The Burden of Substance Abuse and Mental Disorder
There are a variety of reasons why it has been so difficult to quantify the true cost of mental and substance abuse disorders, including:
- Variations in data collection and the subjectivity in interpretation can lead to disease classifications that don’t accurately illustrate the severity of such condition. For example, suicides and drug overdoses, often the result of mental and substance abuse disorders are typically classified “accidental” injuries or poisonings.
- Conditions like severe anxiety and alcoholism can manifest themselves in many ways and without a standard set of symptoms, like those that accompany conditions like heart disease or diabetes, it can be difficult to accurately identify such conditions when treatment is likely to be of greater benefit.
- No clear consensus exists in how to best measure the true social and economic cost of conditions whose physical and social impact is not as easily identifiable. According to the data, as insensitive as it may sound, mental and substance abuse disorders don’t generate the number of deaths as other diseases like HIV and AIDS, malaria and tuberculosis.
- Conditions that don’t have a direct impact upon one’s physical health are typically not reported or accurately diagnosed. This is fairly intuitive when we think about how often alcoholism skirts diagnosis because one is unwilling to accept their condition or unable to recognize its manifestation.
And, the inability to accurately account for their social and economic impact stifles effective policy development and treatment strategies aimed at reducing their burden on a global scale.
However, that may soon change as two studies recently published in The Lancet go to great lengths to overcome deficiencies in reporting and measuring to help policy makers, public health officials and the public better recognize the toll that mental and substance abuse disorders cause around the world.
According to first study we are going to highlight, mental and substance abuse disorders are the leading cause of non-fatal illness worldwide in 2010 and are responsible for more of the global burden of death and illness than the well known and more easily measured conditions mentioned above. Sourcing its data from the GBD (Global Burden of Disease) initiative undertaken by the Institute for Health Metrics and Evaluation, or IHME, researchers found that, although these conditions were the fifth leading contributor to death and disease, looking at them through the lens of disability-adjusted life years, or DALYs, they are responsible for more than a fifth (22.8%) of the disease burden worldwide.
According to the second study, when we drill down to the burden attributable to illicit drug use we find that substance abuse and dependence is highest among industrialized economies and is weighted more heavily against men. The study was also able to almost intuitively conclude that the burden associated with the four most habit forming illicit drugs – amphetamines, cannabis, cocaine and opioids – is still eclipsed by the effects of legal drugs like tobacco and alcohol. But, according to a article published in Medical Press, per capita disease burden of illicit drug use exceeds that of tobacco use and alcohol dependence worldwide.
In my opinion, this is truly ground breaking information. Now that we are getting closer to fully understanding the scale of mental and substance abuse disorders around the world, we can enter policy discussions more informed about the current situation with actual data to guide the decision-making process.
Awareness is a beautiful thing, right?!
The real trick is going to be mobilizing those in power to make the decisions necessary to effect real change.
According to IHME director Christopher J.L. Murray, “Health is a lot more than simply avoiding death,” and we would be well served to fully account for the impact that mental and substance abuse disorders have upon global wellness.
For the data nerds out there, the video below provides a little insight into how the fine folks at the IMHE are working towards collecting and analyzing global health information as it pertains to non-communicable diseases like mental disease and substance abuse while providing you access to a few tools that may help us recognize how such conditions may impact us on a more personal level.