Impact of depression on treatment for addiction

As outlined on the slide, depression, one of the comorbidities that often accompany substance-use disorders and addiction, can impact an individual’s treatment for that substance-use disorder.^[1,2,3,4,5] One systematic review investigated the treatment of individuals with co-occurring depression and substance-use disorders.^[1] After selecting eight studies, including a total of 132,373 individuals, the outcomes of treatment were analysed.^[1] Depression, often treatment-resistant depression, was sometimes challenging to treat in people with substance-use disorders; effective treatment of this depression with pharmacotherapy or psychotherapy may help individuals in maintaining their abstinence from substance use.^[1]

Furthermore, the presence of a comorbidity can cause complication for healthcare systems, because effective treatment requires communication and networking between the different health systems.^[6] A holistic approach is required for an individual with substance-use disorder and comorbidities, to avoid the risk that one or other of these illnesses is not fully addressed.^[6]

References:

[1] Alsheikh AM, Elemam MO, El-Bahnasawi M. Treatment of depression with alcohol and substance dependence: a systematic review. Cureus 2020; 12 (10): e11168.

[2] Ostacher MJ. Comorbid alcohol and substance abuse dependence in depression: impact on the outcome of antidepressant treatment. Psychiatr Clin North Am 2007; 30 (1): 69–76.

[3] Hersh J, Curry JF, Kaminer Y. What is the impact of comorbid depression on adolescent substance abuse treatment? Subst Abus 2014; 35 (4): 364–375.

[4] Santisteban DA, Mena MP, Muir J, et al. The efficacy of two adolescent substance abuse treatments and the impact of comorbid depression: results of a small randomized controlled trial. Psychiatr Rehabil J 2015; 38 (1): 55–64.

[5] Beaufort IN, De Weert-Van Oene GH, Buwalda VAJ, et al. The Depression, Anxiety and Stress Scale (DASS-21) as a Screener for Depression in Substance Use Disorder Inpatients: a Pilot Study. Eur Addict Res 2017; 23 (5): 260–268.

[6] Fantuzzi C, Mezzina R. Dual diagnosis: A systematic review of the organization of community health services. Int J Soc Psychiatry 2020; 66 (3): 300–310.