Large increase in male mentally ill drug abusers

The amount of mentally ill male drug abusers has increased by more than 79% in five years across England and Wales, finds research in the Journal of Epidemiology and Community Health.

And those affected are becoming younger: the average age has fallen from an average of 38 to 34, the findings show.

The researchers assessed information submitted by family doctors to the General Practice Research Database on the extent of combined mental illness and drug abuse seen at surgeries in England and Wales. The information covered adults between the ages of 16 and 84.

Drug abuse excluded alcohol and tobacco, but included prescription and illegal drugs.

The data were taken from 230 general practices—equivalent to just over 3% of the population of England and Wales—for the five years between 1993 and 1998.

The authors used patient years of exposure as a unit of measurement to reflect how long patients were treated, rather than how many were registered.

Between 1993 and 1998, the rate of combined mental illness and substance abuse rose from 50 per 100,000 patient years of exposure (PYE) to 80/100,000 PYE, equivalent to an increase of 62%.

Men were more likely to be affected than women. Rates climbed 79% among men during the study period compared with 44% for women.

Applying these figures to the population suggests that the number of people with mental illness and drug abuse problems rose from 23,624 in 1993 to 37,361 in 1998. Numbers in the age band 25 to 34 more than doubled in five years.

The problem was greatest in certain types of mental illness. The rate of psychosis and drug abuse soared by 147% in five years, while that of paranoia and drug abuse rose by 144%. Rates of schizophrenia combined with drug abuse rose 128%.

Based on their findings, the authors suggest that the average family doctor practice sees seven patients who are both mentally ill and misusing drugs, and that this will double to 14 by 2006. The problem seems to be greater and rising more rapidly among those with serious mental illness, they say.

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