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Mental Health/Substance Use – Causes


Substance use in the general population

A longitudinal survey conducted in 34,653 people across the United States reported that childhood adversity (all measures) and family history (first-degree relative) of drug or alcohol problems were associated with an increased risk of drug use.1

  • When the models were adjusted for childhood adversity and a family history of addiction, the following factors were associated with new-onset drug use:
    • a pre-existing mood disorder
    • personality disorder
    • previous nicotine dependence
    • alcohol abuse or dependence

Mental illness and substance use among HIV-infected people

  • Mental health problems occur in 20–25% of people living with HIV (PLWHIV) who inject drugs2
  • Some injecting drug users (IDUs) may have a long history of mental illness, without confirmed diagnosis or treatment2
  • The frequency of major depression and suicide in HIV-positive IDUs is higher than the elevated rates associated with advanced HIV infection and AIDS2
  • Mental conditions may result from, or be exacerbated by, the use of substances such as opioids, cocaine and alcohol2
  • Opioids, cocaine and alcohol may subsequently be used as self-medication for symptoms of mental illness2
  • People who are alcohol dependent have higher rates of comorbidity with other psychiatric disorders, particularly depression, anxiety, post-traumatic stress disorder, psychosis and drug misuse, than people in the general population3


  1. Harrington M, Robinson J, Bolton S-L, Sareen J, Bolton J. A longitudinal study of risk factors for incident drug use in adults: findings form a representative sample of the US population. Can J Psychiatry 2011;56(11):686–695.
  2. World Health Organization. HIV/AIDS Treatment and Care. Clinical Protocols for the WHO European Region, 2007.  Accessed 25 October 2011.
  3. National Collaborating Centre for Mental Health. Alcohol-use disorders. Alcohol dependence and harmful alcohol use: NICE guidance.  Accessed 30 October 2011.