Co-occurring Disorders for Cocaine Dependence

Co-occurring disorders occur when a person has a substance use disorder along with a mental health disorder. It is also known as comorbidity, dual disorders or dual diagnosis – though it does not have to be limited to only two. Developing an added substance related problem is quite common for people who are addicted to cocaine, as well as any other types of substance abuse disorder.

Common co-occurring disorders with cocaine use include alcohol abuse, benzodiazepine abuse, cannabis abuse, opiate abuse, PTSD (post-traumatic stress disorder), ASPD (antisocial personality disorder), adult onset ADHD (attention deficit hyperactivity disorder), gambling disorder, febrile neutropenia (fever, infection and low white blood count), agranulocytosis (dangerously low white blood count) and depression.

Alcohol abuse is the most common co-occurring substance use disorder, since it is often used to enhance the gratifying effects of cocaine. It decreases negative effects such as nervousness or feeling on edge as well. Benzodiazepines and opiates are also commonly used with cocaine for comparable reasons.

Mental illness and alcoholism or drug abuse interact in a complicated mixture. Mental illnesses can intensify the risk for drug abuse or alcoholism, sometimes due to self-medicating. One disorder may be worse than the other.

It is common for drug abuse addictions, alcoholism and other psychiatric disorders to happen at the same time. But, they are separate disorders that must be treated individually in order for the patient to have good results.

Relationship between Cocaine Abuse and Co-occurring Mental Disorders

There are other aspects that could clarify the frequent coinciding occurrence of mental illness and addiction, such as genetics, chemical deficiency and a shared environment. Genetic factors are often accountable for dual disorders of substance abuse and mental issues. Studies comparing fraternal and identical twins showed that there was more likelihood of both disorders amongst the identical twins, which indicates that genetics are somewhat responsible.

Many people who are diagnosed with mental disorders are also addicted to drugs, and vice versa. For example, in comparison to the general population, people who have anxiety and mood disorders are approximately twice as likely to suffer from drug addiction, whilst the opposite can be said as well.

Mental Illness as the Root Cause of Addiction

While the exact relationship between mental illness and drug abuse is not crystal clear, there is evidence that the correlation works both ways. People with particular mental illnesses are likely to develop drug abuse problems, while people with drug abuse problems are more likely to develop mental illnesses.

Stephen Gilman, New York University’s addiction psychiatrist, said ‘fifty per cent of those with an addictive disorder will have a psychiatric disorder. And for those who have a psychiatric disorder, about 20 per cent have an addiction problem.’

James Garbutt, the University of North Carolina’s psychiatry professor, added ‘a variety of mental illnesses such as post-traumatic stress disorder, antisocial personal disorder (characterised by a lack of empathy toward other people), anxiety, sleep disorders, or depression, increase the risk of addiction. Those with the highest risk of addiction have bipolar disorder or schizophrenia – up to 50 per cent (of people with these conditions) can have an addiction.’

Drug addiction in itself is a mental illness because it alters the fundamental ways in which the brain works, disturbs a person’s standard hierarchy of desires and needs, and substitutes priorities in order to procure and use the drug. The compulsive behaviours that occur as a result of drug addiction lessen one’s ability to control their urges, regardless of the consequences, in a way that is similar to other mental disorders.

Even though cocaine abuse can easily occur with other mental disorders, it does not mean that one is the root cause, even if that is how it appears. Finding out which came first is difficult to determine without more information. However, research shows that there are several possibilities for co-occurrence. Abusing drugs can make symptoms of other mental disorders more apparent, whilst mental disorders can cause one to eventually abuse drugs.

Other Underlying Causes of Co-occurring Disorder

Genetic factors are often accountable for dual disorders of substance abuse and mental issues. Studies comparing fraternal and identical twins showed that there was more likelihood of both disorders amongst the identical twins, which indicates that genetics are somewhat responsible.

Chemical deficiencies are also common with co-occurring disorders. For example, individuals with a lower level of serotonin (a chemical that is vital to brain function) can cause substance abuse and anxiety disorders to regularly coincide. There is further evidence that mental disorders and addiction are linked to the dysfunction of brain chemicals known as monoamine oxidases.

Studies conducted with twins lead to findings that one’s environment plays an important role in developing a co-occurring disorder. It is also worth noting that mental disorders and cocaine abuse are developmental disorders. These disorders can start in periods of adolescence, and occasionally childhood, when the brain starts to experience dramatic developmental changes. Being exposed to drugs at an early age can affect the brain in ways that promote mental illness. Additionally, early signs of a mental disorder can intensify vulnerability to drug abuse.

Treatment for Co-occurring Disorders & Cocaine Abuse

The high rate of comorbidity between mental disorders and cocaine abuse requires a comprehensive method that identifies and evaluates both. Consequently, anyone who is looking for help for mental disorders or drug addiction needs to be checked for both and treated appropriately.

Since mental disorders can increase vulnerability to cocaine addiction, proper diagnosis and treatment of the mental disorder can help reduce the risk of drug use. Because the opposite can also be true, proper diagnosis and treatment of cocaine abuse can lessen the risk of developing mental disorders as well. If mental disorders are already apparent as a result of cocaine abuse, then their severity can be reduced or more responsive to effective treatment.

It is vital, though often difficult, to determine which symptoms are addictive, and which are psychiatric. A person has to remain substance-free for a minimum of two weeks in order to start separating the symptoms.

From a clinical perspective, the addiction and the psychological symptoms must be treated simultaneously. It is common for misdiagnosis, and consequently under-treatment, to occur. For example, if alcohol abuse is covering a bipolar disorder.

Treating a mental disorder and cocaine abuse at the same time is possible, and starts the process of identifying the underlying causes of both. People who experience co-occurring disorders can benefit from integrated treatment, which is particularly beneficial if it is conducted simultaneously, in the same location and by the same treatment team.

The best type of treatment for co-occurring disorders will address both issues. A personalised treatment plan must involve the individual through various processes, such as decision-making, and call for active participation in creating approaches for change and reaching goals. Treatment should include basic education about their disorder and associated issues and teach them coping strategies and skills that will help in various areas of their life.

Treatment for co-occurring disorders often helps the addict to think about the role that cocaine plays in their life. This is often done in private, safe and non-judgmental environment, where negative consequences do not exist. The addict is given a chance to find out more about cocaine and learns how they interrelate with mental disorders. They are assisted in identifying and developing their own recovery goals and ways to become more involved with services that can help with the recovery process.

People with co-occurring disorders should be given special counselling that is specifically designed for their diagnosis, which can be done individually, in a group, with family or in combination.

Getting sober is just the start of the process, but it is an important step to seeking help and turning one’s life around. If you or someone you know is dealing with co-occurring disorder then contact us to get help right away and begin the road to recovery.