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Allan Schwartz, Ph.D.Allan Schwartz, Ph.D.
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Alcoholism, Drug Addiction and Mental Illness

Allan N. Schwartz, LCSW, Ph.D. Updated: Jan 10th 2008

Increasingly, research is demonstrating that the treatment of alcohol and drug addiction must include the treatment of mental disorders because of the co-occurences of these problems. In other words, it is not possible to treat alcohol and drug addiction without also treating the mental problems of this population of people. Here is a summary of the findings of two recent studies:

1) The VA Medical Center of Minneapolis completed a study of the success rate of treatment for alcoholism. The results were interesting because they included the rate of success of giving up cigarette smoking along with alcohol. There were 462 subjects included in the study. All the subjects received intensive alcohol and smoking cessation treatment. One year later all the subjects were studied to determine how many had remained free of cigarette smoking and alcohol usage. A major variable that was studies was the impact of depression on the ability to remain free of alcohol and cigarettes.

The results of the study showed that smoking cessation was not affected by depression, whether mild, moderate or severe in nature.

However, the same could not be said for the relationship between depression and alcoholism. Those subjects with mild, moderate and severe levels of depression had more difficulty remaining free of alcohol use six and twelve months after treatment.

While the researchers admitted that more studies were needed on the alcoholism and depression they concluded that treatment for alcoholism cannot have long term success unless depression is also treated. In other words, treating depression may increase the chances of successful outcome in the recovery from alcoholism.

At the present time some alcohol treatment programs treat depression while others do not. It is likely that all programs will need to address the problem of depression in order to maximize the chances of recovery from alcohol abuse.

It is important to note that this study neither implies that depression is a cause of alcoholism nor that alcoholism is a cause of depression.

2) Another study conducted sponsored by NIDA (National Institute on Drug Addiction) found that there is a strong co morbidity between drug addiction and mental problems in both adolescents and adults. In fact, among young people there is a strong correlation between having ADHD or Conduct Disorder and becoming addicted to drugs. The findings included the fact that large percentages of these individuals, both adolescent and adult, were traumatized during their childhood and came from families where there was a high incidence of alcohol use.

Among adult addicts the problems of ADHD continued but were accompanied by such mental health problems as depression, somatic disorders, suicidal ideation and very high levels of anxiety.

If you know someone who is seeking treatment for a drug or alcohol addiction it is important that they ask whether the treatment center they are considering includes mental health treatment.

What are your thoughts and opinions about this issue?

Allan Schwartz, LCSW, Ph.D.

Readers who live in the Boulder, Colorado metro area, or in Southwest Florida may contact Dr. Schwartz for face-to-face consultation. He is also available for psychotherapy through Skype video for those who are not in Florida or Colorado. He can be reached via email at for details.

Reader Comments
Discuss this issue below or in our forums.

ADHD, Drug Addiction and High levels of Anxiety - - Nov 26th 2012

The above research just described my son.  His dad was a meth user and had problems with cross dressing.  He was also ADHD.  My son is struggling and I do not know what to do for him.  He is a drug addict, he was diagnosed in 2nd grade as ADD, he battles anxiety, and has similas sexual issues as his dad.  He is hurting and confused.  What do I do, where do I take him.  He is 21, and I have him living on his own in an apartment.  He has a girlfriend who doesn't want him to go to a rehab, but will take him to an outpatient program for addicts only.  HELP!


persecuted by association - Stephen - Mar 8th 2011

I didnt know much about what it meant to be an alcoholic, until I was forced into visiting this website after my association with a drunk who has blamed me for her life falling apart. No matter how much I thought I was helping this person, just by association I was deemed the common denominator in relation to her problem by her family. They *alcoholics* are liars and selfish at best. People associated to her take great pride in showing her flaws as a badge of honour. This is the first time ive ever been associated with an alcoholic and her family have attempted to destroy my life just for being friendly to this woman. Alcohol addiction goes far beyond the abuser and her close family but as far wide to anybody who associates with them. They have no dignity and because they dont give a shit about themselves they will drag down anybody they deem to have done them an injustice. The abuser is usually leant on by a bullying husband or over zealous family members who are extremely controlling. REHAB AND DRUGS CAN NOT HELP A DYSFUNCTIONAL UNIT.

