Comorbidity Discussions in the Addiction and Mental Health Circles

An important topic of discussions among Patients, families and healthcare professionals has been comorbidity of ADHD and drug abuse and the causes of each and their effects on each other. Comorbidity is described as when two disorders or illnesses occur in the same person, simultaneously or sequentially. Also, interactions between the illnesses that affect the course and prognosis of two simultaneous or sequential disorders also are described as comorbidity.

It has been known for years that there is co-occurring illnesses with drug addiction. In many cases drug and alcohol addicts suffer from HIV, hepatitis C, cardiovascular disease and even cancer. It is not to say that drug addiction or alcoholism brings about, for example, HIV. But the fact that HIV is present in many hardcore drug addicts and abusers compels the health care professional to look for the other when one of these illnesses is present.

NIDA has put disease comorbidity on its top research priority, hoping to provide the needed information to states and the science community in general. In one report, NIDA has specifically focused on comorbidity of drug use disorders (abuse or dependence) and other mental illnesses.

One such area that the presence of comorbidity has been documented is in the sequential occurrence of childhood ADHD and the presence of drug abuse later in life. Even though studies have pointed to comorbidity of childhood ADHD and drug abuse, many suggest that only a subset of children with ADHD will develop drug addiction in later life.

In order to highlight the importance of understanding comorbidity, one can point to the fact that, for example, once comorbidity between ADHD and drug use disorders is established, then the next step could be determining if  effective treatment of ADHD at childhood will result in prevention of subsequent drug abuse and its associated behavioral problems later in life.

Another benefit in understanding illnesses comorbidity is answering the question of whether high prevalence of comorbidity between two disorders means that one caused the other, even if one appeared first. In case of drug abuse and ADHD, it was proven that neither is the cause of the other.

Another example is comorbid drug use disorder and mental illness. Once this relation was established, the drug and alcohol treatment centers included both disorders in their treatment plans.

In conclusion, understanding the comorbidity of diseases such as addiction and mental health issues provide us with important clues to understand those diseases and to make advances in treating them.

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