Link Between Anxiety Disorders and Self-Medicating with Drugs and Alcohol

People often use alcohol and drugs for relief from stress and anxiety. However, there is a lack of studies on the long-term effects of self-medication for anxiety and its association with anxiety disorders and substance use disorders. Therefore, this study attempted to investigate whether the use of self-medication for relief from anxiety symptoms leads to the risk of developing substance abuse. It was found that self-medication using alcohol or drugs holds a high risk of new substance use disorders in those who are suffering from anxiety disorders, leading to the co-occurrence of both the disorders.

Coexistence of anxiety disorders with alcohol or substance abuse is common. This combination has serious adverse effects on the health of an individual. Indulging in self-medication is believed to be an important cause for such coexistence. When a person tries to reduce the symptoms of anxiety disorder by consuming alcohol or drugs for a long time, that person becomes addicted to the drug or alcohol, thereby falling prey to another substance-use disorder. In the present study, anxiety disorders such as panic, phobias such as social phobia, and generalized anxiety were assessed in people who had a history of self-medication. Along with this, addiction to alcohol or drugs was also assessed.

* Data for the present study was gathered from the “National Epidemiologic Survey on Alcohol and Related Conditions,” which was a large, long-duration study conducted in the U.S. Apart from information regarding alcohol/drug use and anxiety levels, data regarding various socio-demographic factors such as age, sex, income, ethnicity, marital status, place of stay, and education were also collected.
* The study was conducted in two parts. The first part included 43,093 participants and the second part included 36,356 respondents from the first part of the study. In the first part, conducted between 2001 and 2002, data regarding the anxiety levels of participants and self-medication with drugs were collected.
* In the second part, conducted between 2004 and 2005, data regarding various anxiety disorders and alcohol/drug use was collected.

* Over a period of three years, about 10 percent of the participants had developed anxiety disorders. Of these, 5.9 percent had started the use of alcohol in the second part of the study.
* Of those participants who had developed anxiety disorders and reported self-medication with alcohol, 12.6 eprcent had developed an alcohol use disorder. Of those participants who self-medicated with drugs, 10.4 percent had developed a drug use disorder. In participants who did not self-medicate any time, the incidence of alcohol and drug use disorders was 4.7 percent and 1.7 percent, respectively.
* In participants who self-medicated with alcohol or drugs, the incidence of anxiety disorder was high, especially that involving social phobia.

Shortcomings/Next steps
Apart from self-medication, there are various other factors, such as hereditary factors, which may induce disorders such as alcohol dependence and anxiety. These factors also must be considered before arriving to a conclusion. In this study, data regarding self-medication was self-reported and is therefore subjective to recall bias. Moreover, anxiety disorders such as obsessive compulsive neurosis and posttraumatic stress disorder were not assessed in the present study.

This study has shown that indulging in self-medication is an important reason for people getting addicted to drugs or alcohol, and for the development of anxiety disorders. Alcohol and drugs, which are used to relieve the symptoms of anxiety, further induce anxiety disorders in people when they withdraw or abstain from their use, by altering the levels of various neurotransmitters in the brain. The findings of the present study are especially useful for physicians and psychiatrists, who frequently prescribe anxiety-reducing drugs to their patients. By judicious use of these drugs and by avoiding their prolonged use, the co-existence of drug dependence and anxiety disorders can be minimized.

For More Information:
Role of Self-medication in the Development of Comorbid Anxiety and Substance Use Disorders
Publication Journal: Archives of General Psychiatry, 2011
By Jennifer Robinson; Jitender Sareen, MD; University of Manitoba, Winnipeg, Canada

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