ABSTRACT
A substantial proportion of all clients presenting for help in mental health settings have misused alcohol or other drugs, and many struggle with concurrent psychological and substance use disorders. The lifetime prevalence of substance use disorders in the general population exceeds that of any mental disorder, with estimates ranging from 16 to 27 percent (Kessler et al., 1994; Regier et al., 1990). Regier and colleagues (1990) report that comorbidity rates between substance use disorders and common psychological afflictions such as affective and anxiety disorders are substantial (32 percent and 14.6 percent, respectively). Comorbid substance abuse is also common among the seriously mentally ill. Regier and colleagues report that 47 percent of those with schizophrenia meet the lifetime criteria for at least one drug/alcohol disorder, and 32 percent of those with affective disorders also meet these criteria. Perhaps more important, lifetime prevalence of substance use disorders among those in psychiatric inpatient settings is approximately 39 percent (Regier et al., 1990).
