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Congressional Briefing on Co-Occurring Substance Use and Mental Illness
By Anne Bettesworth
On June 27, 23 scientific and professional organizations of the Friends of the National Institute on Drug Abuse (NIDA) sponsored the eighth in a series of educational briefings on Capitol Hill. Organized by APA Science Government Relations staff, the briefing, titled “Double Jeopardy: When Addiction and Mental Illness Coexist,” drew a standing-room-only crowd of nearly 200 people, including staff from 60 different House and Senate offices.
The event received tremendous support from the mental health community on Capitol Hill, evident by the endorsement and co-sponsorship of three relevant congressional caucuses: the Addiction, Treatment and Recovery Caucus, the Mental Health Caucus, and the newly-formed Drug Policy Caucus. Congresswoman Grace Napolitano (D-CA), co-chair of the Mental Health Caucus, spoke about her strong commitment to improving the lives of those struggling with mental disorders.
The focus of the briefing was co-occurring mental disorders and substance use, and that research increasingly supports studying and treating co-occurring disorders together, with both medication and behavioral therapies. Estimates show that as many as six out of ten people who have substance use disorders also suffer from mental illness. Researchers in the health care community are looking closely at the following three scenarios: that substance use disorders can cause a mental illness; that mental illness can lead to substance use disorders; and that substance use and mental disorders are caused by other common risk factors. Genetic vulnerabilities and environmental causes are both risk factors that predispose or trigger mental illness and drug abuse. Each set of disorders may involve similar brain regions and developmental alterations.
Nora Volkow, Director of NIDA, began with a presentation on the Institute’s work in this crucial area. She noted that although researchers have not conclusively found causation between drug abuse and mental illness, across the line there is a significant association between the two diseases. Volkow emphasized that it has been found that people who suffer from mental disorders are significantly more at risk of suffering injuries or dying from drug-related incidents. For example, people with depression are 40 percent more likely to develop lung cancer than the average person, while schizophrenics are at double the risk. In addition, 60 percent of deaths of those with co-morbid disorders occur due to poisoning when attempting to self-medicate.
Following Volkow was a presentation by Patrick Flynn, Professor of Psychology and Deputy Director of the Institute of Behavioral Research at Texas Christian University. He described the two distinct treatment systems for co-occurring substance use and mental disorders. Flynn suggested that the health care system should provide integrated treatment for both drug abuse and mental illness so that both conditions receive necessary attention and support. He spoke of developing a treatment plan which is long-term, accessible, and uses funding from both populations of the psychiatric patient community--those who are drug dependent and those who are mentally ill. Flynn additionally noted that the community must ensure that treatment centers are available in all communities, especially rural areas, and not solely in areas with large universities, which is where coverage is now primarily based.
The final speakers were Brittany and Basil Calomeris, who shared the story of their family’s personal struggle with a co-occurring disorder and the arduous journey to treatment.