Substance Abuse & Mental Health Services Administration

The Substance Abuse and Mental Health Services Administration (SAMHSA)

A Behavioral Health Lens for Prevention

Overlapping Problems, Collaborative Solutions

In the past, practitioners and researchers saw substance abuse prevention as distinct from the prevention of other behavioral health problems. But mounting evidence indicates that the populations affected by these problems overlap significantly, as do the factors that contribute to these problems. Consequently, improvements in one area often have direct impacts on the other.

"One in five individuals with a diagnosable mental health disorder also suffer from a substance abuse disorder."

(O'Connell, 2009)

Many young people have more than one behavioral disorder. These disorders can interact and contribute to the presence of other disorders, leading to concurrent diagnosable disorders or “comorbidity”. An estimated 37% of alcohol abusers and 53% of other drug abusers also have at least one serious mental illness.

Despite extensive research documenting strong associations between multiple problems, it’s not always clear what leads to what. For example, can substance abuse lead to thoughts of suicide, or can thoughts of suicide lead to substance abuse? Or are they both the product of a third, unknown causal factor?  

Mental and physical health is also connected. Good mental health often contributes to good physical health. Similarly, the presence of mental health disorders, including substance abuse and dependence, is often associated with physical health disorders (O'Connell, 2009). A large number of studies provide strong evidence that drinking alcohol is a risk factor for primary liver, breast, and colorectal (colon) cancer. Positive lifestyle adjustments, however—like sleep, diet, and activity and physical fitness—can also significantly strengthen mental health (O'Connell, 2009).

As prevention practitioners, our responsibility is to be mindful of these linkages and see our work as part of a broader effort to improve overall health. Recognizing these linkages can help us identify opportunities to address health in a more comprehensive way—by working across disciplines, pooling resources, and reaching people in those settings and during those times in their lives where and when services are most likely to have an impact.


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