Drug Use And Mental Health.

Question 1

Smoking and mental health

Answer 1

Very high rates. 45% of schizophrenics smoke. 32% of depresssion.vs 15% of gen pop. 75-85% of addicts have mental illnesses.
Office for national statistics, higher neurotic symptoms are linked to heavier use.

Question 2

Premature deaths and MI

Answer 2

Twice as much cardiovascular, three times as much respiratory issues and cancer. Life expectancy is 61 not 75. Smoking causes more deaths than suicide.

Question 3

Self medication hypothesis

Answer 3

Poor MI increases drug use to relieve symptoms. Stimulants have reinforcing mood altering effects. Used as meds for mood disorders and schiz. Depressants sedate CNS so self med for anxiety, fear and PTSD. Opioids are paint relieving used for trauma (PTSD) 41% bipolar claim to self med.

Question 4

Withdrawal hypothesis

Answer 4

Claims drugs don’t help MI but treat withdrawal which causes anxiety depression ect. Leads to cycle of withdrawal.

Question 5

Pasman 2018. Schiz causing cannabis.

Answer 5

Bidirectional 2 sample MR. Genetic risk factors for schiz predict cannabis use.
X need to measure frequency and heaviness of use.

Question 6

Wootton 2018

Answer 6

Bidirectional MR sample, measured lifetime smoking and depression genes. Depression predicts smoking.
Also works the other way round. Longitudinal measured smoking at time point 1 and dperession a year later. Smoking predicted depression, depression was 4x higher in smokers.

Question 7

Cannabis and psychosis

Answer 7

Meta-analysis of longitudinal studies. 40% increase in risk of psychosis of had ever used cannabis. Studies accounted for confounding factors.

Question 8

Self medication and smoking.

Answer 8

Review of the effect to smoking cessation on mental illness. Self medication says mental health should fall, withdrawal says should get better. 6 weeks later showed lower anxiety and dperession, increased quality of life, and lower stress. Undermines self medication. Supported by Wootton 2018.

Question 9

Smoking as harm reduction

Answer 9

Some people encouraged to start smoking in secondary mental health services. Very very prevalent in inpatient settings. Used as a reward system. Drs strongly believe in self medication.

Question 10

Actual impact of smoking

Answer 10

Leading cause of death in patients with MI and addictions. Increase depression and suicide, adversely impacts psych treatments and is ineffective long term for stress. Cessation doesn’t harm recovery.

Question 11

Smoking and hospital policy

Answer 11

87% have active policy, 79% active comprehensive policy. 2/3rds mentally ill smokers want to quit.