Untreated alcoholism and the alcoholic - Follower - Sep 15th 2010

A very ironic thing about alcoholism is that it's not the alcohol that is the problem, it's the individuals condition of alcoholism which is at issue.  The way alcoholics treat alcoholism is to drink. It is plain, it is simple. I am alcoholic and the best medicine for me to feel the ease and comfort I didn't have when sober was to drink alcohol. It is the “medicine” for the alcoholic. When the medicine no longer works and the alcoholics life falls apart many single handily attempt to abstain. In abstinence they then suffer from untreated alcoholism and suffer it's many symptoms. Which include depression, anxiety, discontent, sleeplessness and the like. Invetiably the symptoms become so unbearable they drink to relieve them.

So, the problem then becomes “what do I do to treat my alcoholism now that I cannot use alcohol to treat it? The alcoholic exclaims "I do not wish to drink again but what can I use to treat my alcoholism"? The answer many have found is the spiritual program of AA. AA is a spiritual program which has successfully treated alcoholism in alcoholics for over 70 years. Practicing the program of AA with support from agood solid AA group whose roots lie in studying the big book start the alcoholic into a brand new life with freedom from alcohol. I abstained from alcoholism many times, once for as long as 6 months. Always during those intervals I failed to treat my alcoholism. If I was lucky and did not drink, as the days went by I began to suffer from untreated alcoholism. Symptoms like irritability, depression, anxiety, restlessness, sleeplessness always surfaced. So, when it came to the point where things were unbearable I inevitably drank. It was only until in desperation that I asked for help and found a wonderful sponsor who did not sugar coat the program or tell me to take it easy and work a step a month. He instructed me to get into action immediately and work the steps as soon as possible. For with real alcoholics to drink is to die and it is no where written to take the steps slowly. I have never seen any one get into trouble for working the steps too soon, but have seen many people suffer for working them too late or not at all.

Sad but true - - Sep 2nd 2010

I strongly believe that when a child experiences a divorce, rejection or rape or anything traumatic that it can lead to alcoholism.  Alcoholism can repress or suppress the bad experience.  The individual was unable to deal with the traumatic experience, hence alcoholism will help forget it.

Rehab and Therapy is over rated. - Stigmatized - May 21st 2010

I enjoyed getting high for 30 years. I smoked pot for 7years, then drank for the other 23 years. During the last 10 years I drank 8-12oz. 5.9% beer a day. After a yearly phyiscal exam indicated that I was starting to have negitive effects from drinking. I decided it was time to give it up. I stopped by eating as soon as I got home from work instead of drinking my beer. Eating stopped my craving for the beer. After one week the craving for beer was gone. It has now been just over 3 years since I gave up drinking. I thought I might have withdrawl symptoms like the shakes, but nothing happend other than the cravings; which eating took care of.

In the past I tried to get help for depression from the local mental health department. They refused to talk about my depression and were only interested in my drinking. My wellbeing meant nothing to them. I was used by them for my insurance policy. My medical doctor saved my life by treating my depression. He was not concerend with my drinking.

I do not buy into the mindset that you are powerless over your problems, and there is a higher power. If you are truly ready to stop what ever it is your doing; then it is your decision to change that makes all the difference. Without your decision to change; no amount of rehab and/or therapy can help you.

there is help - Angela - Feb 6th 2010

To KC. Please contact an interventionist.They are trained to help get loved ones into treatment.

Help - KC - Jan 17th 2010

How can a family help an adult family member (37 years old) who has drug and alcohol addictions, and ADHD (and possibly other mental illnesses) when the individual refuses to get mental health treatment?  Is there anything family members can do in this situation?  Anything will help.  Thank you.

