Comorbid mental disorders and substance use disorders: epidemiology, prevention and treatment

What are the implications for service delivery?

Page last updated: 2003

Comorbidity presents substantial treatment problems — standard interventions are complicated or even excluded in individuals with comorbid disorders. On the one hand comorbid substance use disorders can pose difficulties for treatments that are narrowly defined for specific symptoms, or those treatments may have been developed on pure diagnostic groups and therefore of unknown benefit for comorbid individuals. Conversely, anxiety and depression can complicate the treatment of a substance use disorder. Yet the treatment services have to deal with disproportionate numbers of comorbid individuals who are over-represented in treatment settings. Staff are trained within the one discipline and rarely have the skills to recognise, let alone deal with, these more complex presentations.

The challenges outlined in this introduction are those addressed in the following chapters by experts in both the drug and alcohol and mental health fields.