Having discussed some genetic and physiologic factors, I will now address the interconnected ideas of self-medication and co-morbidity. Self-medication, by definition, is the use of drugs by an addict to lessen the discomfort of an existing problem other than the addiction problem. Everyday problems that can coexist with using drugs are, for example, stress, grief and loss, crises of some kind, violence, or trauma, or pain. We know that sometimes these can be very difficult to deal with, and we might not be surprised if someone tried to escape by using drugs. Because of mutations in polymorphisms, we are all genetically different, except for identical twins. Some of us are shorter, or taller than others, some men get bald, while others don't. It's interesting that it's been suggested, that some of us may be deficient in reward mechanisms in our brain. Such a deficiency in reward, if it exists, could spur us to seek more intense rewards to feel normal. And, this could be a factor in someone using drugs, and perhaps in becoming an addict. It's be shown that addicts frequently have additional coexisting problems that seem to predispose them to addiction, or at least excessive drug use. For example, someone with high anxiety, may consume alcohol to calm himself, or herself. The following diagnoses have been associated with drug use, attention disorders, aggressive behaviors, conduct disorders, mood disorders and anxiety disorders. They are referred to as co-morbid disorders. Co-moribidity implies that two or more disorders or problems, exist in the same person, often at the same time, or maybe also one after the other. Co-morbidity also suggests that the disorders can interact, and make all of them worse. Let's look at some data from the International Consortium in Psychiatric Epidemiology. 35% of a group of drug users met the criteria for mood disorder, 45% for anxiety disorder, and 50% for conduct, or personality disorder. There's more data. In another study, the occurrence of various disorders in drug users, over a lifetime, was examined. 29.9% of drug users, at one time or another, were diagnosed with an anxiety disorder. Almost 41% with a mood disorder, over 33% with a depression, and almost 11% with a social phobia. Some of these disorders can be very problematic, and it wouldn't be surprising if some people tried to self-medicate with a legal or illegal drug. So, what does this mean? Well, co-morbidity has important implications. Sometimes, the causes or factors that contribute to continued drug use are not simply, dependence or addiction. There are other problems. For some addicts to stop using drugs, the coexisting disorders need to be treated, as well. Treatment programs are impacted, and know about this. So co-morbidity is obviously important.
