Comorbid chronic physical and behavioral health conditions (mental and substance use disorders) are associated with greater functional impairment and increased health care costs.
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Is chronic care necessary for substance use disorders?
· Chronic medical conditions and substance abuse often co-occur — this type of co-occurrence is referred to as comorbidity. On the one hand, long-term, regular substance abuse can result in physical damage to various body systems that can lead to chronic disease. One well-known example of this is the connection between long-term tobacco use and various types of …
What are the health conditions as a result of substance abuse?
In particular, asthma and pain-related diagnoses surfaced as common and costly health conditions among the patient group. Myers and Brown 34,35 found that independent of other drug involvement, respiratory problems continued from two to four years after substance abuse treatment for adolescent smokers. Although definitive causal relationships across medical …
What are the effects of substance abuse on society?
Because substance use complicates many other medical conditions, early identification and management of substance misuse or use disorders presents an important opportunity to improve health outcomes and reduce health care costs. 68 Research shows that primary care patients with mild or moderate substance use have higher rates of other medical problems, including …
Are substance use disorders treatments cost-effective?
the chronic nature of the disease means that relapsing to drug abuse is not only possible but also likely, with symptom recurrence rates similar to those for other well-characterized chronic medical illnesses—such as diabetes, hypertension, and asthma (see figure, "comparison of relapse rates between drug addiction and other chronic …
What are the factors affecting substance use and abuse?
Certain factors can affect the likelihood and speed of developing an addiction:Family history of addiction. Drug addiction is more common in some families and likely involves genetic predisposition. ... Mental health disorder. ... Peer pressure. ... Lack of family involvement. ... Early use. ... Taking a highly addictive drug.
Which conditions are associated with substance use disorders?
Chronic pain, chronic obstructive pulmonary disease, congestive heart failure, and hepatitis C were among the most elevated.
What common risk factors can contribute to mental health conditions and substance use disorder?
1. Common risk factors can contribute to both mental illness and substance use and addiction.Genetic Vulnerabilities. ... Epigenetic Influences. ... Brain Region Involvement. ... Environmental Influences. ... Stress. ... Trauma and Adverse Childhood Experiences.
How does substance abuse affect the healthcare system?
Most of the adverse health consequences of substance abuse result in diseases and premature deaths. About 28 percent of all deaths annually can be traced to the use of tobacco, alcohol, or illicit drugs.
What are some challenges that may inhibit a person identified with a co occuring disorder from participating in medication assisted therapies?
Barriers within the mental health systemOrganizational failure to sustain integrated care.Limited support for training staff in co-occurring disorder treatment.Diagnostic and billing restrictions.
How does the presence of a mental illness influence the development of a substance use disorder?
Substance use and addiction can contribute to the development of mental illness. Substance use can lead to changes in some of the same brain areas that are disrupted in other mental disorders, such as schizophrenia, anxiety, mood, or impulse-control disorders.
How does drug use affect mental health?
Prolonged use of certain illicit drugs can result in a dopamine deficiency and lead to compulsive, drug-seeking behavior and long-term changes to mood and mental health. Sometimes, illicit drugs can cause symptoms of intoxication and withdrawal that mimic mental disorders.
How do risk factors affect mental health?
Risk factors Certain factors may increase your risk of developing a mental illness, including: A history of mental illness in a blood relative, such as a parent or sibling. Stressful life situations, such as financial problems, a loved one's death or a divorce. An ongoing (chronic) medical condition, such as diabetes.
How does drugs affects your mental and physical health?
There are different ways drugs can affect your mental health. For some people, taking drugs can lead to long-term mental health problems. Regular cannabis use can increase your risk of anxiety or depression. There's also a link between using stronger cannabis and developing psychosis or schizophrenia.
Why is substance abuse important in healthcare?
The benefits may also be felt more broadly, as the evidence suggests that improving substance use treatment can help to improve treatment success for other conditions, reduce hospital readmissions, reduce the spread of infectious diseases like HIV and hepatitis, and reduce drug-related accidents and overdoses. 2.
What is the role of public health in addressing substance abuse?
Public health approaches recognize the multi-faceted nature of substance misuse and focus on addressing the myriad of individual, environmental, and social factors that contribute to SUDs.
What are the three options for drug abuse treatment?
Successful treatment has several steps: detoxification. behavioral counseling. medication (for opioid, tobacco, or alcohol addiction)
Why is it important to treat substance abuse concurrently with physical disease?
For this reason, treating substance abuse concurrently with physical disease treatment, whether the substance abuse is a cause or a result of the illness, is vital to managing this disease burden for a number of the world’s most common and challenging chronic illnesses.
What is the co-occurrence of substance abuse?
