Substance abuse: Are pwBPD prone to have subtance abuse problems?

[O'Maria]

Just read that 50% of the BPD patients also have another disorder/addiction, often Alcoholism. Drinking helps them cope with the intensity of feelings. Should they be treated for alcoholism first? Another addiction is gamling and/or sex addiction.

As many as 60% of outpatients diagnosed with BPD have other addictions, and Alcoholism was the most common.

[Skip]

This is a problem for the most serious of the BPD populations - those that are inpatients in psychiatric hospitals.

One study* found that about 60% of patients in psychiatric hospitals who have been diagnosed with BPD also have a co-occurring substance use disorder (the symptoms and course of BPD and the substance use disorder overlap). The most common substance use disorder among people with BPD is alcoholism. It has been estimated that about 50% of people with BPD in inpatient treatment settings are also alcoholics.

Should they be treated for alcoholism first?

"A variety of treatments are effective for BPD, treatments for the co-occurring subgroup are much less well established. Initial studies of modified forms of cognitive-behavioral and psychodynamic therapies hold promise for the development of effective treatments in this very challenging population. This group appears to be especially impaired and difficult to engage in treatment. "~ Robert J. Gregory, MD.  Dr Gregory is associate professor of psychiatry in the department of psychiatry at the State University of New York Upstate Medical University in Syracuse.


*Morgenstern J, Langenbucher J, Labouvie E, & Miller KJ. "The Comorbidity of Alcoholism and Personality Disorders in a Clinical Population: Prevalence Rates and Relation to Alcohol Typology Variables." Journal of Abnormal Psychology, 106: 74–84, 1997.

[Randi Kreger]

Sunstance abuse is self-medicating; a way to deal with the pain and emptiness.



Randi Kreger
Randi @BPDCentral.com
Author, "The Essential Family Guide to Borderline Personality Disorder: New Tools and Techniques to Stop Walking on Eggshells"
Available at www.BPDCentral.com
 

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[Gardener]

My bpdd self-medicated by taking drugs while she was working as a nurse. She was using morphene as an IV under her uniform.

[Readytoquit]

Its a triad really. Axis II, Cluster B/Substance abuse/Domestic violence.

[targus2010]

My bpdw ( we are seperated) self medicates with pain medicine and abused ambien.  The amnien is more of a problem than the pain medicine.  She takes half about 8:30 or 9:00 when she really plans on going to bed at 12 or 1'oclock.  she bounces around the house.  She like the way it feels ( the high) but does not want the sleep effects.  She tells me "my ambien is not working" I tell her to get in bed turn the lights off and let it work, but that is really not what she wants...then, when she is ready to go to bed, she will take the other half.  She is always in the hospital or "doc in a box"  nort onlyh for the pain medicine but the attention they pay her when she is there, the focus is all on her.

[buzz1234]

our 20 yr old probably had BPD. We read the books and she even identifies with it. She also has been using drugs to deal with her pain. Shes been in and out of therapy for years. Anyone know of a  good drug rehab that will also address BPD? thanks

[Orchid]

For the past several years I thought my H was simply showing signs of his addictions/withdrawls but it was much more than that.  Just like I made excuses for him...like him being stressed from work in the past, I allowed the addictions to be front and center instead of the deeper issue of BPD/NPD.

[Mystic]

Strange, I've been around alcoholism all my life (father, exH, colleague), and still I think I'm terribly naive about it. 

My ex pretty much drank daily as I can recall, for the time we were together. 

I remember being taken aback when he would start before noon. (beer or rum and coke).   My son was over one day and commented on it to me.   

I passed it off to stress.  My son said "Mom, you've been stressed, do you drink like that?"  Good point.  I said...I wonder if he (exbpd) has a problem...son said "YA THINK?"

I excused behaviors to stress, figured I'd change what I could about me and our surroundings to better accommodate, keep peace, be pleasing. 

[clairejoy]

i'm new and overwhelmed by the wealth of information on this site.

my estranged husband is either a high-functioning bp or is someone who has all of the characteristics of one. to our horror, he seems to be worsening and on the path to becoming a low-functioning bp.

my adult children,their spouses and i have had a number of discussions about whether he is a drug addict and it's resulted in a warped sense of himself and the world or if he's got a mental health disorder and self-medicates.

some family members (especially recovering addicts) believe that he will only get better if he gets treatment and that drug use is his core problem.

is it possible to untangle these two?

thanks

[beyondbelief]

A professional might be able to get to the bottom of things.  It may well be possible he needs treatment for both.

[clairejoy]

a really good professional could help if i could find one and if he would go. these are big ifs.
he was seeing a therapist and she told him that as an adult he had the right to smoke pot in his home and his family should accept it as his personal decision. i'm sure she was unaware of the amount and frequency of the smoking or that he would do whatever prescription drugs he could as well.

i called some places that specialize in mental health/drug addiction as a package deal but most said they could only treat one at a time and it was difficult for them to know which way to go. i did make an appointment for him but he said that they wouldn't see him without a prepaid credit card payment. he was probably lying.

i seek clarification for myself and my family. some want to do an intervention and get him into rehab. i think this would either further alienate him or he'd go through a program that doesn't address his disorder and he'd do his amazing bulls__t repertoire and we'd still be standing on square one.

i don't know if it even matters which is the larger challenge but think that the bpd is the most destructive element.

[beyondbelief]

Interesting perspective his T has.  Even if it is legal where you live there are plenty of other legal things (drinking, gambling, etc) that can cause all sorts of problems and do not have to be accepted by others.  Anyone can choose to do what they want however the consequences that result are chosen by others.

I am not a drug counselor nor mental health professional.    Don't know what the result of any kind of intervention would be.  Nor do I know the effects of not doing something will be on you and the rest of the family.  However it seems to me that getting off drugs is a lot quicker than curing a PD.

If he is unwilling to get some kind of help, it probably doesn't matter what is going on as things are not likely to improve.

[Im done]

I'm not a professional either, but from what I've read, the usual course is to treat the substance addiction first, and then to treat the underlying disorder(s).

[hendrie]

Does any one know good therapists in the Washington DC area who can diagnose and treat BPD?  Can also be in suburban Maryland; Bethesda, etc.