Understanding the Diagnosis and Treatment of Psychological Disorders

An overview of common mental health conditions, their diagnosis, and treatment approaches, with a focus on co-occurring substance use disorders.

Introduction

Psychological disorders are conditions that impact a person’s thinking, feeling, behavior, or mood. These conditions can be occasional or long-lasting (chronic) and affect someone’s ability to relate to others and function each day. Understanding the complexities of psychological disorders is crucial for effective diagnosis and treatment. This article provides an overview of various mental health conditions, exploring their connections with substance use disorders, diagnostic approaches, and available treatments. Recognizing the nuances in diagnosis and treatment is essential for healthcare professionals, educators, and anyone seeking to deepen their knowledge of mental health.

The Interplay Between Substance Use Disorders and Mental Illness

It’s widely observed that individuals grappling with substance use disorders (SUDs) frequently face concurrent mental health disorders, and conversely. National surveys indicate a significant overlap, with approximately half of individuals experiencing a mental illness during their lifetime also encountering a substance use disorder, and vice versa. This co-occurrence, known as comorbidity, is not merely coincidental; these conditions often interact, influencing the trajectory and prognosis of both. Research highlights that over 60% of adolescents in community-based SUD treatment programs also meet the criteria for another mental illness, emphasizing the vulnerability of youth.

High comorbidity rates are evident between SUDs and anxiety disorders, encompassing generalized anxiety disorder, panic disorder, and post-traumatic stress disorder (PTSD). Furthermore, SUDs are prevalent alongside mood disorders such as depression and bipolar disorder, attention-deficit hyperactivity disorder (ADHD), psychotic illnesses like schizophrenia, borderline personality disorder, and antisocial personality disorder. Notably, patients with schizophrenia exhibit higher rates of alcohol, tobacco, and drug use disorders compared to the general population. As illustrated in Figure 1, this overlap is particularly pronounced in individuals with serious mental illness (SMI). SMI, defined as a diagnosable mental, behavioral, or emotional disorder causing serious functional impairment, affects approximately 1 in 4 individuals with SMI who also have an SUD.

Figure 1: Visual representation of the significant overlap between serious mental illness and substance use disorders, highlighting the prevalence of co-occurring conditions.

Data from representative samples suggest that individuals with mental, personality, and substance use disorders face an elevated risk of nonmedical prescription opioid use. Research indicates that a substantial percentage of people in SUD treatment for nonmedical prescription painkiller use present with mental health disorder diagnoses or symptoms, particularly depression and anxiety, further underscoring the intricate relationship between these conditions.

Youth: A Critical Period

While substance use and addiction can manifest at any age, adolescence is a typical onset period, coinciding with the emergence of initial mental illness signs. Comorbid disorders are also prevalent among youth, requiring coordinated support during the transition to young adulthood (ages 18-25). This phase often involves navigating significant life changes in education, employment, and relationships, making integrated support crucial.

Early Drug Use and Mental Health Issues Increase Later Risks

The adolescent brain is still developing, especially the circuits governing executive functions like decision-making and impulse control. This developmental stage heightens vulnerability to drug use and SUD development. Early drug use is a strong predictor of later SUDs and may also increase the risk of other mental illnesses. However, it is crucial to note that this association doesn’t automatically imply causation and may reflect shared risk factors, including genetics, psychosocial experiences, and environmental factors. For instance, frequent adolescent marijuana use can elevate the risk of adult psychosis in individuals with specific gene variants.

Conversely, childhood or adolescent mental disorders can increase the risk of later substance use and SUD development. Some studies suggest mental illness often precedes SUD, indicating that early and accurate diagnosis of youth mental illness could mitigate comorbidity. For example, adolescent-onset bipolar disorder has been linked to a higher risk of subsequent SUD compared to adult-onset bipolar disorder. Similarly, research suggests youth may develop internalizing disorders like depression and anxiety before SUDs.

The Impact of Untreated Childhood ADHD

Numerous studies link untreated ADHD in youth to an increased risk of SUDs. While some research suggests this link is stronger in those with comorbid conduct disorders, the overall association highlights the importance of effective ADHD treatment in potentially preventing later drug problems. Treatment for childhood ADHD often involves stimulant medications, raising concerns about addiction potential. However, current research suggests ADHD medications do not elevate SUD risk in children with ADHD when properly managed and combined with behavioral interventions, family education, and counseling.

