When two disorders or illnesses occur simultaneously in the same person, they are comorbid. Surveys show that drug abuse and other mental illnesses are often comorbid. Six out of ten people with a substance abuse disorder may also suffer from another form of mental illness. The high prevalence of comorbidities does not mean that one condition causes the other, even if one appears first. Drug abuse can cause a mental illness. Mental illness can lead to drug abuse. Common risk factors cause drug abuse and mental disorders.

Addiction Treatment Medications

Medications help with different aspects of the treatment process. Withdrawal Medications can suppress withdrawal symptoms during detoxification. However, medically assisted detoxification is not in itself "treatment." Detoxification is only the first step in the treatment process. Patients who go through medically assisted withdrawal but do not receive any further treatment show drug abuse patterns similar to those who were never treated. Treatment Medications can help reestablish normal brain functioning and prevent relapse by diminishing cravings an addict may have. Currently, doctors prescribe detox medications for opioid additions like heroin, morphine, tobacco (nicotine) and alcohol addiction, and are developing others for treating stimulant addictions to cocaine, methamphetamine and cannabis (marijuana) addictions. Most people with severe addiction problems use and abuse more than one drug and require treatment for multiple substance abuses. Opioids Methadone, buprenorphine and, for some individuals, naltrexone are effective medications for treating opiate addictions. Acting on the same targets in the brain as heroin and morphine, methadone and buprenorphine suppress withdrawal symptoms and relieve cravings. Naltrexone works by blocking the effects of heroin or other opioids at their receptor sites and doctors only prescribe these drugs for certain patients who underwent detoxification. Because of compliance issues, naltrexone is not as widely used as other medications. All medication helps patients disengage from seeking out drugs and other criminal behavior, and aid addicts in being more receptive to behavioral treatments. Tobacco Drug companies make many kinds of nicotine replacement therapies including the patch, a spray, gum and lozenges, which are available over the counter. In addition, the Federal Drug Administration approves two prescription medications for tobacco addiction: bupropion and varenicline. These drugs have different act on the brain differently, but both help to prevent relapse in people trying to quit smoking. Doctors recommend each medication for use in combination with behavioral treatments, including group and individual therapies, as well as telephone-quit lines. Alcohol The Federal Drug Administration approves three medications for treating alcohol dependence: naltrexone, acamprosate and disulfiram. A fourth drug called topiramate exhibits encouraging results in clinical trials. Naltrexone blocks opioid receptors that are involved in the rewarding effects of drinking and in the craving for alcohol. Naltrexone reduces relapsing to heavy drinking and is highly effective in some patients, likely due to genetic differences. Doctors believe that acamprosate reduces symptoms of protracted withdrawal, such as insomnia, anxiety, restlessness and dysphoria, which is an unpleasant or uncomfortable emotional state, similar to depression, anxiety or irritability. Acamprosate may be more effective in patients with severe dependence. Disulfiram interferes with the degradation of alcohol, resulting in the accumulation of acetaldehyde, which, in turn, produces a very unpleasant reaction that includes flushing, nausea and heart palpitations when a patient drinks alcohol. Compliance can be a problem, but among patients who are highly motivated, disulfiram can be very effective.

What Disrupts Sleep?

Many factors can prevent a good sleep. These factors range from well-known stimulants, such as coffee, to certain pain relievers, decongestants and other culprits. Many people depend on the caffeine in coffee, soft drinks (for example, colas) or tea to wake up in the morning or to stay awake. Caffeine is blocks the cell receptors that adenosine uses to trigger its sleep-inducing signals. In this way, caffeine fools the body into thinking it is not tired. It can take up to eight hours for the effects of caffeine to wear off completely. Drinking a cup of coffee in the late after­noon consequently may prevent a person from falling asleep at night.
Nicotine is another stimulant that can keep a person awake. Nicotine also leads to lighter than normal sleep. Heavy smokers also tend to wake up too early because of nicotine withdrawal. Although alco­hol is a sedative that makes it easier to fall asleep, it prevents deep sleep and REM sleep, allowing only the lighter stages of sleep. People who drink alcohol also tend to wake up in the middle of the night when the effects of an alcoholic "nightcap" wear off.
Certain common prescription and over-the-counter medicines contain ingredients that can keep people awake. Many pain relievers contain caffeine. Heart and blood pressure med­ications known as "beta blockers" can cause difficulty falling asleep and increase the number of awakenings during the night. People who have chronic asthma or bronchitis also have more problems falling asleep and staying asleep than healthy people, either because of breathing difficulties or because of medicines. Other chronic painful or uncomfortable conditions, such as arthritis, congestive heart failure and sickle cell anemia, can disrupt sleep, too.
A number of psychological disorders, including schizophrenia, bipolar disorder and anxiety disorders, disrupt­ sleep. Depression often leads to insomnia and insomnia can cause depression. Some of these psychological disorders are more likely to disrupt REM sleep. Psychological stress also takes its toll on sleep, making it more difficult to fall asleep or stay asleep. People who feel stressed also tend to spend less time in deep sleep and REM sleep. Many people report having difficulties sleeping after having recently lost a loved one, are undergoing a divorce or are under stress at work.
Menstrual cycle hormones can affect how well women sleep. Progesterone is known to induce sleep and circulates in greater concentrations in the second half of the menstrual cycle. For this reason, women may sleep better during this phase of their menstrual cycle, but many women report trouble sleeping the night before their menstrual bleeding starts. This sleep disruption probably relates to the abrupt drop in progesterone levels in the bodies just before the period begins.
Certain lifestyle factors may also deprive a person of needed sleep. Large meals or exercise just before bedtime can make it harder to fall asleep. Studies show that exercise in the evening delays the extra release of melatonin at night that helps the body fall asleep. Exercise in the daytime, on the other hand, is linked to improved nighttime sleep.
Most people report that it is easier to fall asleep after having time to wind down into a less active state before sleeping. Relaxing in a hot bath before bedtime may help a person fall asleep. Body temperature also drops after a hot bath in a way that mimics, in part, what happens as the falls asleep. Probably for both these reasons, many people report that falling asleep more easily after a hot bath.
Sleeping environment also can affect sleep. Clear the bedroom of any potential sleep distractions, such as noises, bright lights, a television or computer. Having a comfortable mattress and pillow can help promote a good sleep. People also sleep better if the temperature in the bedroom is on the cool side.