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Duel Diagnosis

Bipolar Disorder and Opiates: Understanding this Co-Occurring Condition

Understanding the intersection between mental health disorders and addiction is crucial for effective treatment and recovery. Bipolar disorder, when paired with opiate addiction, presents a particularly complex challenge that requires care and comprehensive understanding. 

What is Bipolar Disorder?

Bipolar disorder is a mental health condition characterized by significant mood swings, including emotional highs (mania or hypomania) and lows (depression). These swings affect sleep, energy levels, behavior, judgment, and the ability to think clearly. 

Symptoms and Impact on Life

Episodes of mood extremes may occur rarely or multiple times a year. While most individuals will experience some emotional symptoms between episodes, some may not experience any. The unpredictable nature of bipolar disorder can significantly impact a person’s life, affecting their relationships, career, and ability to perform daily tasks. 

What Exactly Are Opiates?

Opiates are drugs that are derived from the opium poppy plant. Sometimes, opiate drugs are referred to as opioid painkillers. They have a calming effect on those who use them and can provide pain relief. There are two main categories of opiates. These include agonists and antagonists. 

Types of opiates and opioids include the following substances: 

  • Fentanyl 
  • Codeine 
  • Morphine 
  • Oxycodone 
  • Methadone 
  • Hydrocodone 

Generally, opiates are prescribed for pain. Unfortunately, however, many people suffer from opiate dependence. When a person uses opiates regularly, he or she may develop a tolerance for the drugs. As a result of this tolerance, individuals may begin to use higher doses of opiate drugs. This leads to opiate dependence and addiction. 

What is a Co-Occurring Disorder?

A co-occurring disorder refers to when an individual simultaneously experiences a substance use disorder and a mental health disorder. This complexity often complicates diagnosis and treatment, making specialized care essential. 

The Significance of Recognition

Recognizing the presence of co-occurring disorders is critical because symptoms of one disorder often exacerbate the other. This makes the individual’s condition more severe and recovery more challenging. 

Statistic on Bipolar disorder and Opiate Addiction

How Opiates and Bipolar Disorder Are a Harmful Combination

When bipolar disorder coexists with opiate use, the results can be particularly detrimental to an individual’s mental and physical health.

The National Alliance on Mental Illness states that about 56% of individuals with bipolar disorder experience drug or alcohol addiction during their lifetime. 

Opiate abuse among people with bipolar disorder is associated with a higher incidence of suicide attempts, legal issues, and financial problems compared to those with bipolar disorder who do not use opiates. 

Understanding the harmful interaction between opiates and bipolar disorder emphasizes the need for targeted treatment strategies. Addressing both issues simultaneously through a dual diagnosis program can significantly improve outcomes, offering a more stable recovery path and better overall health. 

Here’s a closer look at the risks and dynamics of this combination: 

Exacerbation of Mood Swings

Opiates can dramatically increase the frequency and severity of mood swings associated with bipolar disorder. The depressant effects of opiates can deepen and prolong the depressive phases, while their intoxicating effects can mimic or enhance manic episodes, leading to: 

  • Increased impulsivity and risky behaviors during manic phases. 
  • Intensified feelings of sadness or hopelessness during depressive phases. 

Increased Risk of Addiction

People with bipolar disorder are at a higher risk of addiction compared to the general population. The National Institute of Mental Health notes that the impulsivity associated with manic episodes can lead to substance misuse, which includes opiates. Opiates, being highly addictive, can quickly lead to physical dependence and addiction, complicating bipolar disorder treatment and recovery. 

Dual Impact on Cognitive Function

Both bipolar disorder and opiate use independently impair cognitive function. When combined, these effects are compounded, potentially leading to: 

  • Poor decision-making and judgment. 
  • Decreased ability to focus and process information. 
  • Memory problems. 

Risk of Dual Diagnosis Complications

Having both a substance use disorder and a mental health disorder can complicate the diagnosis and treatment of each condition. Symptoms of one can mimic or mask symptoms of the other, often leading to: 

  • Under-treatment of bipolar symptoms because they are mistaken for typical drug use behavior. 
  • Overlooking opiate dependence because symptoms are attributed to bipolar disorder. 

Treatment Challenges

The presence of both disorders requires an integrated treatment approach, which is more complex and often more prolonged than treatment for a single condition. According to a study in the Journal of American Medical Association, individuals with dual diagnoses are less likely to receive appropriate care for both conditions, and they have a higher rate of hospitalization and emergency care use 

The Importance of Dual Diagnosis

Dual-diagnosis treatment is vital for individuals dealing with both bipolar disorder and opiate addiction. This approach addresses both conditions simultaneously, recognizing that each can influence the course and recovery of the other. Effective dual diagnosis programs provide integrated treatment that offers better outcomes than treating one condition at a time. These programs typically combine medication management, psychotherapy, and support groups to ensure holistic care.

Recovery is Possible with Sana Lake

Understanding the interplay between bipolar disorder and opiate addiction highlights the need for specialized treatment approaches like dual diagnosis. If you or someone you know is facing these challenges, reaching out for professional help can be a crucial step towards recovery. Consider seeking treatment facilities that specialize in co-occurring disorders in St. Louis to start on the path to recovery. 

At Sana Lake Recovery, we have several programs including residential treatment, outpatient rehab, and recovery supportive housing. With locations in O’Fallon, St. Louis, Dittmer, Maryland Heights, and Affton, we have the resources to support you on your recovery journey. Call us today.

  • U.S. Department of Health and Human Services. (n.d.). Substance use and co-occurring mental disorders. National Institute of Mental Health. 
  • Rizk MM, Herzog S, Dugad S, Stanley B. Suicide Risk and Addiction: The Impact of Alcohol and Opioid Use Disorders. Curr Addict Rep. 2021;8(2):194-207. doi: 10.1007/s40429-021-00361-z. Epub 2021 Mar 14. PMID: 33747710; PMCID: PMC7955902. 
  • SAMHSA. (2016). An Introduction to Bipolar Disorder and Co-Occurring Substance Use Disorders  . In Brief, 15(2). 
  • Fahimi, J., Aurrecoechea, A., Anderson, E., Herring, A., & Alter, H. (2015). Substance Abuse and Mental Health Visits Among Adolescents Presenting to US Emergency Departments. Pediatric Emergency Care, 31(5), 331.  
Picture of Ashley Murry LCSW
Ashley Murry LCSW
Ashley Murry, LCSW, is the Chief Clinical Officer at Sana Lake Recovery. She oversees clinical operations, ensuring effective treatment strategies and compliance. Before this, she was Program Director at Gateway Foundation, managing care programs and collaborating with state departments. Ashley has also served as Director of Clinical Services at Treatment Management Company, improving staff retention and clinical standards. She holds a Master's in Social Work from the University of South Florida and a Bachelor's in Social Work from Saint Leo University. She is licensed in Florida, Arizona and Missouri.
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