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The American Journal on Addictions

Exploring the Association between Lifetime Prevalence of Mental Illness and Transition from Substance Use to Substance Use Disorders: Results from the National Epidemiologic Survey of Alcohol and Related Conditions (NESARC)

Authors

  • Shaul Lev-Ran MD,

    Corresponding author
    1. Addictions Program, Centre for Addiction and Mental Health, Toronto, Ontario, Canada
    • Translational Addiction Research Laboratory, Centre for Addiction and Mental Health, Toronto, Ontario, Canada
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  • Sameer Imtiaz BSc,

    1. Translational Addiction Research Laboratory, Centre for Addiction and Mental Health, Toronto, Ontario, Canada
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  • Jürgen Rehm PhD,

    1. Social and Epidemiological Research Department, Centre for Addiction and Mental Health, Toronto, Ontario, Canada
    2. Department of Psychiatry, Dalla Lana School of Public Health, and Institute of Medical Sciences, University of Toronto, Toronto, Ontario, Canada
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  • Bernard Le Foll MD, PhD

    1. Translational Addiction Research Laboratory, Centre for Addiction and Mental Health, Toronto, Ontario, Canada
    2. Addictions Program, Centre for Addiction and Mental Health, Toronto, Ontario, Canada
    3. Departments of Psychiatry, Pharmacology, Family, and Community Medicine and Institute of Medical Sciences, University of Toronto, Toronto, Ontario, Canada
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Address correspondence to Dr. Lev-Ran, Centre for Addiction and Mental Health, 33 Russell St., Room 2035, Toronto, ON, M5S2S1 Canada. E-mail: shauli.levran@gmail.com.

Abstract

Background and Objectives

The association between substance use disorders (SUDs) and mental illness (MI) has been well established. Previous studies reporting this association in various clinical populations have not taken into account former substance use. This may be important as increased prevalence of substance use among individuals with MI may partially explain the strong association between SUDs and MI.

Methods

In this study we included only individuals with previous substance use and explored the association between lifetime diagnosis of MI and transition from substance use to SUDs. Analyses were conducted across six different categories of substances (alcohol, nicotine, cannabis, cocaine, hallucinogens, inhalants) based on a large representative US sample, the National Epidemiologic Survey of Alcohol and Related Conditions (NESARC, n = 43,093).

Results

Lifetime diagnoses of any MI, and particularly personality disorders and psychotic disorders, were found to be associated with higher prevalence of transition from substance use to SUDs across most categories of substances. This association was particularly strong for nicotine (adjusted OR = 2.95 (2.72–3.20)).

Conclusions and Scientific Significance

This cross-sectional study expands on previous research by highlighting the association between lifetime diagnosis of any MI and increased rates of transition from substance use to SUDs across a range of substances. Longitudinal studies exploring temporal effects of this association are further needed. (Am J Addict 2013;22:93-98)

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