Running head: and connection to substance abuse 1
comorbidity and connection to substance abuse 6Literature Review
Comorbidity and Its Connection to Substance Abuse, Treatment, and Relapse
Paula King
Walden University
Capstone
Dr. Jane Lyons
June 23, 2019
Comorbidity and Its Connection to Substance Abuse, Treatment, and Relapse
Comorbidity is considered as two or more conditions that occur in one person. These disorders can happen one after another or at the same time. Comorbidity has a strong connection with substance abuse, treatment, as well as relapse (Kelly & Daley, 2013). It is essential to note that many of those who suffer from substance use disorder usually develop other mental disorders, which is a similar case to many of those diagnosed with mental disorders. Research indicates that about half of those experiencing mental illnesses have a high probability of experiencing substance abuse disorders at some time in their life. Some few research have been conducted on children, and the result indicates that youths with substance abuse disorder typically have a high rate of co-occurring mental diseases like anxiety and depression (Child, 2012). Clinicians must find an effective way to treat individuals with substance use and addictions mental health disorders. To be effective they need to prescribe the right medication to treat alcohol, opioid, and nicotine addiction and there are also medications to alleviate symptoms of mental disorders. There are some behavioral therapies that have promise in treating comorbid conditions. The programs are tailored for the clients according to age, drug misused, and other factors, which can be used alone or with medication. Some effective therapies for treating comorbid conditions: cognitive behavioral therapy, Dialectical therapy, assertive community treatment, therapeutic communities, and contingency management (Kelly & Daley, 2013).
According to Woody and Blaine (1979) for over 25 years there has been a correlation between substance abuse illnesses and other mental disorders is not a visible indication that one resulted in another, albeit one came after another. Understanding the directionality or causality can sometimes be difficult because of different reasons. For instance, emotional or behavior issues may not be severe enough to raise the alarm for diagnosis. However, sub-clinical mental health concerns may prompt abuse of drugs. The main factors that contribute to comorbidity between mental illnesses and drug abuse disorders include the aspect of conventional risk factors, the possibility of mental diseases contributing to addiction and drug abuse, and the possibility of drug abuse and addiction contributing to the growth of mental health disorders (Bukstein & Horner, 2015). Drug use and mental health illnesses can result from coinciding aspects such as epigenetic and genetic exposures, concerns with related parts of the brain, and environmental factors.
Running head and connection to substance abuse1comorbidity an.docx
1. Running head: and connection to substance abuse 1
comorbidity and connection to substance abuse 6Literature
Review
Comorbidity and Its Connection to Substance Abuse, Treatment,
and Relapse
Paula King
Walden University
Capstone
Dr. Jane Lyons
June 23, 2019
Comorbidity and Its Connection to Substance Abuse,
Treatment, and Relapse
Comorbidity is considered as two or more conditions that occur
in one person. These disorders can happen one after another or
at the same time. Comorbidity has a strong connection with
substance abuse, treatment, as well as relapse (Kelly & Daley,
2013). It is essential to note that many of those who suffer from
substance use disorder usually develop other mental disorders,
which is a similar case to many of those diagnosed with mental
disorders. Research indicates that about half of those
experiencing mental illnesses have a high probability of
2. experiencing substance abuse disorders at some time in their
life. Some few research have been conducted on children, and
the result indicates that youths with substance abuse disorder
typically have a high rate of co-occurring mental diseases like
anxiety and depression (Child, 2012). Clinicians must find an
effective way to treat individuals with substance use and
addictions mental health disorders. To be effective they need to
prescribe the right medication to treat alcohol, opioid, and
nicotine addiction and there are also medications to alleviate
symptoms of mental disorders. There are some behavioral
therapies that have promise in treating comorbid conditions.
The programs are tailored for the clients according to age, drug
misused, and other factors, which can be used alone or with
medication. Some effective therapies for treating comorbid
conditions: cognitive behavioral therapy, Dialectical therapy,
assertive community treatment, therapeutic communities, and
contingency management (Kelly & Daley, 2013).
According to Woody and Blaine (1979) for over 25 years
there has been a correlation between substance abuse illnesses
and other mental disorders is not a visible indication that one
resulted in another, albeit one came after another.
