America is facing dual crises: a drug crisis and a mental health crisis. Both contribute to and worsen the other. During Mental Health Awareness Month, it is important that those on the front lines of these crises come together with lawmakers to acknowledge the two-way relationship between drug use and mental illness and chart a course forward that increases access to treatment that addresses their root causes.
The relationship between drug use and mental health issues moves in both directions. As the National Institute on Drug Abuse points out, "many individuals who develop substance use disorders (SUD) are also diagnosed with mental disorders, and vice versa." Those with mental health issues are more likely to use drugs, perhaps to cope or self-medicate. And those who use drugs are more likely to develop mental health issues, given the inherent risks of many illicit drugs.
The 2022 National Survey on Drug Use and Health found that 57 percent of those over the age of 18 with a drug use disorder also had a mental illness, defined as a diagnosable mental, behavioral, or emotional disorder other than a developmental or substance use disorder. Twenty-two percent of adults with a drug use disorder had a serious mental illness.
Likewise, nearly one in four people over the age of 18 with any mental illness also had a drug use disorder, and more than a third of those with a serious mental illness had a drug use disorder. In comparison, among those with no mental illness, only 5.5 percent had a drug use disorder, while adults with a mental illness were more than four times as likely to have a drug use disorder.
Beyond these associations between diagnoses, different drugs pose different risks to users. The American Addiction Centers warn that "both cocaine and crack cocaine can cause brain damage, even when used only a few times." And according to the National Institute on Alcohol Abuse and Alcoholism, "the most common mental health conditions that co-occur with [alcohol use disorder] are depressive disorders, anxiety disorders, trauma- and stress-related disorders, other substance use disorders, and sleep disorders."
As President Joe Biden is seeking to loosen federal restrictions around marijuana, it is important to examine the associated mental health risks. Scientific and medical data increasingly find links between today's high-potency THC drugs and an array of health consequences. According to the CDC, marijuana use is "associated with depression; social anxiety; and thoughts of suicide, suicide attempts, and suicide.
More specifically, a growing body of research has identified a link between marijuana and psychosis. Daily users of marijuana above 10 percent THC are nearly five times more likely to develop a psychotic disorder than non-users. A 2023 study in Denmark determined that 30 percent of cases of schizophrenia among 21-to-30-year-old males could have been averted if cannabis use disorder had been prevented. A 2022 study found that hospital discharges for marijuana-associated psychosis were higher in states with legal marijuana, another precursor if those who push full-scale commercialization have their way.
While many narrowly evaluate the risks of drugs based solely on their overdose potential—such as with an opioid—drugs also pose numerous risks to mental health. Drug-induced disorders can last a lifetime and undermine users' ability to live healthy, fulfilling, self-directed lives.
Many wrongly believe that marijuana, psychedelics, and other psychoactive drugs can improve mental health. Data suggest—aside from some tightly controlled clinical trials of certain psychedelic drugs—they do the opposite. Smoking marijuana exacerbates, not reduces, anxiety. The American Psychiatric Association released a statement in July 2022 that said, "There is currently inadequate scientific evidence for endorsing the use of psychedelics to treat any psychiatric disorder except within the context of approved investigational studies."
Worse yet, harmful perceptions about these drugs are being peddled by the for-profit industry, which seeks to prey on vulnerable individuals. First it was so-called "medical marijuana," and now the recycled narrative is applied to hallucinogens like psilocybin and ecstasy.
To address these issues, policymakers should prioritize prevention education and promote understanding of the inherent risks of drug use. Public health officials should connect those with substance use and mental disorders to treatment that can address both conditions.
At a time when more than half of adults with a drug use disorder also had a mental illness––and approximately one-fourth of adults with a mental illness had a drug use disorder––policymakers must recognize the interconnectedness between drug use and mental illness. You can't address one issue without addressing the other. Our country must renew its commitment to ensuring more Americans live free of substance use and mental disorders.
Dr. Kevin Sabet is a former three-time White House drug policy advisor and the president of Smart Approaches to Marijuana and the Foundation for Drug Policy Solutions.
The views expressed in this article are the writer's own.
Uncommon Knowledge
Newsweek is committed to challenging conventional wisdom and finding connections in the search for common ground.
Newsweek is committed to challenging conventional wisdom and finding connections in the search for common ground.
