Co-occurring and co-morbid relationships between medical and mental-health conditions
February 24, 2010 1 Comment
Blog Post by Joanne M. Gordon, PhD, RN. Dr. Gordon is Emeritus Professor of Biomedical Sciences, Missouri State University, Springfield, Missouri, USA.
All healthcare providers should understand the co-occurring and co-morbid relationships between medical and mental-health conditions. Physical health problems exist in patients who are seen by mental health providers and recognizing physical health problems of mental health conditions may improve co-occurring and co-morbid treatment outcomes. Substance abuse is a significant problem for many patients throughout the world – and often these patients are initially evaluated, and treated chronically, by mental health providers.The use of illicit drugs create significant physical health problems for patients. To improve health-related outcomes, all clinicians should be able to assess, treat, or refer to treatment, those patients identified with medical conditions associated with illicit substance abuse. Unfortunately, there is no resource that catalogs the important epidemiologic associations between illicit drugs and concurrent physical illnesses that co-exist or are caused by drug use.
It is this conviction that prompted the authoring of Physical Illness and Drugs of Abuse, a Cambridge University Press book scheduled for printing in the spring of 2010. Authored by Adam J Gordon, MD, MPH, FACP, FASAM, and a group of health professional co-authors, the book examines the relationship between drugs of abuse and physical illness. Using the PubMed database, epidemiologic studies published in the past twenty years were reviewed for illicit drug associations with 23 general illness categories. Cocaine, marijuana, opioids, and barbiturates, common hallucinogens, and stimulants were the drugs selected because of their likelihood to affect various body systems and because publications have indicated co-morbid associations with substance abuse and physical illness. These drugs also have worldwide use.
The book critically examines the epidemiological evidence of an association between a particular drug of abuse and physical illness, with each study summarized in both text and tables. Additionally, the authors critique the research quality and suggest recommendations for further study.
In their review of the literature, the authors found strong associations between some physical diseases and illicit drug use. These associations were often based on a number of sound research studies supporting the association between a disease condition and a specific drug of abuse. However, in many cases, despite the level of harm attributed to certain drugs of abuse, there was a dearth of studies and limited research evidence of associations (direct or indirect) between an illicit drug and a specific physical condition.
By knowing co-morbid medical conditions that might be found in individuals using illicit drugs, the clinician will be in a better position to identify, treat, and manage the patient and his symptoms. Heightening the awareness of medical symptoms associated with specific drug abuse is important to guide an effective treatment plan and avoid deleterious outcomes.
Designed specifically for health professionals, including students, trainees, practicing clinicians, and policy makers, others would also find the publication a helpful reference as some illicit drugs are used or being considered for use for a number of medical conditions.
Physical Illness and Drugs of Abuse, by Adam J. Gordon, is available from March 2010, and is published by Cambridge University Press