About the Center for Drug & Alcohol Programs

Psychiatric disorders and addiction frequently occur together in what is called comorbidity or dual diagnosis. Over 50% of drug abusers and almost 40% of alcoholics have at least one serious mental illness. In addition, of all people diagnosed as mentally ill, nearly 30% abuse alcohol, drugs or both.

The most common psychiatric conditions that occur with addiction are depressive disorders, anxiety disorders, schizophrenia and personality disorders. People who suffer from panic disorder or major depressive disorder are 4 times more likely to abuse alcohol and/or drugs.

Almost 1/3 of alcoholics have a mood disorder and are 4 times more likely to have a major depressive disorder than those who are not dependent on alcohol. Among people with alcohol dependence, 37% meet the criteria for an anxiety disorder (generalized anxiety disorder, panic disorder and posttraumatic stress disorder (PTSD).

Even tobacco use is linked to psychiatric disorders. In patients with major depression, smoking prevalence rates are as high as 70%. Smoking rates are also elevated in people with panic disorder, posttraumatic stress disorder (PTSD) and schizophrenia. Smoking also goes hand-in-hand with the abuse of drugs and alcohol.

Psychiatric problems can begin either before or after the onset of the addiction. In many cases, alcohol or drugs are used to self-medicate, that is, to reduce anxiety or depression that is already present. In other cases, addiction leads to psychiatric symptoms. For example, 72% of alcohol abusing males report that their alcohol use disorder preceded the onset of a mood disorder.

Whichever problem came first, comorbidity complicates treatment. Addiction relapse rates are high for those with concurrent psychiatric disorders. Optimally, both disorders must be treated with medications and psychosocial therapies. While research is ongoing in this area, more knowledge is needed on the nature and treatment of comorbid psychiatric disorders and addiction.