Dual Diagnosis When two conditions occur together, whether they are psychiatric or medical in nature, it is expected that the symptoms of both conditions interact in some way. Moreover, the interaction of symptoms can have an impact on the course of both conditions, as well as the outcome of each condition individually. Individuals with a dual diagnosis of substance abuse and anxiety are expected to exhibit more functional impairments, which include negative impacts on both their occupational and social functioning. Moreover, dually diagnosed individuals pose unique treatment difficulties to professionals. Rates of Substance Abuse and Anxiety Both substance abuse disorders and anxiety disorder are among the most commonly diagnosed psychiatric conditions in the United States. In fact, the lifetime prevalence rate for a substance abuse disorder has been estimated to be around 14.6% and the lifetime prevalence rate for an anxiety disorder has been estimated to be about 28.8%. Further, findings from studies using samples drawn from both the community, as well as clinical populations, have indicated that being diagnosed with either a substance abuse disorder or an anxiety disorder places the individual at an augmented risk for developing problems with the other. Though nearly all of the anxiety disorders have been linked with substance abuse problems, panic disorder—with or without agoraphobia—is the second leading anxiety disorder related to substance abuse (odds ratios = 1.0-9.2). Substance abuse problems and anxiety disorders both are among the most commonly occurring psychiatric problems within the United States. In the U.S., 14.6% of the population have suffered from substance abuse and 28.8% have suffered from anxiety.
Medically Assisted Treatment One class of medications that has received support for its role in treating comorbid anxiety and alcohol abuse is selective serotonin reuptake inhibitors (SSRIs). More specifically, both paroxetine (brand name: Paxil) and sertraline (brand name: Zoloft) have been explored among samples of individuals who have been diagnosed with alcohol abuse and anxiety. Findings from these studies, however, remain mixed with some finding support for reduced symptoms of both anxiety and alcohol dependence, while others do not. As such, more work is needed to explore the role of selective serotonin reuptake inhibitors on symptoms of comorbid substance abuse and anxiety. One anti-anxiety medication, buspirone (brand name: BuSpar) has received support for its role in treating both alcohol abuse and symptoms of anxiety. Further, the anticonvulsant medication topiramate (brand name: Topamax) has demonstrated potentially positive results in treating individuals with cocaine dependence and symptoms of anxiety.
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