Marijuana Abuse and Social Anxiety Disorder

A recent public health study has brought to light the relationship between marijuana abuse and social anxiety disorder.  The findings have shown that a significant proportion of people who abuse marijuana also suffer from social anxiety disorder.  Additionally, nearly all of those with social anxiety disorder related to or with marijuana abuse had at least one other significant psychiatric problem.  The co-occurrence of a substance abuse disorder and a psychiatric disorder is referred to as a dual diagnosis disorder.  The findings of one study focused on the importance of determining whether patients with marijuana abuse also suffer from social anxiety disorder.  The evidence suggests that social anxiety can be both a cause and a consequence of marijuana abuse.  They suggest that treating both is necessary to helping these patients recover from dual diagnosis disorders.

The Relationship Between Social Anxiety and Marijuana Abuse
The National Epidemiologic Survey on Alcohol and Related Conditions (NESARC) performed a survey on 43,093 people.  Of those respondents, 7.6 percent (3,297 people) reported having abused marijuana at some point in their lives. Of those who admitted to marijuana abuse, 10.3 percent (340 people) also reported having had a diagnosis of social anxiety disorder.  
Assessing for and treating the dual diagnosis of social anxiety disorder in patients with marijuana abuse can help aid in the treatment of those recovering from substance abuse.  In patients with comorbid social anxiety and marijuana abuse, social anxiety must also be treated to facilitate recovery and prevent relapse.

Which Came First?
More than 80 percent of the respondents in the above survey who admitted to marijuana abuse comorbid with social anxiety disorder reported their social anxiety came before their marijuana abuse.  About 15 percent reported the opposite.

Unfortunately, both social anxiety disorder and marijuana abuse exacerbate each other, making it difficult to determine which disorder is the cause and which is the effect.  This is typical of most dual diagnosis disorders.  On the one hand, marijuana abuse may be used by an individual as a self-medicating tactic to help reduce symptoms of social anxiety, but marijuana use could also create social difficulties, including feelings of paranoia, thereby increasing symptoms of social anxiety disorder.

For those who abuse marijuana to help cope with anxiety symptoms, treatment should include skills to help them better manage their social anxiety disorder.   Likewise, those whose social anxiety is caused by marijuana abuse could also learn strategies to help them better cope with social stressors or other interpersonal difficulties that arise from marijuana abuse. 

Other Problems Associated with Comorbid Marijuana Use and Social Anxiety

Research has shown that those with both marijuana abuse and social anxiety disorder experience more severe health problems than those who suffer from marijuana abuse only.  Among the respondents of the NESARC survey, 21 percent of those who had cannabis dependence (a compulsive use of the drug with associated physiological and psychological side effects) also had the diagnosis of social anxiety disorder.  Comparatively, only 8.5 percent of those who met criteria for marijuana abuse (without excessive physiologic and psychological side effects) had a dual diagnosis involving social anxiety disorder.

Other Comorbidities
Patients with marijuana abuse and social anxiety disorder likely have other psychiatric disorders.  Data from the NESARC survey shows that greater than 99 percent of respondents with marijuana abuse and social anxiety disorder also described symptoms of at least one other psychiatric disorder.  Over 98 percent experienced another substance use, mood or anxiety disorder, and about 73 percent reported a personality disorder like obsessive-compulsive disorder, avoidant, paranoid, schizoid or antisocial behavior.  The chances of someone with comorbid marijuana abuse and social anxiety disorder reporting a third psychiatric related illness was over 7 times greater than those who were only diagnosed with marijuana abuse. Of course, individuals diagnosed with both disorders reported more health problems than those diagnosed with only marijuana abuse.

Clinical Indications
Social anxiety disorder is often overlooked in drug treatment settings because providers are focused more on the treating the substance abuse alone. This is also true for other comorbid anxiety disorders with substance abuse.  Addressing the anxiety disorders, including social anxiety, in substance abuse treatment programs will improve the chances of a successful recovery and reduce the chances of relapse. Identifying comorbid psychiatric disorders, including social anxiety disorder, in a patient with marijuana abuse, can also alert the clinician to other possible underlying disorders.  The relationship between anxiety disorders and substance abuse are complicated and the identification of comorbid psychiatric disorders in substance abuse patients is necessary for effective treatment.

Because our substance abuse treatment center relies on evidence based practices, our Substance Abuse Intensive Outpatient Program shares many common methods with other successful rehab programs.  The foundations of our dual diagnosis treatment program for substance abuse also rely on the principles of harm reduction, motivational interviewing, stages of change and cognitive behavioral therapy to promote recovery from alcohol abuse and drug treatment.  In fact, our Intensive Outpatient Program in Memphis, TN that has been proven to be effective in the alcohol abuse treatment and drug abuse treatment in peer reviewed treatment outcome studies.   Our treatment center  provides services to those who need more treatment than one hour a week, but less than 24 hour care, by providing three hours of treatment per day, three to five days per week, in an intensive outpatient setting.  If you or a loved one is showing signs of alcohol abuse or needs drug treatment rehab, they should be assessed by a trained mental health professional who can help design a substance abuse treatment plan that can result in recovery.  Treatment for substance abuse can be highly successful.  Call us at 901-682-6136 to schedule an appointment.

Source: http://www.alcoholismdrugabuse.com