October 9, 2023

World Mental Health Day: The impact of alcohol and other drugs

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Each year, October 10 is marked as World Mental Health Day, a time to raise awareness and organise efforts to support mental health.1

This year's theme: Mental health is a universal human right, is about improving knowledge, raising awareness and driving actions that promote and protect everyone’s right to mental health.2

Here, we look at the relationship between mental health and alcohol and other drugs (AOD).

Mental health and alcohol and other drugs

Not everyone with a mental health condition experiences an issue with AOD.

And not everyone who drinks, or uses drugs, will experience mental ill health.

But, around half of the people accessing AOD treatment in Australia also have a mental health condition.3-5

And in 2019, those diagnosed or treated for a mental health condition were 20% more likely to drink at risky levels than those who weren’t.6

People with a mental health condition were also 1.7 times more likely to have used illicit drugs in the past year.6

What’s the relationship between mental health and alcohol and other drugs?

The relationship between AOD and mental health can be complex, and it can go both ways.

Drinking or using drugs may affect a person’s mental health symptoms; and a person’s mental health symptoms can affect their AOD use.

For example, someone experiencing symptoms of depression or anxiety may drink to cope with those feelings. But over time, drinking can contribute to making those symptoms worse. The person may also develop an alcohol dependence.7, 8

Others might experience a dependence on AOD initially that causes issues in their personal and work life, which could result in the end of a relationship or loss of a job. Negative life events may then lead to symptoms of anxiety and depression, alongside the existing AOD dependence.7, 8

It’s often difficult to say which of these comes first – mental ill health or AOD use. But we do know they can influence each other.

What are co-occurring mental health and AOD conditions?

This is when someone is experiencing an AOD and mental health condition at the same time.

This is also sometimes called ‘dual diagnosis’ or ‘comorbidity’.

The type of diagnosis and its severity can vary from person to person, as can the impact it has on a person’s life.9

There is no single factor that guarantees a person will - or won’t - experience a co-occuring condition. It is the result of a combination of highly personal and complex experiences.7

Co-occurring mental health and AOD conditions affect each person differently.

Co-occurring conditions and other complex needs

Many people who experience co-occurring conditions may also have a number of overlapping needs relating to their physical health and social, financial, or legal situations.5

While each individual’s experiences and needs will be different, most people will likely need support from a number of different services.9

People with co-occurring conditions can face other harms, including:

  • poorer physical and mental health
  • risk of self-harm and suicide
  • increased risk of homelessness
  • increased stress in relationships.5

The impact of stigma

Stigma is where a person or group of people are seen as ‘other’, and involves the judgement, labelling, and stereotyping of difference.

People who experience mental ill health, and/or an AOD dependence often face stigma and discrimination.10 For those with a co-occurring condition this stigma is increased.11

Stigma often leads to:

  • people avoiding treatment, support or other services
  • feelings of shame, anger, rejection, worthlessness and hopelessness
  • worse overall wellbeing.12, 13

Treatment and care for mental health and alcohol and other drug conditions

There is no single definition of success for treatment of a mental health condition or AOD dependency.

Each person is the expert of their own goals and can determine what recovery means for them.14

For example, someone who uses alcohol or drugs may decide that abstinence is not what they want to achieve. Instead, they might aim to cut back their use or reduce their risk of harm.

Others may seek professional help and require the support of multiple organisations.

When this occurs, services that adopt a ‘no wrong door’ approach to treatment can help people navigate the network of services and get the support they want.

‘No wrong door’ means that no matter how a person comes into the health care system, they are guided to treatment that is appropriate for them and provided with further support for other needs they may have.

The Victorian Government is working to provide integrated treatment for people with co-occuring conditions, read more on the Vic Gov website.

Find out more

Help and support

  1. World Health Organization. World Mental Health Day [19.09.2023].
  2. World Health Organization. World Mental Health Day 2023 [19.09.2023].
  3. Kingston REF, Marel C, Mills KL.A systematic review of the prevalence of comorbid mental health disorders in people presenting for substance use treatment in Australia. Drug and Alcohol Review [Internet]. 2017 [22.09.2023]; 36(4):[527-39 pp.].
  4. Fisher A, Mills K, Teesson M, Marel C.Shared decision-making among people with problematic alcohol/other drug use and co-occurring mental health conditions: A systematic review. Drug and Alcohol Review [Internet]. 2021 [21.09.2023]; 40(2):[307-24 pp.].
  5. Marel C, Siedlecka E, Fisher A, Gournay K, Deady M, Baker A, et al. Guidelines on the management of co-occurring alcohol and other drug and mental health conditions in alcohol and other drug treatment settings (3rd edition)2022 [22.09.2023].
  6. Australian Institute of Health and Welfare. National Drug Strategy Household Survey 2019. Canberra Australian Institute of Health and Welfare; 2020 [22.09.2023].
  7. McHugh RK, Weiss RD. Alcohol Use Disorder and Depressive Disorders. Alcohol Research: Current Reviews [Internet]. 2019 [22.09.2023]; 40(1).
  8. Anker JJ, Kushner MG.Co-Occurring Alcohol Use Disorder and Anxiety. Alcohol Research: Current Reviews [Internet]. 2019 [22.09.2023]; 40(1).
  9. Yule AM, Kelly JF. Integrating Treatment for Co-Occurring Mental Health Conditions. Alcohol Research: Current Reviews [Internet]. 2019 [22.09.2023]; 40(1).
  10. Room R. Stigma, social inequality and alcohol and drug use. Drug and Alcohol Review [Internet]. 2005 [06.09.2023]; 24(2):[143-55 pp.].
  11. Department of Health Victoria. Integrated treatment, care and support for people with co-occurring mental illness and substance use or addiction. Guidance for Victorian mental health and wellbeing and alcohol and other drug services [Internet]. 2022 [22.09.2023].
  12. Wogen J, Restrepo MT. Human Rights, Stigma, and Substance Use. Health and Human Rights [Internet]. 2020 [06.09.2023]; 22(1):[51-60 pp.].
  13. The Cabinet Office NSW Government. Special Commission of Inquiry into the Drug 'Ice' 2020 [08.09.2023].
  14. De Ruysscher C, Vandevelde S, Vanderplasschen W, De Maeyer J, Vanheule S. The Concept of Recovery as Experienced by Persons with Dual Diagnosis: A Systematic Review of Qualitative Research From a First-Person Perspective. Journal of Dual Diagnosis [Internet]. 2017 [22.09.2023]; 13(4):[264-79 pp.].

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