Epidemiology - Substance Use Disorders

Epidemiology

·        1986 CHCH Psychiatric Epidemiology Study: Lifetime prevalence rates:

·        Adolescents:

o   5% of 15 year olds meet criteria for alcohol abuse (Fergusson 1994)

o   Cannabis dependence 7% at 18 years, 10% at 21 years.  Higher in males

·        Co-morbidity or Dual Diagnosis:

o   Epidemiologic Catchment Area (ECA) Study 1990 found the lifetime co-morbidity of substance use disorders by specific diagnoses:

·        Those with a mental disorder have twice the risk of an alcohol disorder and 4 times the risk of any other drug disorder

·        Those with a lifetime alcohol disorder have twice the risk of another mental disorder (37%) and 6 times the risk of another drug disorder (22%)

·        Those with a lifetime other drug disorder have a 4 times risk of another mental disorder (53%) and 7 times the risk of an alcohol disorder (47%)

·        Co-morbidity is higher in institutional settings (70- 80%) than in the community

·        Þ Dual diagnosis is an expectation not an exception