Substance Abuse and Mental Health: The Question of Psychiatric Medication


As noted last week’s blog on mental illness and substance abuse, many people with substance abuse and mental health greatly impact each other. This runs the spectrum from mild but chronic depression to complete lack of capacity for comprehending reality. Proper understanding and treatment of mental illness may keep many from turning to addictive substances to counter their misery of chemical medication. Is there a danger that use of psychiatric medications could itself lead to substance addiction?

To some degree, any drug used to treat a chronic condition is “addictive” in that stopping it suddenly is likely to result in old symptoms reasserting themselves with painful intensity. (Even with acute illness where the whole point of medication is to take it only long enough to effect a complete cure, doctors warn that stopping prematurely may leave the strongest germs alive to trigger a relapse.) Although few modern psychiatric medications contain chemicals with high risk of physical addiction—the sort that demands periodically increased doses and causes dangerously severe illness during withdrawal—they do create a “new normal” for the brain, which struggles to adjust in the early stages of use and even more upon discontinuation. This is in part how many individuals develop an issue with their substance abuse and mental health.

Medication and Your Brain Function

The brain is our most complicated and individualized organ. So, it’s not surprising that finding the “right” psychiatric prescription is often a matter of trial and error. Most patients endure a “lab rat” period of a year or more. During this time, they must try several different drugs and dosages before finding the prescription that works. The question of whether psychiatric medication is “for life” also has varying answers. Some people only need it to give strength until they build other coping skills or make it through a tough period. Others, particularly those with severe schizophrenia or other psychotic disorders, have little choice but to take long-term medication.

In light of all that, one rule concerning psychiatric medication is absolute: take it only under the guidance of a qualified doctor, and only according to prescription; if the prescribed dose isn’t “doing it” for you or is causing side effects, ask a doctor for advice and never experiment with changes on your own.

Self-Care is Key

Another thing to remember: recovery from any illness involves more than a prescription. The patient is responsible for taking practical action. For example, you need extra bed rest if you have the flu. If you have prediabetes, you need to watch your diet. And if you have major depression or bipolar disorder, you need to regularly practice healthy thinking and action. This is no less than you would when rebuilding life after substance abuse and mental health issues. The #1 impediment to regaining good health (physical, mental, or behavioral), and the bane of many a doctor’s existence, is the attitude “just give me a pill that will let me continue my coffee-and-doughnut-fueled, office-bound, achievement-obsessed life with impunity.” Anyone who has been down the substance-abuse road knows the folly of trying to manage life by “pill popping.”

Most former substance abusers also know there is no “cure” for addiction; the weakness that makes even one drink a special risk will remain. Likewise, there is no “cure” for most mental illnesses, only “recovery” to the point of regaining healthy everyday function, with or without ongoing use of medication.

But then, no one ever said effective life management was meant to be free of challenge.

Appendix: Common Types of Psychiatric Medication

These are the four most recognized categories, grouped by the mental symptoms they treat:

Anti-Anxiety Medications

Used to treat panic disorders, phobias, and compulsive worrying (generalized anxiety disorder) by reducing physical tension and other symptoms associated with anxiety. They are subdivided into long-term medications (which include antidepressant properties) and short-term medications (which have a strong tranquilizing effect that reduces sweating, heart pounding, and other physical symptoms of panic). Short-term medications have greater addictive potential than the long-term variety.


These medications increase the effectiveness of “positive-feeling” brain chemicals such as serotonin and dopamine, which boost energy and block the “down” feeling. Antidepressants are frequently prescribed for PTSD and OCD as well as clinical depression. Most medications in this category pose little danger of addiction.


Prescribed for schizophrenia and other psychotic disorders, this category of mental illness that most impairs real-world functioning. These medications work primarily by adjusting the brain’s dopamine levels, thus reducing susceptibility to hallucinations and delusions. (Excessive amounts of dopamine, the feel-good chemical your brain releases in pleasurable situations, are associated with a detachment from reality, similar to that associated with “pleasure” drugs.) Antipsychotics are not typically addictive, but missed doses carry significant danger to the patient’s wellbeing.

Mood Stabilizers

Typically used to treat bipolar disorder, informally called “manic-depression” for the intense mood swings that patients experience. Some mood stabilizers have anticonvulsant properties; most carry danger of physical side effects and necessitate regular medical checkups to ensure overall good health. However, they pose little addictive risk.

Substance Abuse and Mental Health Treatment with Kemah Palms

Kemah Palms Recovery® recognizes the need for dual diagnosis treatment in addiction recovery. Our comprehensive addiction therapy services include key programs such as:

These programs are key to ensuring we treat both the substance abuse and mental health issues at all levels. For more information, call Kemah Palms at 855-568-0218 today.