Being addictive to drugs is a chronic disease that affects both a person’s brain and their behavior resulting in a significant impact on their quality of life. People suffering from drug addiction have a higher incidence of also experiencing other mental illnesses and vice versa. Taking a holistic treatment approach to all elements of an individual’s mental health can have an instrumental impact on those peoples’ lives.
Addiction related diseases are a chronic brain disease
Substance use disorders, SUD, also named drug addiction, is a chronic relapsing brain disease affecting the reward, memory, and motivation systems of the brain. It is caused by use of substances such as drugs, alcohol and nicotine. The reasons behind developing an addiction are wide-ranging, with genetic factors thought to account for a large part of a person’s vulnerability to developing addictive behavior. Environmental factors such as stress and exposure to addictive substances also play a part in developing addiction.1 Drug and alcohol addiction often have a strong impact on patients private and professional life.
Mental illness deeply impacting day-to-day living
Mental illness applies to a wide range of mental health conditions, affecting people’s mood, thinking and behavior, leading to functional impairment impacting life activities. Examples of mental illness are anxiety, depression, schizophrenia, post-traumatic stress, ADHD2 and bipolar disorder. Mental illness is thought to be caused by a variety of factors such as genetics, brain chemistry and environmental issues.
Mental illness can trigger a substance use disorder and vice versa
Mental illness frequently co-occurs with substance use disorders. The relationship between the two is bi-directional, meaning that people who abuse substances are more likely to suffer from mental illness, and the other way around. For example people who are depressed may drink or abuse drugs to lift their mood or escape from feelings of guilt or despair. While substances like alcohol, which is a depressant, can increase feelings of sadness or fatigue.
Studies show that 25 percent of people suffering from a serious mental illness3 also have a SUD. While 17 percent of them with a SUD experienced a serious mental illness.4 With respect to opioid use disorder, Orexo’s own retrospective data from the RESOLV study performed in 2016, showed 32 percent of patients were diagnosed with co-existing depressive disorder to highlight just one of the co-existing mental illnesses many of these patients have.
Having a holistic treatment approach can have an instrumental impact on people’s lives.
Access to health care and social services capable of providing treatment and social support is key for people suffering from mental illness and addiction diseases. The treatment gap is huge and from a co-occurring perspective, only about half of individuals with comorbid mental health and drug addiction received treatment in 2018.5
Having a holistic treatment approach for comorbid SUD’s and mental illness can have an instrumental impact on those peoples lives.6 Cognitive Behavioral Therapy based techniques in conjunction with traditional pharmaceutical treatments have a long history in helping treat many mental illnesses, helping tosupport motivation and functional recovery to improve overall treatments results.
Opioid use disorder (OUD)
Treatment of opioid use disorder is often administered over long periods of time or chronically. Medication Assisted Treatments or MAT for short is the combination of a pharmacological treatment indicated for OUD along with behavioral based therapy. The most common treatments arebased on buprenorphine, methadone or naltrexone. Buprenorphine is often combined with the antagonist naloxone to help prevent misuse by intravenous injection. The most frequently used medication as part of a MAT program in the US is buprenorphine/naloxone which can be taken under the tongue as a tablet or film. Methadone is most commonly administered orally in a supervised setting while naltrexone is most frequently given as a monthly injection. Pharmacological treatment should be provided as part of a complete treatment plan to include behavioral therapy. People where misuse of opioids has turned to illicit drug use face a large risk of suffering life-threatening overdoses where rescue medications such as naloxone are often required.
Alcohol abuse and alcohol use is a growing challenge we are facing. Treatment may involve individual or group therapy, outpatient programs, or a residential inpatient stay where for example cognitive behavioral therapy is often used to coach patients to change behavior. Currently, there are only three medications approved by the FDA for the treatment of alcohol abuse and alcohol dependence. These medications are largely targeted to those who have already stopped drinking and are trying to maintain abstinence.7 There remains a significant gap in helping individuals manage their drinking behavior.
Depression is a leading cause of disability around the world and contributes greatly to the global burden of mental health illness. There are many approaches to the management of depression with pharmacological and behavioral therapies being the cornerstone of many of the management approaches.