Unraveling the Comorbidity: Why Substance Use Disorders and Mental Illnesses Co-Occur

The high comorbidity between SUDs and other mental illnesses doesn’t automatically imply a cause-and-effect relationship, even if one condition emerges before the other. Establishing causality is complex due to factors like subclinical symptoms, recall bias, and shared risk factors.

Three primary pathways contribute to this comorbidity:

1. Shared Risk Factors: Genetic and epigenetic vulnerabilities, affected brain regions, and environmental influences.
2. Mental Illness as a Contributor to SUD: Self-medication attempts.
3. SUD as a Contributor to Mental Illness: Substance-induced changes in brain structure and function.

1. Shared Risk Factors: Common Ground for Mental Illness and SUDs

Both SUDs and mental illnesses stem from overlapping factors:

• Genetic Vulnerabilities: Genetics contribute significantly (40-60%) to SUD vulnerability. Research explores genes predisposing individuals to both SUDs and mental illnesses. Most vulnerability arises from complex interactions among multiple genes and gene-environment interactions. For instance, a specific gene variant combined with adolescent marijuana use can increase psychosis risk in adulthood. Genes can act directly, influencing drug response, or indirectly, affecting stress response and risk-taking behaviors. Neurotransmitters like dopamine and serotonin, impacted by drugs and dysregulated in mental illness, are also influenced by genes.

• Epigenetic Influences: Epigenetics examines changes in gene activity regulation not dependent on DNA sequence. Environmental factors like stress, trauma, or drug exposure can induce stable changes in gene expression, altering neural circuit function and behavior. These epigenetic modifications can be long-term, even heritable, and may be reversible with interventions. Developmental stage significantly influences epigenetic impact, with environmental factors interacting with genetic vulnerability during specific periods to increase mental illness and addiction risk. Animal studies illustrate how maternal diet and care quality can epigenetically influence offspring’s neurotransmission and stress response. Understanding these mechanisms is crucial for developing improved treatment strategies.

• Brain Region Involvement: Many brain areas are implicated in both SUDs and mental illnesses. Circuits mediating reward, decision-making, impulse control, and emotions are affected by addictive substances and disrupted in SUDs, depression, schizophrenia, and other psychiatric disorders. Neurotransmitter systems such as dopamine, serotonin, glutamate, GABA, and norepinephrine are also implicated in both SUDs and mental disorders.

• Environmental Influences: Numerous environmental factors increase the risk for both SUDs and mental illness, including chronic stress, trauma, and adverse childhood experiences. Many of these factors are modifiable, making prevention interventions effective in reducing both SUDs and mental illness.

Stress: A Common Neurobiological Link

Stress is a well-established risk factor for mental disorders, providing a neurobiological link between SUDs and mental disorders. Stress also significantly contributes to drug use relapse. The hypothalamic-pituitary-adrenal (HPA) axis mediates stress responses, influencing brain circuits controlling motivation. High stress levels reduce prefrontal cortex activity and increase striatum responsivity, impairing behavioral control and increasing impulsivity. Early life and chronic stress can cause long-term HPA axis alterations, affecting limbic brain circuits involved in motivation, learning, and adaptation, which are often impaired in SUDs and other mental illnesses. Dopamine pathways are implicated in how stress increases SUD vulnerability, with HPA axis hyperactivity altering dopamine signaling and enhancing drug reinforcement. Substance use itself alters neurotransmitter systems involved in stress response, creating a cycle linking stress to escalating drug use and relapse. Stress-reduction treatments like mindfulness-based stress reduction have shown benefits in reducing depression, anxiety, and substance use.

Trauma and Adverse Childhood Experiences

Traumatized individuals face a significantly elevated risk for drug use and SUDs, with co-occurrence linked to poorer treatment outcomes. PTSD sufferers may use substances to alleviate anxiety and avoid trauma-related issues. The connection between SUDs and PTSD is particularly concerning for military personnel returning from conflict zones. Data indicates that a significant percentage of veterans experience untreated SUDs and serious psychological distress, with a substantial proportion of veterans with PTSD also having a co-occurring SUD.

2. Mental Illness Contributing to Substance Use and Addiction

Certain mental disorders are established risk factors for SUD development. The self-medication hypothesis suggests individuals with mental disorders, even subclinical ones, may use drugs to alleviate symptoms. While some drugs might temporarily reduce mental illness symptoms, they can also worsen symptoms in the long run. Cocaine use, for example, can exacerbate bipolar disorder symptoms. Mental illness-related brain activity changes may enhance substance rewarding effects, reduce awareness of negative consequences, or alleviate unpleasant symptoms, increasing vulnerability to problematic substance use. Neuroimaging suggests that ADHD-related brain circuit changes, also linked to drug cravings, may partially explain why SUD patients with comorbid ADHD report greater cravings.

