When the weight of depression was too great, Christine drank. But when a friend told her about Oxycodone, a doctor-prescribed opioid that might make her feel better, Christine simply told her doctor that she had back pain and walked out of the office with a prescription. Oxycodone helped, but it was expensive and her doctor eventually asked questions. Christine did what thousands of others do: she turned to a cheaper, more accessible solution: heroin.

The open window

Stories like this one are repeated all over the country. The pain of untreated mental illnesses can lead people to self-medication, using drugs and alcohol to temporarily assuage their symptoms. A sudden and substantial drop in opioid prescriptions—19 percent in two years—meant many of those who turned to opioids had to find alternatives, like heroin.

Mental health problems can be a catalyst for substance use, and it works the other way, too. While alcohol and drug use provides release from mental health symptoms, it can also interfere with awareness of the drug’s negative effects, increasing the likelihood of addiction. For others, drug use creates conditions in which latent mental illness can flourish, or it can actually cause symptoms of mental illness, feeding the addiction and creating a vicious cycle.

"A sudden and substantial drop in opioid prescriptions—19 percent in two years—meant many of those who turned to opioids had to find alternatives, like heroin."

Symptoms vs. causes

We need to stop seeing the illness and treat the whole person. Too often, we treat the addiction, while the mental illness is ignored. Integrating mental health, addiction and primary care services produces the best outcomes when caring for people with multiple health needs, like addiction and mental illness. Community treatment providers nationwide are already implementing this holistic approach, but it still needs broader adoption.

Access to medical care for addictions and mental illnesses is now ensured under the Affordable Care Act, Mental Health Parity and Addiction Equity Act and expansion of Medicaid services. This means help and hope for all Americans, even the uninsured. But only if these policies and laws are enforced.