COMORBIDITY IN ADDICTION AND OTHER MENTAL ILLNESSES

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COMORBIDITY IN ADDICTION AND OTHER MENTAL
ILLNESSES

• The Chiromo Lane Medical Centre (CLMC) Approach

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Definitions

• Mental illness
• A wide range of mental health conditions
  disorders- that affect the mood, thinking and
  behavior (Mayo clinic).
• Co-morbidity
• - Two or more disorders occurring in the same
  person (NIDA).
• Addiction
• - A primary chronic disease of brain-reward,
  motivation, memory and related circuitry (ASAM).

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• Drug Abuse and Mental Illness
• A Complex Dance

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Complexities

• Mental illnesses are often compounded by drug and
  alcohol abuse, making it a challenge to get the
  right diagnosis, treatment and management for
  both.
• Mental illnesses can increase the risk for
  alcoholism or drug abuse
• Alcohol and drug abuse can exacerbate underlying
  mental illnesses.

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• Drug Abuse and Mental Illness
• Underlying Causes
• There are also other factors that could explain
  the frequent simultaneous occurrence of addiction
  and mental illness, including

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Underlying Causes cont

• Genetics
• Certain studies have found genetic variations
  that are associated with mental illness.
• Chemical deficiency.
• Neuro-chemical deficiencies have been linked to
  mental illnesses
• Some of these deficiencies are found in dopamine,
  serotonin, norepinephrine

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Underlying Causes cont.

• Environment
• Some environments were found to be more stressful
  leading to mental breakdowns. These increase risk
  of alcohol and drug abuse

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• Drug Abuse and Mental Illness
• Co-morbidities

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Co-morbidities

• Depression
• In some cases, individuals may start to abuse a
  substance to handle the symptoms of depression.
• Bipolar Disorder
• Those with bipolar disorder may attempt to smooth
  out mood swings with alcohol.

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Co-morbidities contd

• Anxiety Disorders
• e.g. social anxiety persons may use alcohol and
  other drugs to get the courage to socialize.
• Generalized Anxiety Disorder people use
  substances to alleviate the worrying.
• Trauma and Stressor related Disorders
• e.g. People with Adjustment Disorder, Acute
  Stress Disorder and Post-Traumatic Stress
  Disorder may use substances to cope with the
  flashbacks of the trauma event.
• .

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Comorbidities contd

• Schizophrenia
• Marijuana is commonly used by people with
  schizophrenia disorders to cope with the
  symptoms.
• Cigarette smoking is prevalent among people with
  schizophrenia.
• Attention Deficit Hyperactive Disorder (ADHD)
• Persons with ADHD are likely to use substances
  impulsively and use cannabis to manage
  concentration.

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• Drug Abuse and Mental Illness
• Treating Two Sets of Symptoms

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• It is very important, but often difficult, to
  distinguish primary mental disorders from drug
  induced symptoms.
• It is recommended that one is substance-free
  for a short period in order to tease apart the
  various symptoms.

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Dual Management

• Treatment needs to focus on both conditions at
  the same time, once the right diagnosis has been
  made.
• CLMC Retreat Relationship
• Multidisciplinary approach Psychiatrists,
  psychologists, psychiatric nurses, counselors,
  social workers, pharmacists..

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Recommendations

• Research on local Kenyan co-morbidity rates
  informed by a specialized treatment facility
• Increase appreciation for dual treatment
• Enable formulation of effective policies that
  ensure best clinical practice
• Spearheading incorporation of context-based
  interventions to improve mental health in private
  and public institutions

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Thank You