Heroin abuse is a problem with potentially fatal consequences. The risk of mortality does not just lie in the many physical problems that can result from abusing heroin over a long period of time. And adding the risk of fatal overdose into the picture doesn’t completely account for the many people who do not survive abusing this illegal street drug. Heroin users are also much more likely to commit suicide, and abuse of drugs or alcohol is the biggest risk factor for suicide after depression. There were 16,651 known opioid overdoses in the year 2010, and 10 percent of them were determined to be suicides. The total number of fatal suicide attempts in the U.S. in 2010 was 38,364. However, it would not be entirely accurate to say that X number of suicides were primarily due to the presence of major depression while X number were primarily attributable to heroin use. The reality is that many people who suffer from drug or alcohol addiction are dealing with other psychiatric problems. Depression, anxiety disorders, bipolar disorder and schizophrenia are all common mental health problems among people with addictions. In total, about 30 percent of people who regularly abuse drugs have an underlying mental illness. It usually takes a variety of adverse factors to bring someone to the state of hopelessness present in most people who commit suicide. Many heroin users who commit suicide through overdoses have also been living with comorbid mental illness.
Patients Face Similar Stigma
Substance abuse and mental illness have other similarities besides increasing a person’s risk of suicide. Both types of illness face a considerable amount of social stigma, which can be an obstacle for people when they consider seeking treatment. The stigma surrounding mental illness often means that people are not educated about the nature of various disorders and the symptoms associated with them. Many people who suffer from illnesses like anxiety or depression do not realize that they have a diagnosable and (more or less) treatable condition. Regular wellness and preventive care increases the likelihood that their physicians may identify a problem, but many people do not have access to such regular care. Many people with substance use disorders also fail to realize that they have a problem. And even when people suffering from addiction or mental illness do recognize their illness, the social stigma around these conditions makes many hesitate to get treatment. Some attempt to deal with the problem themselves; “self-medication” with drugs or alcohol in people with psychiatric distress is a common way in which mental illness gives rise to substance abuse. Not only can mental illness lead to substance abuse, substance abuse can exacerbate mental illness. Intoxication from either drugs or alcohol can sometimes intensify symptoms of existing mental illness (e.g., leading individuals with depression to feel suicidal). Substance withdrawal can also lead to intensifying symptoms that could trigger suicide attempts, panic attacks or other serious consequences. There is little evidence that substance abuse can be the primary cause of mental illness. However, it can in some cases trigger latent mental illness. Drug use has been known to trigger the first episode of psychosis, after which further psychotic episodes may arise.
Comorbidity Creates Complications with Treatment
The presence of both heroin addiction and mental illness makes treatment more complicated for both. People who continue to use heroin while receiving treatment for mental illness are much less likely to reliably attend counseling sessions, take prescribed medications and otherwise comply with a treatment regimen. On the other hand, mental illness is sometimes unrecognized and/or untreated in people with drug or alcohol addictions. It can be very difficult to accurately diagnose underlying mental illness when substance addiction is present. In some cases, the addiction may be seen as the primary concern, and any comorbid mental illness seen to be of secondary importance. However, unaddressed mental illness makes it much less likely that patients will be able to maintain long-term sobriety.