Following on from last weeks article we will be looking at drug use and mental illness; whether drugs can cause mental illness, contribute to mental illness and why some people may be genetically vulnerable to drug induced psychosis.
There are various reasons why people use drugs. To have a good time and relax, to get that high that nothing else can give them, their friends are using them and they decide to try them, to self medicate and sometimes just because they can.
In the 2019 National Drug Strategy Household Survey an estimated 9 million or 43% of Australians aged 14 years and older had done some sort of illicit substance in their lifetime (including the non-medical use of pharmaceuticals) and an estimated 3.4 million or 16.4% had used an illicit drug in the past 12 months. While this may come as shock to some, it shouldn't really surprise us considering how accessible drugs are these days and it's often cheaper (and quicker) to get a high off of drugs than it is with alcohol. The top 4 types of drugs people used were cannabis, cocaine, ecstasy, and pharmaceutical drugs for non-medical use. The survey didn't look at the frequency of drug use which varies between different types of drugs, but noted that people who used cocaine or ecstasy did it infrequently compared to those who used cannabis or meth, who were more likely to use it on a frequent basis. People with a mental illness were 1.7 times more likely to use drugs than those without a diagnosis. This included people with anxiety, depression, schizophrenia, bipolar, eating disorders and other forms of psychosis.
There is a complex relationship between drug use and mental illness. Like with alcohol use, drug use can increase mental health symptoms and their severity. Making what would normally be a straightforward diagnosis and treatment plan more complicated. This also makes it hard for research to take place looking at whether drugs can cause mental illness as when people who use drugs seek treatment it can be hard to say which came first the mental illness or the drug use. This is called Dual Diagnosis and is a relatively new realisation that mental illness and drug use can be linked more closely than first thought. There are many factors that come into this and as more research is being done more are being discovered. The first one is that it’s not uncommon for people to self-medicate with drugs, who also have severe cases of mental illnesses and are unsure how to manage them. Also, in some cases a substance can also worsen the symptoms of a person’s mental illness such us someone smoking marijuana which can trigger a psychotic episode in some people. While there’s still a lot more research that needs to be done to looking into Dual Diagnosis. Estimates of numbers in Australia lead us to believe that around 75% of people with alcohol and substance use may also have a mental illness, around 64% of psychiatric-in-patients may have a current or previous drug use problem and around 90% of males with schizophrenia have a drug use problem. As more research is being done into Duel Diagnosis these numbers will become clearer and more treatment can be developed that helps those who struggle with mental illness and drugs.
Genetics have quite a bit to do with how someone reacts to drugs. With it being estimated between 40%-60% of your genetic make up attributes to how you will react to drugs. More research is currently being done but there are links slowly becoming uncovered in genes including; whether you will enjoy drugs, how long they will stay in your system, likelihood of becoming addicted to them and how you will react to them. Most of this is to do with how certain genes interact both with each other along with proteins within the genes and if they influence how a person responds to a particular drug. With research showing that there are genetic factors that influence alcohol dependence and cigarette smoking and further research being done into various other medications and drugs, including opioids.
Something that is new on the drug market is synthetic drugs. These are drugs that aim to mimic the effects similarly to illicit drugs but are easier for people (especially teens) to get their hands on and have the bonus of not showing up on drug tests. There are many names for them, but common names include: party pills, bath salts, herbal ecstasy, synthetic cannabis, legal highs and herbal highs. They are often marketed as ‘legal’ and ‘safe’ of which they are neither. There’s not a huge amount of research done on synthetic drugs at the moment, but the research that is available isn’t looking promising with concerns about the long term impacts they can have being voiced. One thing to be aware is that these drugs can mess with the brain chemistry on a different level and can cause psychosis easily. This has been proven with Spice (or synthetic cannabis), compared to natural cannabis, spice is more likely to cause psychotic symptoms and require ongoing care. It’s becoming impossible to make laws to make every individual synthetic drug illegal as it becomes available as they chance so often. Instead laws are having to be made that don’t make the substance itself illegal but the definition of what is a synthetic drug/psychoactive substance illegal.
It’s probably wise to avoid drugs regardless of if you have a mental illness or not. While they may not cause a mental illness, they can trigger psychosis or increase the symptoms of a mental illness you already have and the short term high isn’t the best for the long term impacts. As with any illicit substance there are always risks and it just takes one bad batch or one bad decision to impact your life.
Feel free to drop by, just say, ‘Hey Erin’ in strict confidence and you can be anonymous if you wish. Or, do not hesitate to leave a question in the comments below any time.
Alcohol, tobacco & other drugs in Australia, People with mental health conditions - Australian Institute of Health and Welfare Physical health of people with mental illness - Australian Institute of Health and Welfare