Understanding the directionality or causality can sometimes be
difficult because of different reasons. For instance, emotional or
behavior issues may not be severe enough to raise the alarm for
diagnosis. However, sub-clinical mental health concerns may
prompt abuse of drugs. The main factors that contribute to
comorbidity between mental illnesses and drug abuse disorders
include the aspect of conventional risk factors, the possibility of
mental diseases contributing to addiction and drug abuse, and
the possibility of drug abuse and addiction contributing to the
growth of mental health disorders (Bukstein & Horner, 2015).
Drug use and mental health illnesses can result from coinciding
aspects such as epigenetic and genetic exposures, concerns with
related parts of the brain, and environmental factors like the
early experience of trauma or stress. Most of the vulnerabilities
come from composite connections with several genes and
3. genetic relations with environmental factors. For instance,
regular use of marijuana during the youthful stage may cause
various complications during adulthood, especially among those
carrying a given gene variant. Environmental aspects such as
trauma, stress, and unfavorable childhood experience increase
the risk of both mental illnesses and disorders associated with
drug use (Ouimette & Brown, 2016). Treatment patients with
substance use and psychiatric comorbidity is a challenge
because they may resist psychiatric or additional treatment.
They could relapse or stop treatment entirely, and placing those
with substance abuse and mental disorders rehabilitation
facilities (Bukstein & Horner, 2015).
Research has established that those with mild, severe, or
sub-clinical mental disorders may tend to use drugs for self-
medication. Even though drugs can reduce the symptoms of
mental illnesses temporarily, they can as well worsen the
symptoms, both in the long run and acutely. For instance, proof
indicates that the use of cocaine can aggravate bipolar disorder
symptoms and lead to the advancement of the disorder (Ross &
Peselow, 2014). When one develops a mental disorder, the
resultant changes in the brain may intensify the susceptibility
for challenging substance abuse use by increasing their positive
impacts, lowering awareness of the harmful effects, or lessening
the unfavorable signs of the mental illness and the side effect of
the medications utilized in its treatment. For instance,
neuroimaging connects ADHD with the neurobiological
alterations in the circuit of the brain which are linked with drug
yearnings, and this can partially explain why those with
substance abuse disorders experience higher cravings when they
have comorbid ADHD (Ross & Peselow, 2014). It is also
essential to note that substance abuse and addiction has the
capability of causing the development of mental illnesses. The
use of drugs can cause alterations in certain parts of the brain,
which are affected by other mental illnesses like anxiety,
impulse control, or mood illnesses (Ross & Peselow, 2014).
Treatment for comorbidity normally entails collaboration
4. between clinicians and organizations that offer supportive care.
Treatment of the problem should focus on substance abuse and
mental illness disorder together instead of focusing on one.
There are effective medications and behavioral therapies to deal
with addiction and mental illnesses. Relapse usually happens
70% of the time for substance use, identifying the
characteristics associated with the patient relapsing and adjust
the treatment program (Andersson, Wenaas, & Nordfjaern,
2018).
References
Andersson, Helle Wessel, Wenaas, Merethe, & Nordfjaern,
Trond (2018). Relapse after inpatient substance use treatment:
A prospective cohort study among users of illicit substances.
https://reader.elsevier.com/reader/pii/SO30640318308542?token
=4D108E6999079029E
Bukstein OG & Horner MS. (2015) Management of the
adolescent with substance use disorders and comorbid
psychopathology. Child Adolescent Psychiatric Clinics North
America 19(3):609-623. doi:10.1016/j.chc.2010.03.011.
Child, J. (2012). Adolescent Substance Abuse. 2012 Jul 1;
21(4): 310–322. doi:10.1080/1067828X.2012.709453/
https://www.ncbi.nlm.nih.gov/pmc/articles/PMC3923628/
Kelly, TM, Daley, DC. Integrated Treatment of Substance Use
and Psychiatric Disorders. Soc Work Public Health. 2013;
28(0): 388-406. doi: 10.1080/19371918.2013.774673
Ouimette, P. E., & Brown, P. J. (2016). Trauma and substance
5. abuse: Causes, consequences, and treatment of comorbid
disorders. American Psychological Association.
