Reducing the Adverse Impacts of Substance Abuse

The treatment of substance use disorders potentially affects not only the patient, but also society at large. This past year, studies suggested that substance abuse accounts for most of the putative link between mental illness and violence (JW Psychiatry Mar 16 and May 22) and increases the risk for acquaintance violence, whether the substance abuser is perpetrator or victim. Substance abuse also worsens outcomes (e.g., risk for rehospitalization) in patients with mood disorders.

Coincident with our improved understanding of the effects of substance abuse and dependence, we have greater appreciation of its strong neurobiological underpinnings. Elegant studies have demonstrated that chronic substance use causes progressive changes in gene exp…