Poor Mental Health Linked to Higher Drug Use Disorder Odds

Anyone who’s looked for behavioral health care while managing a substance problem and a mental health condition knows the system tends to treat them as separate diagnoses. New survey research on co-occurring disorders adds to the case that they’re one problem with two faces. 

Analysis of the 2023 National Wellbeing Survey found that poor self-rated mental health among US adults correlated with close to twice the odds of having a drug use disorder. Results also associated with cannabis use specifically to escape problems or manage daily stress.

However, the findings varied by whether the person had an ADHD diagnosis.

Study Results

The analysis drew on a nationally representative web panel of 2,400 US adults aged 18 to 64 who reported cannabis use in the previous 12 months. Researchers matched the sample to census benchmarks on age, sex, race and ethnicity and region.

Participants reported lifetime diagnoses of depression, anxiety and ADHD and rated their own mental health on a five-point scale.

The team examined six reasons for cannabis use. These were medicine, escaping problems, managing daily stressors, reducing the effects of other drugs, sleeping and getting high.

Primary outcomes were typically drug use disorder diagnoses. Secondary outcomes were how often the person used cannabis.

Design Limitations

The study captured a single point in time. It establishes that poor mental health and drug use occur together more often than chance would predict. The survey can’t establish that one caused the other.

That distinction matters more than usual because the plausible explanations run in both directions. Folks with untreated depression may use cannabis, even if self-medication rarely works. Heavy use may also worsen mood, sleep and anxiety. Both can be true in the same person at the same time.

Motive Findings Matter Clinically

Reasons people gave for taking drugs matter. Using cannabis to escape problems and to manage daily stressors is a self-medication pattern. It points at an unmet need rather than a moral failing.

That pattern also shifted by ADHD status. Same behaviors may mean different things in different patients. A clinician who asks only whether someone uses cannabis learns much less than those who ask why.

Either way, findings supported the greater need to address co-occurring disorders. Also called dual diagnosis, they describe the presence of a substance use disorder alongside a mental health condition. They’re common rather than exceptional.

Integrated treatment addresses both conditions at once, with a single team and a single plan. The alternative is to treat them in sequence or in separate places, but this approach tends to fail because the untreated condition keeps destabilizing progress on the treated one.

Dealing with Co-Occurring Conditions

Behavioral treatment centers that handle dual diagnosis typically combine several approaches.

• Group behavioral therapy, which targets the thought and emotion patterns driving both mood symptoms and substance use.
• Medication management for the mental health condition, coordinated with any substance use medication.
• Trauma-focused therapy where a trauma history is present.
• Peer support and family involvement to sustain gains after structured treatment ends.

Levels of care are delivered across a range of settings from residential treatment centers through various levels of outpatient care. Starting at the right level depends on symptom severity, safety and how much structure a person needs.

Comprehensive Care Available Now

When comparing mental health treatment facilities, look into whether the program treats co-occurring disorders as a specialty or simply accepts patients who have them. Inquire who manages psychiatric medication, whether the mental health and substance use teams meet together and how the program handles a patient whose psychiatric symptoms worsen.

You can search our comprehensive directory for dual diagnosis programs by location, level of care and insurance accepted.

Also, feel free to dial 800-908-4823 (Sponsored) to speak with an expert, 24/7.

Author

Quentin Blount

Content Manager

Read Bio

Quentin brings nearly a decade of experience as a writer, editor, and digital publisher to his role as Content Manager for Rehab.com. He aims to help people better understand their treatment options by creating engaging and informative content that is user-friendly, factually accurate, and optimized for search engine visibility. In his free time, Quentin enjoys the company of his friends, family, and his dog, Coop.

Editor

Peter Lee, PhD

Read Bio

Peter W.Y. Lee is a writer and historian of American history during the Cold War. His primary focus is the relationship between youth and popular culture and its impact on U.S. society during the twentieth century. He has published widely on how the public has used popular culture as a mechanism to address political and social shifts throughout time