Cocaine addicts who use other substances have more mental health problems

May 1 2008

A study carried out by Spanish scientists shows that cocaine users who take other addictive substances demonstrate a higher risk of mental health problems.

The Grupo de Epidemiología de las Drogas de Abuso (The Epidemiology Group on Drug Abuse) at the Instituto Municipal de Investigación Médica (Municipal Institute of Medical Research- IMIM-Hospital del Mar) in Barcelona, has performed an epidemiological study that confirms the existence of dual pathology in young, habitual cocaine users. Antònia Domingo, one of the main authors of this study, points out the main conclusion of this study to SINC: "We observed more mental health problems in those people who had consumed both cocaine and other substances".

There have been many studies performed over the last few years about drug addiction linked to other mental illnesses, the so-called "dual pathology", which is defined generically as the existence of a double diagnosis: substance use disorder and associated psychiatric disorder.

The Manual diagnóstico y estadístico de los trastornos mentales (DMS-IV) (Diagnostic and Statistical Manual of Mental Disorders), the diagnostic guide used by mental health professionals, lists substance-related disorders (dependency, abuse, substance-induced disorders), in one of the main diagnostic cornerstones, and mood, eating behaviour and psychotic disorders, amongst others. Antònia Domingo explains to us, "although it has not been possible to distinguish whether a psychic disorder predisposes a person to drug consumption, or whether this consumption precipitates certain psychiatric disorders, the distinction between mental disorders not related to drug consumption and substance-induced disorders has important implications in the treatment and progress of individuals".

The researchers examined the psychopathological state of 139 registered cocaine users (between 18 and 30 years of age) outside the healthcare context using the Psychiatric Research Interview for Substance and Mental Disorders (PRISM). This allowed the researchers to observe the cases in which the mental pathology was unrelated to substance abuse and when it was drug-induced.

From the total number of people interviewed, 84 (60.4% of the total) did not have any other psychiatric problem. However, 33 (23.8%) had non drug-induced mental disorders, and 22 (15.8%) had drug-induced disorders. Amongst the latter, some subjects had non substance-related disorders as well, essentially psychiatric illnesses (in 42.5% of the cases). The more common disorders were related to mood (26.6%), such as depression, anxiety (13%), and panic. Likewise, two personality disorders were diagnosed (almost 14%).

On the other hand, those who self administered free base cocaine (also called crack), had a greater propensity to induced disorders, although, from Domingo's explanation: "this represents a greater risk in countries such as the United States of America, because cocaine is administered nasally in Spain, to a greater extent".

The results published in the review Addiction form the first part of a wider research project, in which this group re-assessed the same participants after nearly two years. "We hope to analyse their drug consumption patterns and determine to what extent they are linked with psychiatric problems. These studies will contribute to formulating better treatments for the cessation of cocaine use", concludes the investigator.