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Contents Introduction Anxiety Disorders Substance Abuse One-Two Punch Chicken & Egg Diagnosis & Treatment Conclusion

The co-occurrence of anxiety disorders and substance abuse is a cruel double blow. Individually, these disorders can be very challenging to diagnose and treat. Each is accompanied by a degree of social stigma. Each manifests in a way that is unique to the individual. When paired, they form a destructive, self-perpetuating combination that both intensifies pathology and increases resistance to treatment. 

Yet more is being learned about the brain every day, and with that knowledge comes a better understanding of the conditions that affect it. The continued development of new pharmacological agents and emerging research in the field of mental health are expanding the treatment options for those with comorbid anxiety and substance abuse issues, providing stronger results and a better hope for a healthy future.

List of Visuals

1. The a ge-standardized disability-adjusted life year rates from panic disorder by country (per 100,000 inhabitants).
   http://en.wikipedia.org/wiki/File:Panic_disorder_world_map_-_DALY_-_WHO2002.svg
   Wikipedia, the Free Encyclopedia

2. Washing one's hands is a common Obsessive Compulsive Disorder symptom. Other symptoms include clearing one's throat, making sure certain items are in a straight line, constantly organizing in a certain way, turning lights on and off, touching objects a certain number of times before exiting a room, walking in a certain routine way like only stepping on a certain color of tile, or having a routine for using stairs, such as always finishing a flight on the same foot.
   http://en.wikipedia.org/wiki/File:OCD_handwash.jpg
   Wikipedia, the Free Encyclopedia

3. The Health Officers Council of British Columbia – in their 2005 policy discussion paper, A Public Health Approach to Drug Control in Canada – has adopted a public health model of psychoactive substance use that challenges the simplistic black-and-white construction of the binary (or complementary) antonyms "use" vs. "abuse." This model explicitly recognizes a spectrum of use, ranging from beneficial use to chronic dependence.
   http://en.wikipedia.org/wiki/File:Spectrum_Diagram.PNG
   Wikipedia, the Free Encyclopedia

4. Compared with the general population, patients with mood or anxiety disorders are about twice as likely to also suffer from a drug disorder. Also, patients with drug disorders are roughly twice as likely to be diagnosed with mood or anxiety disorders.
   http://www.drugabuse.gov/publications/topics-in-brief/comorbid-drug-abuse-mental-illness
   The National Institute on Drug Abuse, National Institutes of Health

5. Soldiers and civilians watch a presentation about Post Traumatic Stress Disorder December 15, 2009 at Fort Hamilton Army Garrison in Brooklyn, New York. The presentation and associated questionaire are part of the Military Pathways program, a free, anonymous mental health and alcohol self-assessment for troops, civilian employees, and their families. The self-assessments are a series of questions that help establish whether respondents could benefit from talking to an available health professional. PTSD and related mental health ailments have increased in recent years as hundreds of thousands of troops have served in the wars in Iraq and Afghanistan.
   Taken from Proquest's eLibrary
   Chris Hondros/Getty Images

6. In 2003 the Dual Diagnosis Capability in Addiction Treatment (DDCAT) index was created and field tested. The DDCAT, based on the American Society of Addiction Medicine's (ASAM) taxonomy of program dual diagnosis capability, has been subjected to a series of psychometric studies. The map reflects the widespread implementation in various stages of the DDCAT as well as two parallel instruments, the Dual Diagnosis Capability in Mental Health Treatment (DDCMHT) and Dual Diagnosis Capability in Health Care Settings (DDCHCS).
   http://www.samhsa.gov/co-occurring/ddcat/introduction/introduction.html
   Substance Abuse and Mental Health Services Administration

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16. Robinson, Jennifer, Jitender Sareen, Brian Cox, and James Bolton. "Role of Self-medication in the Development of Comorbid Anxiety and Substance Use Disorders." Archives of General Psychiatry. 68.8 (2011): 800-807.


17. "Treatment Statistics." National Institute on Drug Abuse. U.S. Department of Health and Human Services, Mar 2011. Web. 27 Apr 2012.


18. Tull, Matthew. "Self-Medication in PTSD." About.com. The New York Times Company, 20 July 2009. Web. 26 Apr 2012.