Ross S. & Peselow E. (2014) Co-occurring psychotic and
addictive disorders: neurobiology and diagnosis. Clin
Neuropharmacol. 35(5):235-243.
doi:10.1097/WNF.0b013e318261e193
Woody GE, Blaine J. Depression in narcotic addicts: Quite
possibly more than a chance association. In: Dupont RL,
Goldstein A, O’Donnell J, Brown B, editors. Handbook on Drug
Abuse. Washington, DC: U.S. Government Printing Office;
1979. pp. 277–285
DataMining
Homework/bankdata_csv_all.csvidagesexregionincomemarriedc
hildrencarsave_actcurrent_actmortgagepepID1210148FEMALEI
NNER_CITY17546NO1NONONONOYESID1210240MALETO
WN30085.1YES3YESNOYESYESNOID1210351FEMALEINNE
R_CITY16575.4YES0YESYESYESNONOID1210423FEMALET
OWN20375.4YES3NONOYESNONOID1210557FEMALERURA
L50576.3YES0NOYESNONONOID1210657FEMALETOWN378
69.6YES2NOYESYESNOYESID1210722MALERURAL8877.07
NO0NONOYESNOYESID1210858MALETOWN24946.6YES0Y
ESYESYESNONOID1210937FEMALESUBURBAN25304.3YES
2YESNONONONOID1211054MALETOWN24212.1YES2YESY
ESYESNONOID1211166FEMALETOWN59803.9YES0NOYES
YESNONOID1211252FEMALEINNER_CITY26658.8NO0YES
YESYESYESNOID1211344FEMALETOWN15735.8YES1NOYE
SYESYESYESID1211466FEMALETOWN55204.7YES1YESYE
22. SYESNOID1269730FEMALEINNER_CITY9672.25YES0YESY
ESYESNONOID1269831FEMALETOWN15976.3YES0YESYES
NONOYESID1269929MALEINNER_CITY14711.8YES0NOYE
SNOYESNOID1270038MALETOWN26671.6NO0YESNOYESY
ESYES
DataMining Homework/bankdataDescription.doc
Bank Data Description
(For bankdata file obtained from DePaul University data mining
course materials.)
The marketing department of a financial firm keeps records on
customers, including demographic information and, number of
type of accounts. When launching a new product, such as a
"Personal Equity Plan" (PEP), a direct mail piece, advertising
the product, is sent to existing customers, and a record kept as
to whether that customer responded and bought the product.
Based on this store of prior experience, the managers decide to
use data mining techniques to build customer profile models.
The data contains of a number of the following fields
id
a unique identification number
age
age of customer in years
sex
MALE / FEMALE
region
inner_city/rural/suburban/town
income
income of customer
married
Is the customer married (YES/NO)
children
23. number of children
car
Does the customer own a car (YES/NO)
save_acct
Does the customer have a saving account (YES/NO)
current_acct
Does the customer have a current account (YES/NO)
mortgage
Does the customer have a mortgage (YES/NO)
pep
Did the customer buy a PEP after the last mailing (YES/NO)
Each record is a customer description where the "pep" field
indicates whether or not that customer bought a PEP after the
last mailing.
DataMining
Homework/fedPapers85.csvauthorfilenameaallalsoanandanyarea
satbebeenbutbycandodowneveneveryforfromhadhashaveherhisifi
nintoisititsmaymoremustmynonotnowofononeonlyorourshallsho
uldsosomesuchthanthatthetheirthentherethingsthistoupuponwasw
erewhatwhenwhichwhowillwithwouldyourdisptdispt_fed_49.txt0
.280.0520.0090.0960.3580.0260.1310.1220.0170.4110.0260.009
0.140.0350.02600.0090.0440.0960.0440.0350.0170.04400.0170
0.2620.0090.1570.1750.070.0350.0260.02600.0350.11400.90.14
0.0260.0350.0960.0170.0170.0170.0350.0090.0260.0090.1841.4
250.11400.0090.0090.0440.507000.0090.01700.0090.1750.0440
.0090.0870.1920disptdispt_fed_50.txt0.1770.0630.0130.0380.39
30.0630.0510.1390.1140.3930.16500.13900.01300.02500.0760.
1010.1010.0130.152000.0250.2910.0250.0380.1270.0380.03800
.013000.12700.7470.1390.02500.114000.0130.0130.063000.152
1.2540.1650000.0510.35500.0130.0510000.1140.0380.0890.063
0.1390disptdispt_fed_51.txt0.3390.090.0080.030.3010.0080.068
0.2030.0230.4740.0150.0380.1730.02300.0080.0150.0230.0980.