De-addiction - Deepak - Dec 9th 2008

I was an alcoholic for 14 years and i was powerless over alcohol and my lives had became unmanageable.In this Addiction we are depressed, dishonesty, stress, guilt, stress, mental health, jealous, etc. These are some of them and i had these tahts why i was not able to manage my lives.This post is true and it will happen when you are addicted of anything.Thank you.I am sober now.

The Battle for both addiction & bi-polar - Jamie - Oct 29th 2008
I was 8 years clean and went through a severe stress - I lost my job of 2 1/2 years as a substance abuse counselor.  I had been taking my medications (an anti-depressant and an anti-psychotic) for many years, but found myself attracted once again to methamphetamines.  I relapsed for a whole year, found myself bankrupt, and almost lost my boyfriend.  Now I am back "on track" with 21 days clean and back on my medications.  I find that DRA (dual recovery anonymous) helps and that I am going to have to work up a recovery plan not only for my drug addiction, but for my mental illness also, which I had never paid much attention to before except to take the meds.  It is possible to not lose sobriety/clean time by understanding my mental illness and the severity of stressors in my life - something I hadn't paid much attention to before.  Now I am researching and building a network of not only clean & sober people but also people that understand my mental illness so I can get the support I so dearly require. 

NarCONon _IS_ Scientology - Fredric L. Rice - Jul 17th 2008

Note to editor: Scientology's "NarCONon" fake front isn't just "associated with Scientology," their NarCONon _IS_ Scientology -- the insane quack medical notions dreamed up by L. Ron Hubbard include his dangerous, unscientific, outrageously nutty "Purification Rundown," something Hubbard dreamed up while stoned on "pinks and reds," as Hubbard called his drugs of choice.

Hubbard had no medical training, no science training, he FAILED the few colleged courses that he took, he died screaming about being infested with invisible murdered space aliens he called "Body Thetans" while stoned on the psycho drug visteral.

His "NarCONon" fake front reflects all the insanity, all the criminality of Scientology and its insane founder L. Ron Hubbard. covers all of the aspects of this criminal enterprise from its attempts to try to pretend legitimacy by sneaking in to public schools under a massive list of fake fronts and names from medical doctors' findings about the dangerous, some times deadly procedures that people falling for Scientology's NarCONon subject themselves unwittedly to.

The last thing that drug or alcohol addicts need is to be rooked and swindled out of some $20,000, or to be diverted from _real_ addiction treatment.

The web site lists legitimate treatment facilities, none of which claim the magical, mystical, fraudulent success rates that the notorious Scientology corporation does.  There _are_ no magical answers, no magical treatment for drug addiction.  Anyone -- Scientology crmiminals or any normal people -- who tell you they have magical sucecss rates treating addiction are lying.

Scientology's "success rate" was tested scientifically with a full bevy of protocols and was found to be around %6.3.  The placebo success rate -- success rates where people walk away from their addictions without doing anything for treatment -- is 11%.  Scientology's insane quack notions work _less_ than doing nothing.

It's all on Google, testable, falsifiable, verifiable -- Scientology's NarCONon does not work, it's dangerous, it's Scientology after people's money.  Ask the Scientology corporation why they can't come up with any legitimate scientific research results that can be tested and verified that come anywhere close to their insane claims.  The reason they can't is obvious.

My opinions only and only my opinions, as always.

Anyone who wants to email me about Scientology and/or its NarCONon fake front, or anyone who wants to sue these bastards to try to get their money back may email me at and I will direct you to the information you ask for or the attorny who can help you.


accused of being cruel - - Jul 16th 2008


You made what is known as a "Freudian slip" and I have placed a quote from you last E. Mail about Scientology:

"It is a cruel ideology that doesn't want to lend a helping hand when it can.  Case in point, ..."

Interesting because it has been accused of being cruel.

