Avoiding substance abuse

Practically, half of bipolar patients, specifically 46%, meet DSM-IV (Diagnostic and Statistical Manual for Mental Disorders 4th edition) criteria of alcohol abuse or dependence. According to the data of the Epidemiologic Catchment Area (ECA), the risk for a bipolar patient to present with a drug dependence is more than six times higher than that of the population at large, and a little higher if we speak only of patients with type I bipolar disorder. One out of every three bipolar patients presents with a substance abuse problem as a comorbidity. On the other hand, many of our patients do not meet the criteria for substance abuse or dependence even though they consume alcohol or other substances with a certain assiduity, and we must take into account that the mere consumption of alcohol, cannabis and other toxics, even without reaching abuse quantities, can act as a trigger for new episodes.