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It is vital to consider pre-existing mental health issues when determining how to treat substance abuse among young people with a chronic physical illness. 

New research from the University of ��ݮ��Ƶ considered pre-existing mental health issues when seeking to understand the relationship between youth who have a chronic physical illness and who abuse substances. Researchers found that mental health issues play a significant role in that relationship and note that it is a factor that must be considered when treating young people.

“Our findings affirm the need for a coordinated effort in the provision of health care for youth that includes integrated addiction and mental health services in the physical health setting,” said Mark Ferro, Canada Research Chair in Youth Mental Health in the School of Public Health and Health Systems and lead researcher on the study.

“Coordinating integrated care across sectors is a monumental task which, at the outset, should establish a standardized protocol to screen youth with chronic physical illnesses to identify those requiring more comprehensive assessment and streamlined access to health services.”

The study examined data related to five physical conditions – respiratory, musculoskeletal, cardiovascular, neurological and endocrine – along with a healthy control group. It found numerous connections between different physical conditions, substance abuse and mental illness. For example, depression increased the odds that youth with respiratory or endocrine conditions would report alcohol or other drug disorders, respectively. In contrast, depression decreased the odds that youth with neurological conditions would report alcohol or other drug disorders.

“The association between chronic physical illness and substance use disorder is complex, requiring consideration of many factors, including co-existing mental illness,” said Ferro. “While the links between mental illness and substance use disorder is rather robust in the general youth population, these associations are more nuanced among youth with chronic physical illnesses. Our study is one of the first to incorporate mental illness as a moderating factor.”

The study used data from more than 6,000 youth aged 15-30 taken from Statistics Canada’s 2012 Canadian Community Health Survey. Because the data was collected before the legalization of cannabis for recreational purposes, Ferro says further studies using data since this event will provide a good comparison.

The paper, , was published in Addictive Behaviors and is co-authored by Alexander Luther (��ݮ��Ƶ), Shannon Reaume (��ݮ��Ƶ), Rana Qadeer (McMaster), Kara Thompson (St. Francis Xavier).