0530.0080.0150.023000.0230.3080.0380.150.1730.030.120.038
0.08300.030.06800.8580.150.030.0230.0600.0080.0680.0380.03
37. 0.0350.2221.3890.0900.00700.0760.41000.0070.00700.0140.18
80.0350.2570.0830.0830
DataMining Homework/HW1_Arule_DT_Instructions.docx
CISC520 Data Engineering and Mining
Homework 1
Part I:
For this part, you need to explore the bank data
(bankdata_csv_all.csv), available on the LMS, and an
accompanying description (bankdataDescription.doc) of the
attributes and their values. The dataset contains attributes on
each person’s demographics and banking information in order to
determine they will want to obtain the new PEP (Personal
Equity Plan).
Your goal is to perform Association Rule discovery on the
dataset using R.
First perform the necessary preprocessing steps required for
association rule mining, specifically the id field needs to be
removed and a number of numeric fields need discretization or
otherwise converted to nominal.
Next, set PEP as the right hand side of the rules, and see what
rules are generated.
Select the top 5 most “interesting” rules and for each specify
the following:
· Support, Confidence and Lift values
· An explanation of the pattern and why you believe it is
interesting based on the business objectives of the company.
· Any recommendations based on the discovered rule that might
38. help the company to better understand behavior of its customers
or to develop a business opportunity.
Note that the top 5 most interesting rules are most likely not the
top 5 in the strong rules. They are rules, that in addition to
having high lift and confidence, also provide some non-trivial,
actionable knowledge based on underlying business objectives.
To complete this assignment, write a short report describing
your association rule mining process and the resulting 5
interesting rules, each with their three items of explanation and
recommendations. For at least one of the rules, discuss the
support, confidence and lift values and how they are interpreted
in this data set.
You should write your answers as if you are working for a
client who knows little about data mining. Your report should
give your client some insightful and reliable suggestions on
what kinds of potential buyers your client should contact, and
convince your client that your suggestions are reliable based on
the evidence gathered from your experiment results.
In more detail, your answers should include:
· Description of preprocessing steps
· Description of parameters and experiments in order to obtain
strong rules
· Give the top 5 most interesting rules and the 3 items listed
above for each rule.
Part II:
In this part of homework, you are expected to apply decision
tree induction algorithm to solve a mystery in history: who
wrote the disputed essays, Hamilton or Madison?
1. About the Federalist Papers
39. Quote from the Library of Congress
http://www.loc.gov/rr/program/bib/ourdocs/federalist.html
The Federalist Papers were a series of eighty-five essays urging
the citizens of New York to ratify the new United States
Constitution. Written by Alexander Hamilton, James Madison,
and John Jay, the essays originally appeared anonymously in
New York newspapers in 1787 and 1788 under the pen name
"Publius." A bound edition of the essays was first published in
1788, but it was not until the 1818 edition published by the
printer Jacob Gideon that the authors of each essay were
identified by name. The Federalist Papers are considered one of
the most important sources for interpreting and understanding
the original intent of the Constitution.
2. About the disputed authorship
The original essays can be downloaded from the Library of
Congress.
http://thomas.loc.gov/home/histdox/fedpapers.html
In the author column, you will find 74 essays with identified
authors: 51 essays written by Hamilton, 15 by Madison, 3 by
Hamilton and Madison, 5 by Jay. The remaining 11 essays,
however, is authored by “Hamilton or Madison”. These are the
famous essays with disputed authorship. Hamilton wrote to
claim the authorship before he was killed in a duel. Later
Madison also claimed authorship. Historians were trying to find
out which one was the real author.
3. Computational approach for authorship attribution
In 1960s, statistician Mosteller and Wallace analyzed the
frequency distributions of common function words in the
Federalist Papers, and drew their conclusions. This is a
pioneering work on using mathematical approaches for
40. authorship attribution.
Nowadays, authorship attribution has become a classic problem
in the data mining field, with applications in forensics (e.g.
deception detection), and information organization.
The Federalist Paper data set (fedPapers85.csv) is provided in
LMS. The features are a set of “function words”, for example,
“upon”. The feature value is the percentage of the word
occurrence in an essay. For example, for the essay
“Hamilton_fed_31.txt”, if the function word “upon” appeared 3
times, and the total number of words in this essay is 1000, the
feature value is 3/1000=0.3%
Organize your report using the following template:
Section 1: Data preparation
You will need to separate the original data set to training and
testing data for classification experiments. Describe what
examples in your training and what in your test data.
