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Substance abuse greatly impacts many, if not all, aspects of an individual's life and is typically linked to behavioral, economic, educational, legal, medical, psychological, public health, and social problems. In the past 10-15 years, attention has been increasingly focused on the correlation between psychiatric disorders and substance abuse. Numerous researchers have discovered a strong contemporaneous relationship between psychiatric disorders and substance abuse in both clinical and general population samples of adolescents (Boyle and Offord, 1991; Brook and Brook, 1990; Kessler et al., 1996) and adults (Breslau et al., 1993; Helzer and Pryzbeck, 1998; Kessler et al., 1996). For example, Kessler et al. (1996) found that psychiatric disorders generally preceded the development of addictive disorders in individuals with both co-occurring psychiatric disorders and substance abuse. Other researchers have found a correlation between the diagnosis of behavior or psychiatric disorder and the frequency of alcohol and tobacco use (Boyle and Offord, 1991).
This paper analyzes and examines substance abuse and substance dependence. In Part II, the general causes and effects of substance abuse and substance dependence are addressed. Part III examines the psychiatric aspects of substance abuse. In Part IV, the relationship between substance abuse and crime is outlined. Finally, this paper concludes with a way to improve the awareness and treatment of psychiatric disorders and substance abuse.
II. GENERAL CAUSES AND EFFECTS OF SUBSTANCE ABUSE
Substance abuse is a pattern of use that displays many adverse results from continual use of a substance. (Carson-DeWitt). Characteristics of substance abuse include a failure to satisfactorily meet family, school, or work obligations; continual use under situations that present a hazard (i.e., driving an automobile); financial difficulties resulting from increased money spent to fuel the addiction; and legal problems such as arrests. (Carson-DeWitt). Use of the drug persists despite personal problems caused by the effects of the substance on an individual and/or others.
Substance dependence is a group of behavioral and physiological symptoms that indicate the continual, compulsive use of a substance in self-administered doses despite the problems related to its use. (Carson-DeWitt). Increased amounts are needed to achieve the desired effect or level of intoxication so an individual's tolerance for the drug or substance rises. Withdrawal is a...
(Carson-DeWitt).
While there is no single cause of substance abuse, researchers are increasingly convinced that some individuals possess a genetic predisposition that may impact the development of addictive behaviors. (Carson-DeWitt). One theory is that a particular nerve pathway in the brain (dubbed the "Amesolimbic reward pathway") contains specific chemical traits that may increase the likelihood that substance use will ultimately lead to substance addiction. (Carson-DeWitt). However, other social factors are involved such as family difficulties and peer pressure. Primary mood disorders such as bipolar and manic depression, personality disorders, and the role of learned behavior may also influence the likelihood that an individual will become a substance abuser. (Carson-DeWitt).
III. PSYCHOLOGICAL ASPECTS OF SUBSTANCE ABUSE
There are several distinct psychiatric aspects of substance abuse. For example, an individual who is depressed and/or otherwise psychologically trouble may begin abusing substances and fall into a downward spiral, with the ultimate end being that he or she drops out (or flunks out) of school and/or engages in fighting and violence in relationships. In addition, substance abuse may lead to financial problems (i.e., bankruptcy filing due to increased money spent on addiction) and/or legal problems (ranging from driving under the influence to the commission of crimes designed to obtain the money necessary to support an expensive drug habit). Finally, an individual who is a substance abuser may wind up losing a series of jobs because he or she is unable to complete the work in a satisfactory manner.
Several theories may explain the correlation between psychiatric disorders and substance abuse. First, psychiatric disorders may create difficulties in parental monitoring and in the parent-child attachment relation, or in peer relationships, which may, in turn, lead to substance abuse. (Brook, 1998). In addition, since internalizing disorders may predict higher levels of future substance abuse, it may be that drug use is one way for adolescents and adults to cope with intrapersonal distress (Glass, 1990; Khantzian, 1985; Neighbors et al., 1992). Research has also shown that depression and earlier intrapsychic distress (depressive symptoms) was discovered to be associated with later illicit drug use…
Seven out of every ten men and eight out of every ten women in the criminal justice system used drugs with some regularity prior to entering the criminal justice system (Lipton 1998, pp. 106-109). With that many people in prisons that are using drugs and the connection between drug use and crime, then if there was any success at all it seems like it would be a step in the right direction. Many of these offenders will not seek any type of reform when they are in the community. They feel that they do not have the time to commit to go through a program of rehabilitation. It makes sense, then, that they should receive treatment while in prison because one thing they have plenty of is time.
In most therapeutic communities, recovered drug users are placed in a therapeutic environment, isolated from the general prison population. This is due to the fact that if they live with the general population, it is much harder to break away from old habits. The primary clinical staff is usually made up of former substance abusers that at one time were rehabilitated in therapeutic communities. The perspective of the treatment is that the problem is with the whole person and not the drug. The addiction is a symptom and not the core of the disorder.
The primary goal is to change patterns of behavior, thinking,
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