Diabetes. Chronic Respiratory Illness. Chronic medical conditions and substance abuse often co-occur — this type of co-occurrence is referred to as comorbidity. On the one hand, long-term, regular substance abuse can result in physical damage to various body systems that can lead to chronic disease. One well-known example of this is the connection ...
Why is it important to treat comorbid physical disease?
The treatment of comorbid physical disease and substance abuse is a delicate process. Because substance abuse is also a chronic disorder, it is important to manage the symptoms of this mental illness while also treating the physical disease in order to avoid relapse into substance abuse.
What are the effects of drug use?
However, when the substance is taken heavily on a regular basis, these physical reactions can take a toll on the involved systems, resulting in the development of chronic disease or permanent physical disability, as described by the National Institute on Drug Abuse. This includes such illnesses as: 1 Heart disease, including hypertension, heart attack, or stroke 2 Lung disease, such as asthma, chronic obstructive pulmonary disease, or chronic bronchitis 3 Liver or kidney disease 4 Weight loss or gain, leading to chronic malnutrition or diabetes 5 Cancer
What happens when you have a physical diagnosis?
When a person receives a diagnosis of physical disease, there can be a profound effect on that person’s mental health. People with chronic illness have high rates of mental health disorders, as indicated in a large-scale review from the Substance Abuse and Mental Health Services Administration (SAMHSA).
What is the vicious cycle of tolerance?
Tolerance can result in the person deciding to take higher doses of the drug, or use it more often, which can then lead to a higher degree of tolerance. This vicious cycle leads to addiction and risk of overdose. The condition causes a mental health disorder that contributes to initiating substance use.
Can substance abuse cause emphysema?
Emphysema, chronic obstructive pulmonary disease, and chronic bronchitis are also lung diseases that can be caused or otherwise affected by substance abuse. Many of these drugs can have an effect on respiratory rates, exacerbating symptoms for people who already have a form of lung disease.
How does substance use affect the US?
Substance use is a major public health concern that affects every level of society. Individuals, families, communities, and overall government spending is impacted by the use of licit and illicit substances. Recent reports estimated that annual costs in the United States are approximately USD $193 billion for illicit drug use,1USD $223 billion for excessive alcohol use,2and USD $193 billion for tobacco use.3These costs include lost wages and productivity, criminal activity, and healthcare expenses. The economic burden aside, public health efforts can benefit from a better understanding of the impact of substance use disorder (SUD) on physical and mental health. Particularly, examining SUDs and the constellation of associated health and mental health problems throughout the lifespan provides a full picture of how variations in drug use patterns and outcomes shift with age, on which the present article will focus.
How does substance use affect older adults?
Substance use disorders in older adults may be a continuation of excessive drug and alcohol use initiated while younger, but for some, substance use begins during times of transition or loss. For instance, health declines that accompany older age may lead to reduced independence or associated pain; drug and alcohol use therefore provides an emotional escape from boredom and loneliness.113Unfortunately, the combination of existing chronic conditions and substance use or misuse can result in exponentially negative effects on physical health.113,114Older adults are more likely to experience adverse events from psychoactive medications, and due to the increased likelihood of older adults being prescribed multiple medications, the risk for serious drug interactions is high and often requires emergency medical care.115–117Additionally, prescription medication use, such as regular use or misuse of sedatives and benzodiazepines, has been associated with increased risk for falls in older populations.116,118When alcohol is combined with prescription medications, the effects appear even more detrimental. In a national study of Medicare beneficiaries, heavy drinking more than doubled the risk for hip fractures.111All of these can lead to costly hospital admissions and lengthy stays.
What are the risks of a SUD?
Adults diagnosed with an SUD and comorbid mental health disorder are at increased risk for poor health, social dysfunction, incarceration, poverty, and homelessness.86,87Anxiety disorders represent some of the most commonly co-occurring disorders, with significant associations between any anxiety disorder and any drug dependence.88–90Among the general US population, 30 percent of those meeting criteria for any lifetime drug use disorder had at least one anxiety disorder.88In particular, sedative, opioid, and tranquilizer use disorders have shown a strong association with anxiety disorders.90,91Women have demonstrated greater comorbidity between these specific SUDs and anxiety disorders, especially social and specific phobias.88,91Although epidemiologic surveys cannot definitively support the self-medication hypothesis, some speculate that the calming effects of these drugs play a role in their link to comorbid anxiety.
How does SUD affect health?
