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Self-Medicating Anxiety Disorders Increases Risk of Future Substance Abuse Problems

Those diagnosed with anxiety disorders who attempt to treat their symptoms by self-medicating with alcohol or drugs are not only exacerbating their condition but are also increasing their risk of future chronic substance abuse disorders, according to a new study.

Researchers from the Departments of Psychiatry and Psychology at the University of Manitoba in Winnipeg, Canada caution that anxiety patients who believe they are alleviating their pain through using drugs and alcohol—although it may seem to bring them temporary relief—are creating hazardous risk factors for their long-term health. After conducting a three-year cohort study on patients with anxiety disorders, the researchers found that self-medication through alcohol and drug use was actually self-defeating as it worsened anxiety symptoms, especially panic, and led to an increased prevalence of substance abuse disorders among this population.

Lead researcher Jennifer Robinson, MA, presented the findings of her team’s study at the Canadian Psychiatric Association 60th Annual Conference in late September. In terms of clinical research, the relationship between anxiety disorders and substance use has not been extensively studied, although the comorbidity of these disorders is well known among clinicians and the general public. The researchers’ latest study adds evidence to this commonly assumed observation and can help clinicians become more aware of how to reach their patients’ mental health needs based on the identified link between self-medication and anxiety disorders.

For their study, the researchers used the National Epidemiologic Survey on Alcohol and Related Conditions to gather long-term data on 34,653 different American adult patients. Among this population, the researchers categorized those individuals diagnosed with an anxiety disorder at baseline into a subgroup. Additionally, these individuals did not report having a substance abuse disorder at the start of the study. The researchers sought to discover whether the practice of self-medicating anxiety symptoms with drug use (including prescription drug misuse, illicit drug use, or alcohol abuse) predicted the development of a substance abuse disorder later on for individuals in this subgroup.

In their analysis, the researchers controlled such variable factors as age, gender, ethnicity, education, income, marital status, region, as well as preexisting mood or personality disorders and lifetime substance use. Three years following baseline, the researchers found that individuals who reported self-medicating their anxiety symptoms with drug use were at least four times likelier to develop a drug abuse problem, and more than twice as likely to develop a drug dependency as those who did not self-medicate. Self-medication involving alcohol use was related to a twofold increase for developing an alcohol abuse problem and more than threefold increase for developing alcohol dependency. Furthermore, the researchers found that many of those who were self-medicating through drug use were also using alcohol. Moderate alcohol use at baseline, although initially considered safe, was found to be a risk factor for developing an alcohol-related problem later on, according to researchers.

If these patients’ anxiety symptoms were adequately treated with sustained intervention, then patients would possibly be less inclined to resort to self-medicated substance use to appease their anxiety, the researchers suggest.

The researchers hope that their latest findings will encourage clinicians to consider substance use by their patients as a possible sign of an underlying anxiety disorder, and to become more proactive when it comes to detecting and treating these mental health issues among vulnerable individuals. Although further investigation is needed, the researchers propose that those patients with anxiety disorders who choose to self-medicate with substance use are actually less likely to seek professional treatment for their problems, making early detection and intervention key to their recovery.

Source: Medscape, Kate Johnson, Risk for Future Substance Abuse for Anxious Patients Who Self-Medicate, October 1, 2010

Posted on October 11th, 2010

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