May 27, 2021
A Dual Challenge: When substance use disorder and mental illness happen together

The challenges of opioid misuse are hard enough to manage under any circumstances, but for people also facing mental illness, those challenges are magnified. Unfortunately, finding the two together isn’t at all uncommon.

One affliction can fuel the other, and the link goes both ways: People with substance use disorder are more likely to have mood and anxiety disorders; likewise, half of all people with mental illness can be expected to misuse substances. Statistics around opioid use bear this out. According to Healthline, the portion of the American population with mental health disorders is about 16%, but that population accounts for more than half of all opioid prescriptions.

Not only are people with mood and anxiety disorders twice as likely as others to use prescription opioids; they’re more than three times as likely to misuse them.

The link can be deadly. The National Institutes of Health suggests that, while the exact number isn’t known, as many as 30% of fatal opioid overdoses could be classified as suicide.

All of the strategies for preventing opioid misuse among teens — including talking to them about opioids and disposing of leftover painkillers — become even more important for teens who also have mental illness.

Some experts argue that public policy around substance misuse has to change if society is to make progress against the opioid epidemic. Writing for the National Alliance on Mental Illness in 2018, Dr. Lloyd I. Sederer declared: “We are failing with this epidemic because of this country’s dogged attachment to policies and programs that have never worked for addiction.”

Rather than focus on substance misuse as a criminal matter and employ scare-tactic messages that don’t work with youths, Sederer calls for a three-pronged approach:

  • Prevention, including positive parenting training, mentoring programs such as Big Brothers Big Sisters and school-based training for kids in life skills such as decision-making and controlling their moods and impulses
  • Screening to identify substance use disorder in youths before it becomes too entrenched
  • Treatment, which must include detecting any co-occurring mental illness and treating it as well

Families can increase their chances of getting the treatment they need by understanding their right to mental health treatment under state and federal law. A 2006 Ohio law requires healthcare plans to cover certain biologically based mental illnesses, and the 2008 federal Mental Health Parity and Addiction Equity Act established that insurers’ coverage of mental health and substance use disorders must be as thorough as that for medical and surgical care.

Some kinds of plans are exempt from the law but in most cases, healthcare plans can’t put conditions on their mental health and substance use disorder coverage that are any more restrictive than those on medical and surgical coverage.

The Ohio Department of Insurance recently created an excellent toolkit for understanding mental health parity.

When a loved one is experiencing substance misuse and mental illness at the same time, we can’t hope to fix one without addressing the other.

Press play below to learn more with Lori Criss of Ohio Department of Health and Addiction Services discuss the importance of mental health awareness and the significant role it plays in our lives.



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