University of Calgary

Serious addictions start sooner

UToday HomeFebruary 12, 2013

A recent study by Dr. Anne Duffy, holder of the CAIP Professorship in Child and Youth Mental Health, examined the relationship between substance abuse and bipolar disorder in adolescents. Photo by Janelle PanA recent study by Dr. Anne Duffy, holder of the CAIP Professorship in Child and Youth Mental Health, examined the relationship between substance abuse and bipolar disorder in adolescents. Photo by Janelle PanChildren at risk of bipolar and related mood disorders can develop serious substance abuse as young as 14, says a new study by Dr. Anne Duffy, the holder of the Campus Alberta Innovates Program (CAIP) Professorship in Child and Youth Mental Health at The Mathison Centre for Mental Health Research & Education, Hotchkiss Brain Institute and professor of Psychiatry in the Faculty of Medicine at the University of Calgary.

The study, published recently in the Journal of Affective Disorders, examined the relationship between substance use disorders and the early clinical course of bipolar disorder. It followed 211 youth who are at high risk of developing bipolar disorder because one of their parents have the illness.

“We know that substance abuse is a major complicating factor for youth in in the early course of psychiatric disorders,” says Duffy, the lead investigator of the ongoing, longitudinal study initially launched in 1995. “But the very early age at which serious addictions were manifesting was a big surprise.”

The study found that youth as young as 14 — about the same age that diagnosable mood episodes begin to show themselves — were developing serious drug addictions.

“These are kids at risk for bipolar disorder,” says Duffy. “Most of the ones we’ve been in touch with haven’t made it all the way to full blown illness ― they’re at the early clinical stages.”

Substance abuse “wreaks havoc” on the course of the illness and treatment for bipolar disorder, Duffy says. “Every indicator of outcome is worsened by the development of drug use whether it’s hospitalization, suicidality or poor response to treatment or functioning at school or in relationships.”

The medical literature in the 1970s and 1980s indicated that people with mood disorders would turn to alcohol starting in early adulthood.

“Now we’re seeing it happening a lot earlier and it’s not just alcohol, it’s cannabis and other chemicals,” says Duffy. “Cannabis is a hallucinogen. It’s much more potent than it used to be and it’s often laced with other chemicals and can cause serious brain toxicity.”

Duffy says there is not a lot of longitudinal research into understanding why so many young people develop serious substance abuse so early in the course of bipolar disorder. More research will lead to a better understanding of the factors behind it and therefore more effective early intervention and prevention strategies.

“Substance abuse is a complicating factor earlier in the course of the development of bipolar disorder,” says Duffy. “It has major implications for how we organize care and this should be a public health priority.”

Read the full study.