Comorbidity of mental health and substance use disorders

Mental health problems are very common in those with a substance use disorder, and these patients have more clinically and psychosocially severe problems than patients with substance use disorders without comorbid mental health problems.

The most frequent psychiatric comorbidities among individuals with substance use disorders are major depression, anxiety (mainly panic and post-traumatic stress disorders) and personality disorders (mainly antisocial and borderline).The presence of these comorbid mental health problems increases the difficulty of treating substance use disorders, increases the risk of chronicity, and leads to poorer prognoses for both the psychiatric and the substance use disorders.

There is broad agreement in the literature that the two types of disorders should be addressed using a multidisciplinary approach in which drug and mental health professionals work together towards common goals. However, there is a lack of consensus on the most appropriate treatment setting and the best pharmacological and psychosocial strategies
to use.

The main barrier in treating comorbid substance use and psychiatric disorders is the separation of mental health and drug use treatment networks in most European countries. This often means that each treatment service lacks sufficient expertise to treat both types of disorders and this leads to different treatment approaches, regulations and financial resources.