Addiction Medicine: Closing the Gap between Science and Practice

39.4

(15.1 M)

71.2

(1.5 M) 57.2

(2.6 M) 44.5

(7.5 M) (8.3 M)37.0

Total Controlled

Prescription

Drugs

Illicit Drugs Alcohol Nicotine

P E R C E N T

Source: CASA Columbia analysis of The National Survey on

Drug Use and Health(NSDUH), 2010.

Figure 3.L

Rates of Mental Health Disorders Among

Individuals Ages 18+ with Addiction Involving

Specific Substances, 2010

Percent (Number in Millions)

a controlled prescription drug in their

lifetime.^61

Older Adults .................................................................................................................

The body’s tolerance to addictive substances
declines with age,^62 while the quantity and
frequency of prescription drug use typically
increases.^63 These factors contribute to an
increased chance of risky substance use and
addiction. Also, as the “Boomer” generation
ages, seniors are reporting increasingly higher
rates of substance use and addiction, due to the
higher rates of substance use in this age cohort
compared with prior generations.^64 Currently,
25.2 percent of the population ages 50 and older
engages in risky substance use and 10.6 percent
has addiction.* 65

Co-Occurring Disorders ...............................................................................................

Addiction frequently co-occurs with other health
conditions.^66 CASA Columbia’s analysis of
national data indicates that in the past year, 57.5
percent of non-institutionalized individuals ages
18 and older† with addiction also have another
health condition:

 31.9 percent have been told by a doctor that
they have a medical condition‡ (not
including mental health disorders); and

 39.4 percent meet clinical criteria for a
mental health disorder.§ 67 (Figure 3.L)

• The sample size is too low to provide any further

statistically reliable data on older adults ages 65 and
older.
† Data on mental health disorders among 12- to 17-

year olds are not available in the NSDUH.
‡ In the past year. Includes asthma, bronchitis,

cirrhosis of the liver, diabetes, heart disease,
hepatitis, high blood pressure, HIV/AIDs, lung
cancer, pancreatitis, pneumonia, STDs, sinusitis,
sleep apnea, stroke, tinnitus, tuberculosis and ulcer.
§ Includes those with a current or past year mental,

behavioral or emotional disorder (e.g., depression and
anxiety; excluding developmental disorders and
addiction) that meets DSM-IV criteria, or those with
a major depressive episode in the past year.

People with mental health disorders also are

more likely to be risky substance users and to

have addiction than those without a mental

health disorder. Among those ages 18 and older

who have a mental health disorder,** 30.6

percent are risky substance users and 31.4

percent have addiction.^68

In total, 6.6 percent of the non-institutionalized

U.S. population ages 18 and older (15.1 million)

meet clinical criteria for both addiction and a

mental health disorder.†† 69 Those with co-

occurring addiction and mental health disorders

also are likelier to have other co-occurring

chronic illnesses such as hypertension, asthma

and arthritis.^70

The rates of co-occurring mental health

disorders appear to be even higher among people

seeking treatment for addiction. One large-scale

study of adolescents and adults in addiction

treatment found that two-thirds of the patients

had co-occurring mental health disorders in the

year prior to treatment admission, with 18- to

25-year olds most likely to have co-occurring

** 20.9 percent of adults (18 and older) (^) in the U.S.
population meet clinical criteria for a mental health
disorder.
†† These rates are higher among institutionalized
persons; for example, CASA Columbia’s 2010 study,
Behind Bars Update: Substance Abuse and America's
Prison Population, found that 24.4 percent of prison
and jail inmates have both addiction and a co-
occurring mental health disorder.