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Breaking the Cycle: Treating Co-Occurring Mental Illness and Addiction

Recovering from drug addiction is notoriously difficult. Setbacks are common and relapses occur often. Too often, a critical element is overlooked: co-occurring mental health conditions. Treating mental illnesses like depression, anxiety, post-traumatic stress disorder, ADHD, and others is crucial to address the addiction and overdose crisis that now claims over 100,000 lives annually.

Substance Use Disorders often accompany other mental illnesses. Individuals who experience a Substance Use Disorder (SUD) during their lives may also experience another co-occurring mental disorder and vice versa. For many people, drug and alcohol problems begin as self-medication: using substances to cope with temporary stress or to manage symptoms of chronic mental health problems they may not even know they have. Substance use, particularly alcohol, can be a socially accepted way of dealing with negative emotions.


Surveys show alcohol use rose during the COVID-19 pandemic. Research has also tied problem alcohol use in college students to self-treatment of social anxiety. Similarly, people with untreated depression might discover that opioids or stimulants temporarily boost their mood and use them for that purpose.

Inconsistent or difficult-to-access mental health care means that these conditions and addiction often go untreated. Unfortunately, it is often easier to get illicit drugs than adequate medical mental health care. This scenario creates the perfect storm for co-occurring addiction and other mental illnesses more likely.

But using substances to treat mental illness can begin a difficult cycle. Substance use to manage mental illness can lead to addiction and can in turn worsen the original mental illness. Regularly taking drugs or alcohol causes the brain to adapt to that substance—known as dependence. Effectively, the brain dials down its own neurotransmitter systems upon which the drugs act. A person trying to relieve anxiety through substance use will feel worse anxiety most of the time, because their brain now depends on the drug for relief.

Racism and other forms of discrimination, isolation, childhood trauma, poverty and lack of access to education and healthcare can all play a role in increasing risk of developing mental illness and Substance Use Disorders. The stigma that attaches to both substance use disorders and mental illness exacerbates these factors—making the person with mental illness and addiction even more isolated and vulnerable, and less likely to seek treatment.

The entanglement of mental illness and substance use disorders requires urgent action. But expanded screening and care for mental illnesses including depression, anxiety, PTSD, and others must be a component to successfully address the current addiction and overdose crisis.

Natural State Recovery Centers understands the importance of offering mental health care in harmony with addiction treatment. Our staff of licensed mental health care workers provide a safe space for exploring underlying causes of addiction. All clients at NSRC receive individual and group therapy as part of their treatment. In addition, each client is assigned a Peer Recovery Specialist, a certified staff-member with lived experience who can listen and counsel each individual through processing difficult emotions. If you or someone you love is in need of help, reach out to us today at (501) 319-7074.

This blog post appears as an amended version of an op-ed originally published by Dr. Nora Volkow here.


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