Personality Disorder, Alcoholism Put Opioid Addicts at Increased Risk of Death
People with opioid addiction or opioid abuse have increased chances of dying when they also have co-existing problems with alcohol use disorder or a personality disorder, according to recent findings from a team of British researchers.
Broadly speaking, people affected by opioid use disorder (diagnosable opioid abuse and/or addiction) have higher chances of dying prematurely than their non-substance-using counterparts in the general population. In a study published in January 2015 in the journal Drug and Alcohol Dependence, researchers from two British institutions looked at the impact that co-occurring alcohol use disorder or personality disorder have on the odds that a person with opioid use disorder will die from any cause or die from specific causes.
Opioid Use and Overdose-Related Death
Whether they’re useful medications or illicit/illegal drugs, all opioids significantly slow down the baseline rate of nerve cell communication inside the body’s central nervous system (brain and spinal cord). When central nervous system activity levels fall too low, any opioid user can experience an overdose, which occurs when normally automatic, life-sustaining processes like breathing no longer function reliably. Generally speaking, an overdose is a likely cause of premature death in a person who consumes excessive amounts of an opioid drug or medication, whether or not that person meets the terms for diagnosing opioid use disorder.
Americans improperly consume opioid medications substantially more often than they improperly consume any other prescription substances. While much of the focus on opioid-related overdose centers on heroin intake, prescription opioid overdose is a more likely scenario for the average individual. Figures compiled by the federal Centers for Disease Control and Prevention for the year 2012 indicate that approximately 46 Americans die every day after overdosing on an opioid medication. In contrast, roughly eight Americans die every day from heroin overdoses. However, current trends show a substantial rise in heroin-related overdose deaths that’s at least partially related to a transition from medication misuse to heroin intake in opioid-using population groups.
Alcohol Use Disorder
Alcohol use disorder is defined by separate or overlapping problems with diagnosable alcohol dependence (i.e., alcoholism) or non-addicted but dysfunctional alcohol abuse. Since 2013, doctors have used the American Psychiatric Association-generated criteria for this disorder to identify all serious alcohol-related issues in their patients. Any given person can be mildly, moderately or severely affected by alcohol use disorder. Severely affected individuals commonly have a physical dependence on excessive alcohol intake.
Personality disorders are a group of 10 mental illnesses also defined in the U.S. by criteria established by the American Psychiatric Association. These illnesses get their name because they involve the presence of specific, fixed personality traits that seriously or severely interfere with the ability to do such things as live independently, maintain stable relationships or set or reach achievable life goals. Prominent examples of personality disorders include borderline personality disorder, antisocial personality disorder, obsessive-compulsive personality disorder and paranoid personality disorder.
Impact on Opioid-Related Mortality
In the study published in Drug and Alcohol Dependence, researchers from the United Kingdom’s King’s College London and National Health Service used data from 4,837 adults affected by opioid use disorder to examine the impact that alcohol use disorder and personality disorders have on the rate of opioid-related mortality. The researchers used the same data to determine if alcohol use disorder or a personality disorder increases the chances that people with opioid use disorder will die from specific causes.
A total of 176 of the 4,837 study participants died over the course of the project. The researchers concluded that the presence of either alcohol use disorder or a personality disorder significantly increases the chances that a person with opioid use disorder will die. This fact holds true even when other mortality-related considerations such as the extent of opioid use and general physical well-being are taken into account. The researchers also concluded that both alcohol use disorder and personality disorders influence the specific causes of death in people with diagnosable opioid problems. Affected individuals with alcohol use disorder have greater chances of dying from an overdose, as well as greater chances of dying from liver-related ailments. Affected individuals with a personality disorder also have increased chances of dying from liver disease, but not from overdoses.
Among other things, the study’s authors believe that their findings underscore the critical importance of identifying cases of personality disorder and alcohol use disorder in people already dealing with opioid use disorder.