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Comorbidity is a topic that our stakeholderspatients, family members, health care professionals, and othersfrequently ask about. It is also a topic about which we have insufficient information, and so it remains a research priority for NIDA. This Research Report provides information on the state of the science in this area. And although a variety of diseases commonly co-occur with drug abuse and addiction (e.g. HIV, hepatitis C, cancer, cardiovascular disease), this report focuses only on the comorbidity of drug use disorders and other mental illnesses.*
To help explain this comorbidity, we need to first recognize that drug addiction is a mental illness. It is a complex brain disease characterized by compulsive, at times uncontrollable drug craving, seeking, and use despite devastating consequences behaviors that stem from drug-induced changes in brain structure and function. These changes occur in some of the same brain areas that are disrupted in various other mental disorders, such as depression, anxiety, or schizophrenia. It is therefore not surprising that population surveys show a high rate of co-occurrence, or comorbidity, between drug addiction and other mental illnesses. Even though we cannot always prove a connection or causality, we do know that certain mental disorders are established risk factors for subsequent drug abuseand vice versa.
It is often difficult to disentangle the overlapping symptoms of drug addiction and other mental illnesses, making diagnosis and treatment complex. Correct diagnosis is critical to ensuring appropriate and effective treatment. Ignorance of or failure to treat a comorbid disorder can jeopardize a patients chance of success. We hope that our enhanced understanding of the common genetic, environmental, and neural bases of these disordersand the dissemination of this informationwill lead to improved treatments for comorbidity and will diminish the social stigma that makes patients reluctant to seek the treatment they need.
Nora D. Volkow, M.D. Director National Institute on Drug Abuse
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