I do not believe that you are spamming and I am pleased that you have gotten help with your addiction. However, Scientologists have a long and documented record of harassing, threatening and attempting to control their members through fear.

Dr. Schwartz

Response to Narconon Critic - kayakotto - Jul 16th 2008
My previous comment has nothing to do with spam, and everything to do with sharing my strength and hope and what worked for me.  This program saved my life and is completely non-denominational. Yes Sceintologists do tend to lend their support to this workable technology, much like other religions support social betterment activities.  It is a cruel ideology that doesn't want to lend a helping hand when it can.  Case in point, I myself attended services at my chosen christian church quite regularly while doing my program, this is an opportunity afforded anyone in drug rehab at Narconon Arrowhead.  From the other comment in regards to my post it is easy to see that some people have an ax to grind, which is their right of course.  However I personally consider it a responsiblity to share what worked for me and lots of others I know.  I would consider myself to be pretty heartless if I didn't want to offer what help and resources I know of and that I know work.  Information and options are the key to informed choices when seeking effective drug rehab.  One particular modality is not going to work for everyone, and the more choices the better.  If one has to belittle or even lie about about choices in order to make themselves look better or more important... well that kind of attitude tells its own story.  Narconon saved my life, when nothing else was working.  If somebody wants to consider this spamming then so be it.

Scientology's - Fredric L. Rice - Jul 16th 2008

That's insane.

Scientology's "NarCONon" quack medical fraud does not work.  It has an actual "success rate" of some 6% -- far less than the 11% success rate one gets if one doesn't do _anything_ to stop one's addiction.

Scientology's "NarCONon" is a fraud, a scam, a crimnial enterprise.  Google search the name "NarCONon" and get an eye full at this criminal scam.

Let's face it: If this criminal cult's insane quack medical frauds actually worked, everybody would use it, there wouldn't be _anyone_ left addicted to _anything_.  Fact is that this NarCONon fraud is organized crime, coimmitting fraud by selling unevidenced, unscientific quack medical frauds to the rubes, marks, and suckers who don't have Intgernet access and are too stupid to do a google search to learn the truth about this crime syndicate.

Effective Drug Addiction Treatment - Kayakotto - Jul 15th 2008

In the rehab I attended to beat my addiction and alcoholism I was taught that there were actual mechanics to addiction. I also learned the three main barriers leading to relapse.  More importantly, I gained tools and skills to be used the rest of my life.  I am 7 years sober now and have no cravings whatsoever or fear of relapse.  There is a great booklet that is free for the asking called "Guide to Addiction Recovery for a Lifetime" at the website I helped save my life, may it will help you or someone you love - check it out!

Editor's Note: This is an example of comment spam. You have to fill out a form in order to gain access to this document, which causes me to think its primary purpose is a marketing tool (so that they can get qualified leads for their rehab program). The rehab itself is Narconon, which is affiliated with the Church of Scientology (read the wikipedia article). I don't recommend that anyone actually seek this out, as I believe this is more about religious evangelism than it is about an actual effective treatment for addiction problems.

Genetic Alcoholism and Panic Attacks - Cathi Corn - Jul 14th 2008

I come from a long family line of alcoholism on my fathers side and on my mothers side it is depression, not a good combination.  My son is 17 years old and has severe Panic Attacks and is an alcoholic.  I've had blood test confirm that he has high levels of enzymes in his liver already and have tried numerous treatments.  He is now in a Youth Services Shelter, which I am not sure at all if this is the kind of treatment he needs.  I refuse to put him on anti depressants because of the effects that fluoxetine had one him.  To make this even harder for me is the fact that every generation on my mothers side has committed suicide either because of mental illness ( depression) or alcoholism ( drink for days straight then shoot yourself).  I need help.

