Drug and Alcohol Abuse

It is not unusual for a person to be dually addicted. Meaning, they have drug dependency and alcohol abuse problems. Addiction researchers and treatment professionals have long known that drug and alcohol abuse are strongly linked. In the last decade, research has broadened our understanding of many shared neurobiological and behavioral mechanisms that underpin the two disorders. Yet, while two in five substance abuse treatment patients abuse both drugs and alcohol, the treatment they are likely to receive will target only one disorder. A lack of science-based information on concurrent treatment of drug and alcohol abuse limits the ability of treatment professionals to provide the comprehensive treatment these patients need.

The substantial portion of drug and alcohol abusing patients in community treatment programs provides additional evidence of the need for science based information on treating dual addiction. Patients who abuse both drugs and alcohol accounted for more than 42 percent of admissions to substance abuse treatment facilities. Alcohol abuse is even more likely among patients who abuse certain drugs, such as cocaine, methamphetamine, and marijuana. For example, more than half of cocaine abusing patients who entered treatment also abuse alcohol.

Dually addicted individuals also may combine alcohol and illicit drugs because of interactions between abused substances in the body. Because both drugs and alcohol activate brain areas involved in reward, combining substances may increase these effects. Other alcohol and drug interactions may counter unpleasant effects that often accompany or follow substance abuse. Clinical reports suggest that coca ethylene, a combined cocaine-alcohol metabolite that is formed in the body following concurrent alcohol and cocaine use, appears to reduce the anxiety that can accompany cocaine use. Recent research in rats confirms that coca ethylene plasma levels remain high as cocaine levels fall, producing a delayed, relatively long-lasting rewarding effect that may counter the aversive effect induced when cocaine plasma levels recede.

Recent research suggests that some medications developed to treat drug or alcohol abuse may be useful for treating both problems. This information, along with our increased understanding of the underlying factors that drive drug and alcohol abuse, provides a strong rationale for a coordinated research effort to meet the critical need for treatments for people suffering from both disorders. Coordinated research on dually addicted patients will address the needs of the overwhelming number of Americans who abuse both alcohol and illicit drugs. More than 2.4 million of the 5.6 million people who abused illicit drugs in 2001 also abused alcohol, according to the National Household Survey on Drug Abuse. In fact, the more heavily someone abused alcohol, the more likely he or she was to use illicit drugs, the survey found. In 2001, nearly two of every three American teenagers, ages 12 to 17, who engaged in frequent drinking binges also abused drugs. In comparison, only 1 in 20 young people who didn't drink at all used drugs.

While the perceived benefits of combining alcohol and drugs may play a big part in the high percentages of people who do so, the addictive effects and harmful consequences of both substances increase when they are used together. Dually addicted patients are more likely to drop out of treatment and have poorer results than patients who abuse only one substance. However, since most studies on treating drug and alcohol abuse have examined these disorders separately, drug and alcohol treatment counselors now have little science-based information on which to base their treatment of these patients. Drug and alcohol abuse wreak incalculable damage on individuals, families, and communities. When they occur together, these disorders double the challenge to treatment providers. Drug and Alcohol Resource Center