3. Substance Use and Addiction Contributing to Mental Illness Development

Substance use can induce changes in brain areas also disrupted in mental disorders like schizophrenia, anxiety, mood, or impulse-control disorders. Drug use preceding mental illness onset may trigger brain structure and function changes, kindling an underlying predisposition to mental illness.

Spotlight: Comorbidity Between Mental Illness and Tobacco Use in Schizophrenia

Data reveals a strong association between mental illness, particularly depression and schizophrenia, and tobacco product use. People with schizophrenia have the highest smoking prevalence, significantly exceeding the general population. Smoking might reduce or help manage symptoms like poor concentration, low mood, and stress, potentially explaining why individuals with mental illnesses are less likely to quit smoking. Unfortunately, high smoking rates and quitting difficulties in schizophrenia contribute to higher cardiovascular disease prevalence and reduced life expectancy.

Research on Schizophrenia and Nicotine

Research explores how nicotine and schizophrenia impact the brain, offering explanations for high smoking rates in schizophrenia. Brain circuit abnormalities may predispose individuals to schizophrenia and enhance nicotine’s rewarding effects or impair quitting ability. This aligns with observations that nicotine and clozapine (medication acting on nicotinic acetylcholine receptors) can treat schizophrenia and aid smoking cessation. The dorsal anterior cingulate cortex (dACC), involved in decision-making, attention, and impulse control, shows weaker connections to other brain areas in schizophrenia patients, regardless of smoking status, and also in severe nicotine use disorder, suggesting shared circuit impairment. Lower levels of nicotinic acetylcholine receptors are a hallmark of schizophrenia, impacting cognition and memory. Researchers are developing medications stimulating these receptors to counter cognitive impairments without nicotine’s addictive potential or smoking’s health risks. Understanding nicotine use in schizophrenia can inform new treatments for both conditions. While new treatments are needed, individuals with comorbid schizophrenia and nicotine dependence can quit smoking with proper support without worsening mental health. Bupropion and motivational incentives have shown promise in smoking cessation for this population, while varenicline requires further research due to potential psychiatric symptom worsening.

Diagnostic Approaches for Co-occurring Disorders

The high comorbidity of SUDs and mental illnesses necessitates an integrated intervention approach. This approach concurrently identifies and evaluates each disorder, providing tailored treatment for each patient’s unique combination of conditions. Enhanced understanding of shared genetic, neural, and environmental bases can lead to improved treatments and reduce social stigma, encouraging patients to seek necessary care.

Diagnosing and treating comorbid SUDs and mental illness is complex due to overlapping symptoms. Comprehensive assessment tools are crucial to minimize missed diagnoses. Patients with both SUDs and mental illness often exhibit more persistent, severe, and treatment-resistant symptoms compared to those with a single disorder.

Screening for SUDs should be routine for patients entering psychiatric illness treatment, and vice versa. Accurate diagnosis is complicated by similarities between drug-related symptoms (e.g., withdrawal) and mental disorder symptoms. Observing patients after a period of abstinence may be necessary to differentiate between substance effects and comorbid mental disorder symptoms, leading to more accurate diagnoses and targeted treatment.

Polysubstance Use and Comorbid Substance Use Disorders

Polysubstance use is common, with many individuals developing multiple comorbid SUDs (Table 1). For example, individuals with heroin use disorder frequently have nicotine dependence, alcohol use disorder, and cocaine use disorder. Similarly, cocaine use disorder often co-occurs with alcohol, nicotine, and marijuana use disorders. Multiple substance use further complicates diagnosis and treatment of comorbid SUDs and mental illness.

Table 1: Prevalence of comorbid substance use disorders, illustrating the common co-occurrence of multiple substance dependencies.

Treatment Strategies for Comorbid Substance Use Disorder and Mental Health Conditions

Integrated treatment approaches for comorbid SUDs and mental illness consistently outperform separate treatments. These integrated approaches often incorporate cognitive behavioral therapy (CBT) strategies to enhance interpersonal and coping skills, alongside motivational and functional recovery support.