Section 2: Build and tune decision tree models
First build a DT model using the default setting, and then tune
the parameters to see if better model can be generated. Compare
these models using appropriate evaluation measures. Describe
and compare the patterns learned in these models.
Section 3: Prediction
After building the classification model, apply it to the disputed
papers to find out the authorship and report the performance
accuracy of your models.
41. Running head: substance use disorder and addictions 1
substance use disorder and addictions 8Substance Use
Disorder and Addictions
Paula King
Walden University
Capstone
Dr. Jane Lyons
June 16, 2019
Problem Statement
Substance use disorders and addictions are becoming a common
challenge within the social construct in todays’ society. It is
vying with the normative of social structures that support good
behavior and sustaining from using drugs. A drug is any that
substance that is consumed by a person, that may change typical
substantial capacities. A medication is a compound substance
utilized in the treatment, fix, anticipation, or finding or used to
generally upgrade physical or mental prosperity. Medications
might be endorsed for a restricted term, or all the time for
perpetual issue. Recreational medications are synthetic
substances that influence the focal sensory system, for example,
narcotics or drugs. They might be utilized for apparent gainful
consequences for discernment, awareness, character, and
42. conduct. A few medications can cause dependence and
habituation. Numerous regular substances, for example, brews,
wine, and a few mushrooms, obscure the line among
nourishment and medications, as when ingested they influence
the working of both the brain and body. When an individual fall
ill due to drug use (which they often do), it becomes very hard
to treat them. More specifically, when an individual takes a
drug overdose, it becomes hard to assist them because they
cannot express themselves after passing out.
As mentioned above, the number one barrier to treatment stems
from the inability of patients to talk to physicians the moment
they come into the emergency room. When a physician is not
able to speak to a patient to find out whatever he or she got into
his or her system, it becomes hard to conduct first aid
effectively. In such a situation, what often happens is that the
physician must perform the first aid quickly and screen his or
her blood to determine the exact poison that is causing a
problem. Which again is a challenge because today, people
become addicted to a multiplicity of drugs and medicines. It
requires a dreadful part of an investment to make sense of what
number of kinds of medications a patient has been on (Straus,
Glasziou, Richardson & Haynes, 2018).
Many different factors determine the effectiveness of treatment.
The problem here is that the barriers to treatment delay it and
make treatment untimely. When a physician conducts first aid
but is yet to fully help the patient realize vital signs because of
diagnostic challenges, response to an emergency may be
delayed, and a patient's life may be in danger.
Lack of communication is the first barrier to treatment because
drug and substance abusers have slurred speech, and at times,
they cannot completely talk. A majority of drug and substance
abusers do not use in front of their families. As such, it
becomes difficult for a relative to tell the doctor what the
patient used. Besides, the drugs abused (even if they are in the
form of pills) are never preserved in labeled bottles. The use of
multiple drugs and substances for the sake of realizing a
43. dopamine rush later causes a multiplicity of conditions or
disorders. Afterward, what follows is a diagnosis of confusion
since comorbid disorders may be complicated to deal with
(Djulbegovic and Guyatt, 2017).
Summary
Evidence-Based Practice and Evidence-Based Medicine is yet
to be embraced fully in the medical community. Health care
professionals are, however, to be trained on matters revolving
around Evidence-Based Practice and Evidence-Based Medicine.
It will take a considerable amount of time before health
caregivers figure out how Evidence-Based Practice and
Evidence-Based Medicine can be used to deal with the
multitude of challenges that surface
when a drug and substance abuse patient is brought forward to
the casualty of a hospital.
Reference
Djulbegovic, B., & Guyatt, G. H., (2017). Progress in evidence-
based medicine: a quarter century on. The Lancet, 390(10092),
415-423.
https://www.drugabuse.gov/publications/drugfacts/comorbidity-
substance-use-disorders-other-mental-illnesses
Straus, S. E., Glasziou, P., Richardson, W. S., & Haynes, R. B.
(2018). Evidence-Based Medicine E-Book: How to Practice and
Teach EBM. Elsevier Health Sciences.
