Reducing Substance Use by Reducing Depression

People who have problems with substance misuse often have other mental health challenges. Depression is a commonly co-occurring psychological condition among individuals with substance use problems. Although it has yet to be determined if substance use precedes depressive reoccurrence or depressive symptoms precede substance relapse, it is well known that these co-occurring conditions (COD) are more treatment resistant and result in poorer outcomes than having one condition alone. Research suggests that cognitive behavioral therapy is an effective approach for reducing depressive symptoms. Therefore, Sarah B. Hunter of the RAND Corporation in Santa Monica, California, theorized that addressing depressive symptoms as part of a substance use treatment plan could minimize negative moods, which would reduce the need for negative coping strategies such as substance use.

Hunter and her colleagues administered 16 sessions of group cognitive behavioral therapy for depression (GCBT-D) to 140 individuals being treated at an inpatient facility for substance addiction and compared the outcome to that of 159 individuals receiving usual care. The team assessed the participants at treatment conclusion, 3 months and 6 months posttreatment.

The results revealed significant decreases in substance use, depressive symptoms, and negative outcomes in the GCBT-D group. These results were maintained consistently at both the 3- and 6-month follow-ups. The findings of this study demonstrate that depressive symptoms contribute to substance misuse in this sample. Additionally, Hunter believes that this study clearly shows that efforts aimed at reducing negative affect and depression in substance users can increase abstinence and improve the outcome of treatment in residential settings. Although many of the participants of this study continued to receive therapy at follow-up, the differences in the GCBT-D group and the treatment as usual group at the conclusion of therapy show that it is important for clinicians to address depression in individuals trying to overcome substance addiction. She added that the results suggest the intervention may be effective because it weakens the relationship between depressive symptoms and substance use outcomes.

Hunter, S. B., Witkiewitz, K., Watkins, K. E., Paddock, S. M., Hepner, K. A. (2012). The moderating effects of group cognitive–behavioral therapy for depression among substance users. Psychology of Addictive Behaviors. Advance online publication. doi: 10.1037/a0028158

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  • Norma


    June 23rd, 2012 at 4:06 AM

    It goes without saying that many depressed individuals turn to alcohol or drugs to numb themselves even further to the effects that depressions has on them. They are looking for a way to escape from their pain and when taken to the extreme that is what alcohol and some drugs can do for you. Many fail to realize however that this reprieve is only short lived and that when the buzz and the high goes away it will make the lows of the depression feel even lower.

  • Eric S

    Eric S

    June 23rd, 2012 at 9:13 AM

    Depression may not be the only thing that drives someone to drink and do drugs. Don’t you think that there are some who are gentically predisposed to become addicts? As much as we like to think that we have control over everything, we know that there are some things in us that we have a hard time controlling and overcoming.

  • TravGood


    June 24th, 2012 at 4:13 AM

    Although this is not going to hold true for every single person who is depressed and abuses substances, it does seem that there are now better treatments available that will show better outcomes for patients than the traditional treatment route that has been followed for so long now. I am glad that there are now some people who are looking beyond the way that things have always been done and instead are now seeking new forms of treatment which may help patients get sober for good while at the same time helping to alleviate their depressive symptomology.

  • jerry


    June 25th, 2012 at 12:19 AM

    really happy to read about this.i have lost a cousin to substance abuse and wouldn’t want that to happen to anybody else in the world.

    whether depressive disorder precedes the substance misuse or comes later,treating for the depression I think breaks the cycle of depression and substance misuse and this change itself can be enough of a catalyst hopefully.

  • Eliza


    June 25th, 2012 at 4:09 AM

    Have we come to a consensus that group therapy is more effective than individual in cases like this, or is just that this is the mode of therapy that was administered?

  • Bellamy


    June 25th, 2012 at 11:41 AM

    I know plenty of people who drink and use some mild drugs but don’t have any problems with being deopressed, or at least I don’t think that they do.

    These are my partying friends, the ones who are always up for a good time. How in the world can they want to act like that and then hide under the covers?

    They are just out for a good time, just like most of us are.

  • Ted


    June 26th, 2012 at 12:25 AM

    “Reducing Substance Use by Reducing Depression”

    But is this the best approach even if the depression is an effect of, and did not precede, the substance use?

  • tarquin


    February 23rd, 2013 at 1:07 AM

    The processes of allieviating depression and the inner work one does (beyond physical detox) to stop self defeating subtance use, mutually reinforce eachother. I’m surprised that the social-scientists are just figuring this out.

    Examples of work we do to combat both depression and addiction include : discovering the anger and pain being stuffed down inside and finding ways to free ourselves from it; learning where one feels stuck and our own thresholds for stress and getting overwhelmed, then cultivating a ‘toolbox’ for those situations; evaluating our relationships on the basis of those which are nurturing/positive or toxic/ defeating, then making changes to support our best-selves.

    With regard to antidepressants, sometimes the same medicines that can help a depressed person find thier even keel also will do double duty to reduce cravings and bio-chemical transitions when ditching the subtance dependence.

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