Patients with comorbid disorders often demonstrate poorer treatment adherence and higher dropout rates, negatively impacting outcomes. However, ongoing research continuously advances treatment options for comorbidity. Collaboration between clinical providers and organizations offering supportive services for homelessness, physical health, vocational skills, and legal issues is crucial. Effective communication, including co-location, shared treatment plans, and case review meetings, is vital for service integration. Support and education for staff on co-occurring disorders are also necessary.

Tailoring Treatment for Youth

Given the frequent onset of mental illness and SUDs during adolescence and the increased risk of severe adult problems for those with earlier onset, SUD programs for adolescents should screen for and treat comorbid mental disorders. Evidence-based prevention interventions can significantly mitigate mental, emotional, and behavioral problems in youth, reducing risk factors for SUDs and other mental illnesses. These interventions can address factors like parental unemployment, maternal depression, child abuse, poor supervision, deviant peers, deprivation, poor schools, trauma, limited healthcare, and unsafe environments. Strengthening protective factors, such as supportive family, school, and community environments, is also crucial for enhancing well-being and providing tools for emotional processing and avoiding negative behaviors.

In addition to general comorbidity treatments, specific interventions effective for children and adolescents include:

Medications

Effective medications exist for treating opioid, alcohol, and nicotine use disorders and alleviating symptoms of many other mental disorders. While most haven’t been extensively studied in comorbid populations, some can address multiple problems. For example, bupropion treats depression and nicotine dependence.

Table 2: Overview of pharmacotherapies commonly used in the treatment of alcohol, nicotine, and opioid use disorders.

Behavioral Therapies

Behavioral therapies, alone or combined with medications, are foundational for long-term success in treating SUDs and mental illnesses. Several strategies show promise for specific comorbid conditions. Examples include:

• Family Therapy: Brief strategic family therapy and multidimensional family therapy are effective for adolescents with SUDs and co-occurring problems, engaging families in treatment and addressing multiple factors contributing to substance use.

• Dialectical Behavior Therapy (DBT): DBT effectively treats comorbid borderline personality disorder and SUDs, focusing on emotion regulation and coping skills.

• Assertive Community Treatment (ACT): ACT is beneficial for individuals with severe mental illness and SUDs, providing comprehensive, integrated care within the community.

• Therapeutic Communities (TCs): Modified TCs can effectively treat adolescents with comorbid SUDs and mental health issues, offering a structured environment and peer support.

• Contingency Management (CM): CM, using incentives, can reduce substance use and promote positive behaviors in individuals with serious mental illness and SUDs.

• Integrated Group Therapy: Integrated group therapy addresses both bipolar disorder and alcohol use disorder simultaneously, improving outcomes for both conditions.

• Trauma-Focused Therapies: Trauma-focused therapies like Seeking Safety are crucial for treating comorbid PTSD and SUDs, addressing trauma and substance use in an integrated manner.

• Mobile Health Applications: Emerging technologies like mobile medical applications are showing promise in supporting SUD treatment and potentially addressing comorbid mental health symptoms.

Part 2: Physical Health Comorbidities alongside Substance Use Disorder

Individuals with SUDs frequently experience comorbid chronic physical health conditions, such as chronic pain, cancer, and heart disease. Various substances, including alcohol, heroin, prescription stimulants, methamphetamine, and cocaine, are independently linked to increased cardiovascular and heart disease risk.

Chronic Pain

Chronic pain has a complex relationship with SUDs, particularly opioid misuse and addiction. An estimated 10% of chronic pain patients misuse prescription opioids. Chronic pain and associated emotional distress can disrupt the brain’s stress and reward circuitry, increasing opioid use disorder risk. High rates of opioid misuse and addiction in chronic pain patients necessitate careful pre-treatment screening, education, and ongoing monitoring when opioids are used for pain management.

Tobacco Use

Cigarette smoking is a major driver of physical health comorbidities. It is linked to numerous major health conditions and remains the leading preventable cause of premature disease and death in the U.S. Smoking contributes significantly to lung cancer, other cancers, macular degeneration, diabetes, colorectal and liver cancer, adverse outcomes in cancer patients, tuberculosis, erectile dysfunction, rheumatoid arthritis, inflammation, and impaired immune function. Smoking is also a significant comorbidity among individuals with other SUDs, worsening their physical health problems. A large percentage of individuals in SUD treatment also use tobacco.

