According to Psychology Today, co-occurring disorders are happening today in roughly 8 million people in the United States. While these disorders are documented and treated frequently, a new study suggests that one disorder could actually predict the occurrence of another.
This article looks at the results of a study that examined the absence or presence of personality disorders as predictors of future alcohol use disorder. What did the findings reveal? How might this be of benefit to clinicians dealing with those with either disorder?
BPD and Alcoholism
An article in Very Well Mind recently tracked some of the latest studies correlating alcoholism and other substance use disorders and borderline personality disorder (BPD). According to one study, 78 percent of adults with BPD will develop a substance use disorder at some point in their lives. The most common type of co-occurring disorder is alcoholism. Addiction treatment for these co-occurring disorders is difficult; Very Well Mind suggests that the people with these diseases are less likely to respond successfully to treatment. They suggest that these patients:
- Are less willing to persist with addiction treatment.
- Have more suicidal thoughts.
- Are more likely to develop other addictive behaviors in addition to the BPD and alcoholism.
Borderline personality disorder presents as intense anger, or disassociation from an identity and low self-esteem, to name a few characteristics. People suffering from these disorders self-medicate with mood-enhancing chemicals.
People with a personality disorder often medicate with mood-altering substances.
One study, published in Addiction, suggested that conduct disorders are in fact one of the top risk characteristics for the potential to abuse alcohol or other substances. The very fact that personality disorders are tied to impulsive behavior makes co-occurring substance use likely. In fact, the Addiction study cited prior research that seemed to correlate 10 specific DSM-5 personality disorders to alcohol abuse.
Too, there are genetic predispositions for both alcoholism and personality disorders that may coincide. Alcohol also intensifies the emotional experience that is the hallmark of personality disorders.
Very Well Mind suggests that alcohol, cocaine, and opiates all stimulate the endogenous opioid system (EOS) – the part of the brain that rewards you with pleasure and relieves pain. Personality disorders have been tied to a low functioning EOS. Stimulating the EOS with drugs or alcohol may be a way of finding balance.
These are all reasons for a symbiotic relationship between these two disorders. Clinicians are well-advised to monitor for co-occurrence if a patient presents with alcoholism or is diagnosed with BPD.
Addiction Treatment and Co-Occurring Disorders
Personality disorders seem to be tied closely to alcohol and substance use. The Journal of Substance Abuse Treatment reports that co-occurrence of these disorders is around 65 percent in the U.S. The article also suggests that these individuals have higher rates of relapse and non-compliance with treatment modalities. However, the article concludes that the current literature does not consistently endorse one specific treatment to solve the problem of co-occurring alcohol or substance abuse and personality disorders.
It seems clear that personality disorders are tied to substance abuse; clinicians would do well to proactively conduct simultaneous screenings for both of these disorders.
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