In addition to acute problems, SUDs can result in general health deterioration and specific, ongoing conditions. In a 14-year prospective study of young adults reporting “good” or better health at intake, baseline hard drug use was significantly associated with subsequent self-rated health decline as compared to never using.60They found even if drug use stopped, the decline continued. The authors identified tobacco use as a significant factor for lack of restored health. These results are consistent with national studies in which 77–93 percent of clients in SUD treatment settings use tobacco products61and over 50 percent die of tobacco-related causes.62The combination of multiple substances substantially increases the risk for health problems. For instance, while cancers of the mouth and throat are seven and six times greater for tobacco and alcohol users respectively, the risk is 38 times more for those who use both substances.63Cigarette smoking in particular has been linked to 90 percent of all cases of lung cancer and accounts for approximately one-third of all cancer deaths.64While the research regarding marijuana smoking and lung cancer remains inconclusive,65there is evidence for increased risk of respiratory illnesses among regular marijuana smokers.66,67
What is the purpose of the current review?
The purpose of the current review is to synthesize the research findings to date that examine physical and mental health problems associated with substance use at different stages of life. The goal is not to provide an exhaustive list of studies, but to emphasize the changing needs across the lifespan of those suffering from comorbidities in order to inform development of care and future research. In addition to presenting general patterns of alcohol, tobacco, and licit/illicit drug use, common and troublesome medical and psychiatric conditions associated with SUDs among adolescents, adults, and older adults are discussed. While some substances can result in significant consequences that are both acute and chronic (e.g., alcohol), the negative impact of others (e.g., tobacco) are primarily observed only after prolonged use. Finally, recommendations regarding clinical implications and areas for future research are presented.
What is the risk of SUD in adolescent?
Adolescents diagnosed with an SUD show more acute and potentially chronic health problems than teens without SUD. Nonmedical use of prescription drugs and over-the-counter medications accounted for approximately half of emergency department (ED) visits for drug abuse or misuse in the US in 2011; among youth aged 12–17, the proportion of those seeking emergency medical care due to pharmaceutical misuse exceeds that of alcohol (301 ED visits versus 160 ED visits per 100,000 population).32The risk for substantial harm is increased when medications are abused with one another and/or alcohol.
What are the effects of drug use on adolescents?
Behaviors associated with drinking and drug use in teens contribute to increased risk for injury and violence.21US national survey results indicate that within the month prior to survey, 24.1 percent of high school students reported being a passenger in a car when the driver had been drinking and 8.2 percent reported having driven a car themselves after consuming alcohol.21An examination of older adolescents revealed that one in six college students reported drugged driving (i.e., illicit drugs or prescription drugs used non-medically) in the past year.22The combination of limited driving experience and impaired motor skills results in increased rates of injuries and fatalities from traffic accidents.
Why do people with substance use disorders access the health care system?
But individuals with substance use disorders often do access the health care system for other reasons, including acute health problems like illness, injury, or overdose, as well as chronic health conditions such as HIV/AIDS, heart disease, or depression.
Why do people with substance use disorders not seek treatment?
It is known that most people with substance use disorders do not seek treatment on their own, many because they do not believe they need it or they are not ready for it, and others because they are not aware that treatment exists or how to access it. But individuals with substance use disorders often do access the health care system for other reasons, including acute health problems like illness, injury, or overdose, as well as chronic health conditions such as HIV/AIDS, heart disease, or depression. Thus, screening for substance misuse and substance use disorders in diverse health care settings is the first step to identifying substance use problems and engaging patients in the appropriate level of care.
Why is diversity important in health care?
Just as a diversity of health care settings is needed to meet the needs of patients , a diversity of health care professionals is also critical. Health care services can be delivered by a wide-range of providers including doctors, nurses, nurse practitioners, psychologists, licensed counselors, care managers, social workers, health educators, peer workers, and others. With limited resources for prevention and treatment, matching patients to the appropriate level of care, delivered by the appropriate level of provider, is crucial for extending those resources to reach the most patients possible.
How does health IT help?
Use of Health IT is expanding to support greater communication and collaboration among providers, fostering better integrated and collaborative care, while at the same time protecting patient privacy. It also has the potential for expanding access to care, extending the workforce, improving care coordination, reaching individuals who are resistant to engaging in traditional treatment settings, and providing outcomes and recovery monitoring.
What is integrated care?
Integration. The systematic coordination of general and behavioral health care. Integrating services for primary care, mental health, and substance use-related problems together produces the best outcomes and provides the most effective approach for supporting whole-person health and wellness.3.
How does integration help with substance use?
Integrationcan help address health disparities, reduce health care costs for both patients and family members, and improve general health outcomes.
What is Chapter 6?
Chapter 6 Preview. Services for the prevention and treatment of substance misuse and substance use disorders have traditionally been delivered separately from other mental health and general health care services. Because substance misuse has traditionally been seen as a social or criminal problem, prevention services were not typically considered ...
Can addiction be treated successfully?
Yes, addiction is a treatable disorder. Research on the science of addiction and the treatment of substance use disorders has led to the development of research-based methods that help people to stop using drugs and resume productive lives, also known as being in recovery.