Mental Illness as a Link

Physical illnesses not only affect bodily function but can also increase the risk of mental illnesses like depression and anxiety. Depression negatively impacts individuals with chronic physical conditions, reducing quality of life and health management abilities. Comorbid mental illnesses are associated with greater functional impairments and mortality rates related to physical illnesses. Older individuals with chronic physical illnesses may experience isolation and increased substance use. As discussed earlier, mental illness can lead to SUDs and vice versa, suggesting SUDs play a role in linking mental illness and physical health.

Treatment Adherence Challenges

Beyond direct effects, SUDs can indirectly negatively impact medical condition management. Individuals with SUDs are less likely to adhere to treatment plans or medication regimens, worsening their illnesses. Substance use can also diminish the effectiveness of medications for physical conditions.

Infectious Disease Transmission

Substance use increases infectious disease transmission risk, including HIV and hepatitis C virus (HCV). This increased risk is linked to injection drug use and risky sexual behaviors associated with drug use.

Implications for Integrated Healthcare Delivery

Comorbid chronic physical and behavioral health conditions (mental and SUDs) are associated with greater functional impairment and increased healthcare costs. Integrated care is crucial for addressing physical health comorbidities, mirroring the approach for mental illness comorbidities. Recent healthcare delivery system innovations incentivize integrated care models, offering opportunities for primary care, specialist, and behavioral health providers to collaborate, reducing the impact of mental and physical health comorbidities on SUDs and improving overall health outcomes.

Part 3: Substance Use Disorders and HIV: A Critical Connection

Over a million people in the U.S. live with HIV. HIV is transmitted through infected blood and bodily fluids via unprotected sex, shared needles, mother-to-child transmission, and infected blood products. While antiretroviral therapy (ART) is effective, there is no cure for HIV/AIDS. ART reduces viral load, decreasing community transmission. Substance use exacerbates this public health issue at every stage of HIV, from transmission to treatment. Drug use and HIV have been linked since the epidemic’s beginning. Illicit drug use is a major global HIV driver. Intravenous drug use remains a significant transmission risk, accounting for a notable percentage of new HIV diagnoses. Drug use also broadly contributes to HIV spread by increasing risky sexual behavior with infected partners due to impaired judgment and risk-taking.

Drug use and addiction can accelerate HIV progression and its consequences, especially in the brain. Research suggests drug use may increase viral load, accelerate disease progression, and worsen AIDS-related mortality, even with ART adherence. People with SUDs are also less likely to take HIV medication regularly, worsening their illness. While the influence of HIV infection on drug use in humans is unclear, animal studies suggest HIV can infect brain cells, disrupting circuits affected by drug use and addiction. Drugs can facilitate HIV entry into the brain, triggering inflammation and neurotoxin release, leading to chronic neuroinflammation. HIV-induced brain inflammation underlies neurocognitive disorders (NeuroHIV), a common HIV complication. NeuroHIV diagnosis and treatment are challenging due to overlapping symptoms with aging, drug use, addiction, and psychiatric illnesses. New therapies for neurological HIV complications are needed. As people with HIV live longer due to treatment, the virus’s impact on brain aging and neurocognition is a growing concern, with comorbid SUDs potentially exacerbating neurological aging in HIV-infected individuals.

HIV testing and treatment in criminal justice settings benefit inmate health and public health. People with HIV are overrepresented in prisons. Incarcerated individuals with HIV often begin treatment but face care disruption upon release, alongside SUD and mental health challenges. Linking individuals with HIV and SUD history to community HIV, SUD, and mental health services is crucial to reduce recidivism, improve health, prevent infection spread, and prevent relapse.

The Importance of HIV Screening

Reducing HIV transmission relies on viral load suppression through ART. Despite CDC recommendations, HIV testing rates remain suboptimal. Implementing HIV testing at SUD treatment facilities is a strategy to increase testing rates. Analysis of SUD treatment programs reveals that while education and prevention services are common, on-site HIV testing is less prevalent. Expanding rapid HIV testing in drug treatment facilities is crucial for early identification and engagement in comprehensive treatment for both SUDs and HIV. Many insurance providers cover HIV testing without cost-sharing.

Methods for HIV Prevention and Treatment in Individuals with Substance Use Disorders

Research indicates that SUD treatment, sterile syringe programs, community-based outreach, testing, and linkage to comprehensive HIV care are most effective in reducing transmission among drug users. Unique supports are needed for prevention and treatment within this population due to barriers to testing, treatment, and ART adherence.

