Address correspondence to Katherine Harris, Ph.D., Office of Applied Studies, Substance Abuse and Mental Health Services Administration, 5600 Fishers Lane, Room 16-105, Rockville, MD 20856. Mark J. Edlund is with the Center for Mental Healthcare and Outcomes Research, Central Arakansas Veterans Healthcare System, University of Arkansas for Medical Sciences, Little Rock, AR.
Self-Medication of Mental Health Problems: New Evidence from a National Survey
Version of Record online: 21 JAN 2005
Health Services Research
Volume 40, Issue 1, pages 117–134, February 2005
How to Cite
Harris, K. M. and Edlund, M. J. (2005), Self-Medication of Mental Health Problems: New Evidence from a National Survey. Health Services Research, 40: 117–134. doi: 10.1111/j.1475-6773.2005.00345.x
- Issue online: 21 JAN 2005
- Version of Record online: 21 JAN 2005
- Co-occurring disorder;
- unmet need;
- perceived need;
- mental health care;
- substance use;
- illicit drugs;
- logistic regression
Objective. To evaluate the association between past 30-day use of alcohol, marijuana, and other illicit drugs and past year unmet need for and use of mental health care.
Data Source. A subsample of 18,849 respondents from the 2001 National Household Survey on Drug Abuse and the 2002 National Survey on Drug Use and Health. Subjects were between the ages of 18 and 65 years and had least one past year mental disorder symptom and no past year substance dependency.
Study Design. Logistic regressions of past 30-day substance use on past 12-month unmet need for mental health care and past 12-month use of mental health services controlling for clinical and sociodemographic characteristics. Predicted probabilities and corresponding standard errors are reported.
Principal Findings. Use of illicit drugs other than marijuana increased with unmet need for mental health care (4.4 versus 3.2 percent, p=.046) but was not reduced with mental health-care use. Heavy alcohol use was not associated with increased unmet need for mental health care, but was higher among individuals with no mental health care use (4.4 percent versus 2.7 percent, p<.001). By contrast, marijuana use did not appear associated with either unmet need or mental health care use.
Conclusions. Substance use varies with past year unmet need for mental health care and mental health care use in ways consistent with the self-medication hypothesis. Results suggest that timely screening and treatment of mental health problems may prevent the development of substance-use disorders among those with mental disorders. Further research should identify subgroups of individuals for whom timely and appropriate mental health treatment would prevent the development of substance-use disorders.