Can addiction be cured?
Like other chronic diseases such as heart disease or asthma, treatment for drug addiction usually isn't a cure. But addiction can be managed successfully. Treatment enables people to counteract addiction's disruptive effects on their brain and behavior and regain control of their lives.
Does relapse to drug use mean treatment has failed?
No. The chronic nature of addiction means that for some people relapse, or a return to drug use after an attempt to stop, can be part of the process, but newer treatments are designed to help with relapse prevention. Relapse rates for drug use are similar to rates for other chronic medical illnesses.
What are the principles of effective treatment?
Research shows that when treating addictions to opioids (prescription pain relievers or drugs like heroin or fentanyl), medication should be the first line of treatment, usually combined with some form of behavioral therapy or counseling. Medications are also available to help treat addiction to alcohol and nicotine.
What medications and devices help treat drug addiction?
Different types of medications may be useful at different stages of treatment to help a patient stop abusing drugs, stay in treatment, and avoid relapse.
How do behavioral therapies treat drug addiction?
Behavioral therapies help people in drug addiction treatment modify their attitudes and behaviors related to drug use. As a result, patients are able to handle stressful situations and various triggers that might cause another relapse. Behavioral therapies can also enhance the effectiveness of medications and help people remain in treatment longer.
How do the best treatment programs help patients recover from addiction?
Stopping drug use is just one part of a long and complex recovery process. When people enter treatment, addiction has often caused serious consequences in their lives, possibly disrupting their health and how they function in their family lives, at work, and in the community.
How does psychiatric illness affect substance abuse?
Some evidence on the role of psychiatric illnesses on the risk of substance abuse may indicate the need for improved mental health screening and services in those with cardiovascular disorders. A study of mental health in heart failure patients found that the prevalence of substance or alcohol abuse was associated with major depressive disorder 15. Another study using data from over 1000 patients with cardiovascular disease found that a history of trauma was associated with substance abuse in this population 38. This may indicate that the improved availability of counseling to people with mental health disorders and an increased risk of cardiovascular disease may reduce substance abuse, and its further deleterious effects on heart health, in this population. Patients reporting to treatment centers for substance abuse may take the opportunity to tell doctors about their psychological issues 19.
What is substance abuse?
Substance abuse is defined as the excessive and/or compulsive intake of a compound that can cause changes in the neurological or biochemical state of an individual. This may be associated with physiological and/or psychological dependence on the compound in question. This intake is categorized as abuse when it leads to significant impairments in the ability to function in occupational and/or societal terms. Substance abuse may lead to deteriorations in existing health complaints, or to the need for treatment for complaints that may have arisen due to substance abuse 1. This abuse may be strongly associated with some conditions such as infective disease 2.
What are the effects of cardiovascular disease?
This form of disease may result in brain abnormalities and damage due to interruptions in the supply of oxygen to this organ. It may also lead to tissue starvation, as mentioned above, which may manifest in severe adverse effects including necrosis (tissue death).
Is substance abuse a risk factor for cardiovascular disease?
This guide will discuss the potential roles substance abuse may play in the risk of cardiovascular disease, and the potentially harmful effects of dangerous ingestible (or incorporable into the body by other means, such as intravenously) substances on pre-existing disorders of the vascular system.
How does detoxification affect mental health?
Patients undergoing detoxification frequently present with medical and psychological conditions that can greatly affect their overall well-being and the process of detoxification. These may simply be pre-existing medical conditions not related to substance use or the direct outcome of the substance abuse. In either case, the detoxification process can negatively affect the co-occurring disorder or vice versa. Furthermore, people who abuse substances often present with medical conditions in advanced stages or in a medical crisis. Co-occurring mental disorders also are likely to be exacerbated by substance abuse. For more on treating patients with co-occurring psychiatric disorders, the reader should refer to TIP 42, Substance Abuse Treatment for Persons With Co-Occurring Disorders(Center for Substance Abuse Treatment [CSAT] 2005c).
What is the purpose of the detoxification chapter?
This chapter is intended primarily for medical personnel treating patients in detoxification settings , though nonmedical staff may find it informative as well. This chapter is not meant to take the place of authoritative sources from internal medicine. Rather, it presents a cursory overview of special conditions, modifications in protocols, and the use of detoxification medications in patients with co-occurring conditions or disorders. Overall treatment of specific conditions is not addressed unless modification of such treatment is needed.
What is a condition that results from inadequate blood supply to the intestines?
Ischemic bowel disease (a condition that results from inadequate blood supply to the intestines)
Why is alcoholic hepatitis treated?
Alcoholic hepatitis usually needs acute medical treatment to prevent electrolyte imbalance and dehydration. Protocols may have to be adapted if the patient cannot take oral agents.
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