There is increasing recognition of the importance of managing individuals with comorbidity and special needs. Particular attention should be paid to comorbidities associated with drug use across physical and psychological health domains. At entry to treatment, many individuals with substance use disorders also experience psychiatric symptoms and disorders/5,53) Across several countries, large-scale surveys have gathered data that suggest high concordance between drug and alcohol use disorders and affective and personality disorders.(54,55,5 and 5Z) According to one major study from the United States, approximately one in seven individuals with a current mental health disorder also has a substance use disorder.(55) Special attention may need to be given to the health care needs of drug users who are affected by such comorbidities irrespective of their dependent or non-dependent drug use status. Recognition of the importance of understanding the links between substance use behaviours and psychiatric and physical symptoms and disorders and their implications for treatment services is also gaining momentum. (58)
Drug users may also be at risk of physical comorbidity because of their administration of drugs via injection, where they use infected needles/syringes or an unsafe injecting procedure. These risks include septicaemia, inadvertent overdose, and risks of infection with HIV, hepatitis B and C, and other blood-borne viruses (see above). The nature of this comorbidity may be causal, consequent, or coincidental and will include psychiatric as well as physical comorbidities.
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