Pre-exposure prophylaxis (PrEP)

PrEP is a crucial HIV prevention component. High-risk uninfected individuals take daily medication to prevent HIV acquisition. The WHO recommends PrEP for high-risk individuals. Adherence is critical for PrEP effectiveness. Clinical trials show PrEP reduced HIV risk in people who inject drugs, but adherence optimization and integration into SUD treatment are needed. Despite PrEP’s safety and effectiveness, access for injection drug users should be improved.

The Seek, Test, Treat, and Retain (STTR) Model of Care

New HIV infections persist due to contact with individuals unaware of their status or with inadequately suppressed viral load. The STTR model addresses these drivers, particularly considering delays in testing and treatment for drug users. STTR involves outreach to high-risk drug users not recently tested (seeking), HIV testing (testing), ART initiation and monitoring for positives (treating), and retention in care (retaining). Rapid on-site HIV testing in SUD treatment is crucial for early identification and care initiation. However, resources for testing in treatment programs may be limited. Reducing barriers by providing start-up costs, staff training, and addressing staffing needs is crucial for establishing on-site testing. Regular HIV testing for people who inject drugs is cost-effective.

ART has improved survival for people with HIV, including injection drug users, to near non-infected lifespans. Most patients, regardless of injection drug use history, can achieve viral suppression with ART, significantly reducing transmission. This “Treatment as Prevention” approach relies on identifying undiagnosed individuals, linking them to ART treatment, and retaining them in care. Retention is key to achieving viral suppression and preventing transmission. CDC data indicates that a significant percentage of people with HIV do not have viral suppression, highlighting gaps in diagnosis, care engagement, ART prescription, and ART adherence.

Substance Use Disorder Treatment as HIV Prevention

Studies show behavioral treatments like CBT and motivational interviewing reduce drug use and improve ART and HCV medication adherence. SUD treatment in men who have sex with men is associated with reduced drug use and risky behavior, and improved viral load. Addiction pharmacotherapies also reduce HIV risk. Methadone or buprenorphine treatment for opioid use disorder is associated with a significant reduction in HIV infection risk among people who inject drugs. HIV-infected people who inject drugs are more likely to initiate ART when in methadone treatment. Integrated addiction, psychiatric, and HIV care may increase ART adherence and improve health outcomes, considering the high prevalence of mental illness in people who inject drugs.

Achieving an AIDS-Free Generation

Continued research and dissemination of effective HIV prevention and treatment approaches are essential. NIDA’s strategy is based on three key principles: (1) SUDs and HIV are linked beyond injection drug use; (2) SUDs and HIV remain intertwined epidemics; and (3) the STTR approach, especially in high-risk populations, can reduce viral load and HIV incidence, improving outcomes. Implementing these evidence-based strategies will advance the goal of an “AIDS-free generation.”

Part 4: Barriers to Comprehensive Treatment for Individuals with Co-Occurring Disorders

Despite evidence supporting integrated therapy for comorbidity, only a small percentage of SUD and mental health treatment programs are equipped to serve dually diagnosed patients. Several barriers contribute to this gap:

• System Fragmentation: Mental health and SUD treatment systems often operate independently, hindering integrated care delivery.

• Funding and Policy Issues: Separate funding streams and policies can create obstacles to integrated service provision.

• Training Deficiencies: Many providers lack adequate training in treating co-occurring disorders.

• Attitudinal Barriers: Stigma and differing perspectives between mental health and SUD treatment providers can impede collaboration.

• Programmatic Silos: Program structures may not be designed to accommodate integrated care models.

Healthcare system changes, like the Mental Health Parity and Addiction Equity Act and the Affordable Care Act, aim to improve care for comorbid conditions by increasing insurance coverage for addiction and mental health treatment and incentivizing evidence-based practices and integrated care teams.

Resources for Further Scientific Information

For more information on SUDs, mental illnesses, and related topics, please visit the NIDA website at www.drugabuse.gov or contact the DrugPubs Research Dissemination Center at 877-NIDA-NIH (877-643-2644; TTY/TDD: 240-645-0228).

NIDA’s Website Offers:

• Information on drugs of use and misuse and related health consequences.
• NIDA publications, news, and events.
• Resources for healthcare professionals, educators, patients, and families.
• NIDA research studies and clinical trials information.
• Funding information (including program announcements and deadlines).
• International activities.
• Links to related websites.
• Information in Spanish.

NIDA Websites and Webpages:

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Other Websites:

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References

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