Lost Mother


Is treatment for depression even possible in recovery? - - May 6th 2008

After five years of working 12-step programs, I began experiencing depression. This morning, my Doctor gave me a sample of the antidepressent Cybalta. Within 10 minutes of taking the first dose (60mg,) I felt "high." This has continued for over seven hours, so far. I returned the samples to the Doctor and dumped the remaining six capsules from the open bottle into the office toilet. She claimed that it was impossible to have this reaction, but I know very well what "high" feels like!!! Used as directed, on a Doctors prescription, Cybalta cost me five years of recovery, and I haven't even determined my new sobriety/clean date yet, because I'm still high!!!! Cybalta should NOT be prescribed for patients who take recovery seriously, we're better off with the depression!!!! If this is what anti depressants are like, then treatment in recovery doesn't seem possible.

Editor's Note: There is a difference between medications prescribed by a physician to treat a legitimate health concern and 'recreational' use of drugs and alcohol.  However, no one should have to take a treatment they don't like when there are real alternatives that they may like better.  in this case, the obvious alternative is empirically validated psychotherapy for depression, such as can be found with Cognitive Behavioral Therapy or Interpersonal Therapy.  No side effects at all, but they do require a time committment, some outlay of cash and the willingness to do homework.  

Alcohol - - Apr 21st 2008
Alcohol ruined my fathers life. Alcohol ruins lives. So why would you even buy a bottle of it? Recover fast. Recover and run from the bottle. Run from the pill and the pipe and the straw and the bong and the smoke and the mushroom and the dot and the peyote RUN from it NOW. And watch the colors come back. Drugs are a LIE.                     

I could be a case study - sadie - Apr 6th 2008

I too live out of a pill bottle.

I have been sad as far back as I can remember. I found this site by googling "suicide".

I have had been to doctors, rehabs, church, etc.... I'm still here today (blessing) and still no better.

I'm still messed up. My dad drank, he wasn't violent, just enough to enrage my mental mother, they married and divorced twice. While I would save my food for my sisters, she would make me pray with her to win the publishers cleaning house.

Still don't know if my nuttyness comes from my parents, because of my parents or self induced. I just know I have been miserable most of my life. Can't remember ever having a day when I didn't think of ending my life. I don't look like a pill taker or a depressed person, no one really knows, not even my husband.

I will soon be 45, part of me is afraid I'm going to run out of reasons for keeping the appointments I make with myself (my death) or I'm just so damn tired I could really care less.

I had an aunt that died of breast cancer when she was 36. I have had a few close calls and I always wonder why her instead of me?

Mrs Charlton - doris - Mar 26th 2008
I have bipolr disorder and alcoholism, my insurance soes not cover either. I need help

Close but not quite - Asmos - Jan 25th 2008

Traumatic experiences do not need to be coupled with a high incidence of "substace abuse" within the family to lead to "substance abuse".

One needs to discern between grossly imperfect self medication versus a normal chemically addicted individual. How many times have I tried to reprogram my patterns of thought(with some success for varying lengths of time) through illicit means.

The standardized institutional view of druggies and the pre programmed reactions elicited by both the institution and the individual have done more to harm what should be a relationship with the intent to make a person whole, even if that person may be stuck living out of a pill bottle(like me).

Never ever forget, sometime there are two choices...Bullet in the brain or a bag of weed and a few hits of acid and try like hell to turn it around. If you do it right your temporary cure can last quite some time until a trigger hits and you start looking for your .44 mag or shotgun(closed casket :/)

I have lived in hell since 5, 6, 7, years old and am quite sure of how things work here

I am very aware of the many faucets of my condition(I disassociate alot) and observe that no instantaneous answer exists

Its complex - Freddie - Jan 17th 2008

For some there is an underlying mental illness that can directly or indirectly lead to alcoholism. The illness could be due to an inherited condition (nature) or a learnt condition (nuture) For others there is no illness, alcoholism just creeps up on them. For these people alcoholism is learnt.

Alcoholism then layers over the underlying conditions another illness, which of inself causes depression and so adds to the problems.

Where there is an underlying condition it is obviously imperative to deal with that in parallel with the alcoholism.

I live with an alcoholic and you can see my story here 


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