 
  • Insomnia  
  • Withdrawals 
  • Auditory and visual hallucinations 
  • Increase in violent or aggressive tendencies  

Comorbidity Causes and Risk Factors

Comorbid substance abuse disorder can occur randomly, while others are connected through shared environmental, genetic, or behavioral factors. Anyone can develop comorbidity disorder, but certain groups are at a higher risk than others. The disorder becomes more common with age, meaning older adults are at a high risk of developing comorbidity. It is essential to understand that mental health illnesses can lead to substance abuse, and substance abuse can contribute to the development of mental illness. Here are some of the common comorbidity factors that pose a high risk:
  • Disorder type 
  • Sex  
  • Age  
  • Socioeconomic status  
  • Environmental factors 
  • Other factors 

Comorbidity Diagnosis and Treatment Options

Fortunately, comorbidity is a treatable condition. Researchers have introduced integrated treatment solutions for the condition, which allows doctors to treat both conditions simultaneously. You can also treat each condition independently but managing one condition does not mean the other will improve. Diagnosing comorbidity is still a significant challenge that inhibits the effectiveness of mental health and substance use disorders. Most doctors leverage evidence-based comorbidity diagnosis and treatment to ensure the patient gets the highest quality of care. However, the doctor could attempt to treat comorbidity disorders by addressing each condition individually.
Comorbidity Diagnosis and Treatment Options

Substance Abuse Treatment

There are various treatment opportunities when it comes to treating comorbidity. These include:

Mental Illness Treatment

Listed below are mental illness treatment options:
  • Behavioral therapies  
  • Medication  
  • Support groups   

Treatment for Comorbidity at Ripple Ranch Recovery

Whether you call it co-occurring disorder or comorbidity, proper diagnosis and treatment are essential to guarantee the highest chance of recovery. It’s often difficult to untangle the many overlapping symptoms of mental illness and substance use disorder, which is why it’s crucial to seek assistance from skilled and licensed specialists who understand the challenges associated with comorbidity.

At Ripple Ranch Recovery, we specialize in comorbidity treatment, and thanks to our evidence-based approach, we guarantee you will get the highest quality of care. If you feel that a mental condition has led to substance abuse or vice versa, we are here to help you. Contact us today to learn more about common comorbidity in substance abuse.