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Drug and alcohol use

How is drug an alcohol use related to people with bipolar disorder?

Substance use is a concern for people with a mental illness due to the association with poor clinical and social outcomes. It places additional burden on patients, families, psychiatric services, and government resources due to high rates of treatment non-adherence and relapse.
Abuse leads to risk-taking behaviour, illegal activity, interpersonal problems and a loss of interest in usual activities. It jeopardises physical health and neglect of important commitments at home, school or work.

What is the evidence for drug and alcohol use in people with bipolar disorder?

Moderate quality evidence finds a medium to large increased risk of bipolar disorder in people with any substance use disorder. In children and youth with bipolar disorder, moderate to low quality evidence finds the rate of substance use disorders is around 31%. Rates were higher in youth than in children, and in youth with comorbid post-traumatic stress disorder or disruptive behaviour disorder.

High quality evidence finds more manic episodes in people with bipolar disorder and a substance use disorder than in people with bipolar disorder without a substance use disorder. Moderate quality evidence finds associations between having a comorbid substance use disorder and having a diagnosis of bipolar I rather than bipolar II, being male, having a history of suicidal behaviour, having an early age of onset of bipolar disorder (<18 years), and having a greater risk of hospitalisation. High levels of alcohol increased the risk of a mood recurrence and rapid-cycling, while cannabis use was associated with more treatment non-adherence, depression, anxiety, mania, mood episodes, and more insomnia or hypersomnia.

April 2019

Last updated at: 2:54 am, 5th April 2019
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Fact Sheet Technical Commentary

NeuRA Libraries

Title Colour Legend:
Green - Topic summary is available.
Orange - Topic summary is being compiled.
Red - Topic summary has no current systematic review available.