Psychiatric comorbidity

Several studies have found that 70 per cent of addicts meet diagnostic criteria for a current psychiatric disorder, frequently depression, antisocial personality, and alcohol dependency/!5,1.6) Such diagnoses may be primary or secondary to opiate abuse, and a careful assessment of mental state and social functioning when opiate free should be performed. Many will have had childhood behavioural problems such as conduct disorder, and studies suggest that attention-deficit hyperactivity disorder, truanting, and juvenile offending are markers for subsequent use. (1D Clearly, comorbid psychiatric disorders should be treated in their own right especially if it is felt that they are important in maintaining opiate use. (18) Opiate dependence is also a strong risk factor for suicide, which accounts for up to a third of all deaths among intravenous drug users.(,19)

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