COMORBIDITY

WHAT IS COMORBIDITY? When two disorders or illnesses occur concurrently in the

same person, they are called comorbid

Drug abuse and other psychiatric disorders (mental illnesses) are often comorbid

Infectious conditions such as hepatitis C, B and tuberculosis are common among injecting drug users

Non-infectious conditions such as malnutrition, anemia are prevalent amongst people who inject drugs

RELATIONSHIP BETWEEN DRUG USE AND PSYCHIATRIC DISORDER

Six out of ten people with a drug use disorder also suffer from another form of psychiatric disorder (mental illness)

Drug use can cause a psychiatric disorder

Psychiatric disorder can lead to drug use

Drug use and psychiatric disorders are both caused by some common risk factors

WHY DO DRUG USE DISORDERS AND PSYCHIATRIC DISORDERS CO-OCCUR?

Overlapping genetic vulnerabilities

Overlapping environmental triggers

Involvement of similar brain regions

drug use disorders and psychiatric disorders are developmental disorders

PREVALENCE OF PSYCHIATRIC COMORBIDITY

Compared with general population

Patients with mood or anxiety disorders are 2 times at great risk to develop drug use disorder

Patients with drug use disorders are twice as likely to be diagnosed with mood or anxiety disorders

Comparison between males and females

Antisocial personality disorder is more common in substance using men

Substance using women have higher rates of major depression, posttraumatic stress disorder, and other anxiety disorders

NEED FOR DIAGNOSIS AND TREATMENT

Comorbidity is relatively common

Comorbid patients exhibit more severe symptoms

Need to differentiate symptoms related to intoxication and withdrawal from psychiatric disorders

Greater stigma attached to people with comorbid disorders

NEED FOR DIAGNOSIS AND TREATMENT

Diagnosis and treatment of one disorder will likely reduce risk for the other

Integrated treatment to treat both conditions is important

There should not be any bias in providing necessary treatment with medications for people with comorbid psychiatric disorder

Concurrent therapy with pharmacological and behavioural treatment is ideal

CO-INFECTIONS AMONGST IDUS Hepatitis C

Hepatitis B

HIV

Tuberculosis

Sexually transmitted infections (STIs)

COMMON PHYSICAL DISORDERS AMONG IDUS Anaemia

Malnutrition

POLY-DRUG USERS Many injecting drug users in the country use

multiple drugs

Withdrawals from alcohol, benzodiazepines have to be managed effectively

Opioid withdrawals can be effectively addressed using evidence based approaches