Psychiatric Disorders Are Overlooked in Patients with Drug Abuse
disease is overlooked in drug users. Patients with both drug abuse and a
psychiatric disease - dual diagnosis - suffer decreased compliance to treatment
and decreased life expectancy compared with single-diagnosis patients.
Identifying the patients among either drug addicts or mentally ill patients is
addicts autopsied at the Department of Forensic Medicine, University of
Copenhagen, Denmark, in the years 1992, 2002 and 2012 were included. The group
was divided into two subpopulations of possible dual diagnosis patients either
according to police reports stating mental illness or to psychotropics found in
the toxicology screening after autopsy.
a rise in possible mental illness in both subpopulations in the study period.
Drug addicts with psychotropics in the blood at the time of death increased
from 3.1% in 1992 to 48.1% in 2012, and this group was significantly younger at
the time of death than those without psychotropics in the blood.
dual diagnosis patients have increased in number. They die earlier than their
drug addict counterparts. Methadone remains the leading cause of death in all
subpopulations. Possible causes are misuse of treatment and/or illegally bought
methadone, wrongly assigned cause of death due to unknown tolerance and/or
polydrug toxicity in combination with psychotropic medicine.