Severely Mentally Ill Abuse Substances More Often

substance abuseIndividuals who have severe mental illness, especially psychotic disorders, have higher rates of smoking, drinking, and using drugs when compared with the general population.[1] This is concerning, as individuals with severe mental illness are already more likely to  die younger than those without severe psychiatric disorders.1

Assistant Professor of Psychiatry at Washington University School of Medicine in St. Louis, Sarah M. Hartz, M.D. states, “These patients tend to pass away much younger, with estimates ranging from 12 to 25 years earlier than individuals in the general population. [Many] don’t die from drug overdoses or commit suicide—the kinds of things you might suspect in severe psychiatric illness. They die from heart disease and cancer, problems caused by chronic alcohol and tobacco use.”1

Hartz and colleagues conducted a study that analyzed smoking, drinking, and drug use in nearly 20,000 individuals.1 The number included 9,142 individuals who were diagnosed with schizophrenia, bipolar disorder, or schizoaffective disorder, an illness characterized by psychotic symptoms such as hallucinations and delusions.1 The other half of the individuals were healthy and without mental illness.1

Results showed that 30 percent of individuals with severe psychiatric illness engaged in binge drinking, defined as drinking four servings of alcohol at one time.1 The rate of binge drinking in the general population was 8 percent.1 Among those with severe mental illness, 75 percent were regular smokers.1 This is much higher than the general population, of which 33 percent were regular smokers.1 There were similar findings with marijuana.1 Fifty percent of those with psychotic disorders used marijuana regularly, while 18 percent of the general population did.1 Findings were similar with other illicit drugs.1 Fifty percent of those with severe mental illness used an illicit drug regularly, compared with 12 percent of the general population.1

However, this leads to the real question: Can curbing nicotine, alcohol, and substance abuse in patients with severe psychiatric illness lengthen their lives?1 Hartz believes so, and urges mental health professional to be more adamant about stopping the use of these substances in this population.1

“Some studies have shown that although we psychiatrist know that smoking, drinking, and substance use are major problems among the mentally ill, we often don’t ask our patients about those things,” Hartz said. “We can do better, but we also need to develop new strategies because many interventions to reduce smoking, drinking, and drug use that have worked in other patient populations don’t seem to be very effective in these psychiatric patients.”1

[1] Wood, J. (2014). Rates of Alcohol, Tobacco, Drug Use Far Higher in Severely Mentally ill. Psych Central. Retrieved on January 3, 2014, from http://psychcentral.com/news/2014/01/03/rates-of-alcohol-tobacco-drug-use-far-higher-in-severely-mentally-ill/63993.html

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