Personality disorder and drug use: a review

Area of Science:

• Clinical Psychology
• Addiction Psychiatry
• Public Health

Background:

• Personality disorder (PD) is a relevant concept in managing drug users.
• Differentiating PD behaviors from drug misuse behaviors is diagnostically challenging.
• Antisocial personality disorder (ASPD) is a common PD in this population.

Purpose of the Study:

• To review the prevalence and impact of PD in drug users.
• To explore the association between PD and adverse outcomes in substance use.
• To discuss treatment implications for PD in drug users.

Main Methods:

• Literature review of studies on PD in drug users.
• Analysis of diagnostic challenges in differentiating PD from substance use disorders.
• Examination of treatment outcomes for PD in substance use disorder patients.

Main Results:

• Approximately two-thirds of drug users in treatment exhibit PD, with ASPD being most prevalent.
• PD is linked to psychiatric issues, poor social function, treatment dropout, and increased HIV risk.
• Prevalence may vary across different drug types and in non-treatment settings.
• Outcomes for ASPD individuals in methadone maintenance treatment are generally reasonable.

Conclusions:

• PD is a significant comorbidity in substance use disorders, impacting treatment and outcomes.
• Methadone maintenance treatment may be a practical early intervention for PD opiate users.
• Further research is needed on PD prevalence across diverse drug use populations and settings.
• Addressing PD concurrently with substance use disorder treatment is crucial for comprehensive care.