High-risk alcohol and drug use situations among seriously mentally ill inpatients: a preliminary investigation

Situational factors are important determinants of alcohol and drug use in general samples of substance abusers, with alcohol users and drug users reporting different trigger situations. This study represents an initial attempt to investigate high-risk alcohol and drug use situations in a sample of dually diagnosed individuals. Thirty men and women with both a serious mental illness and an alcohol use or drug use disorder were recruited from an inpatient psychiatric unit and completed questionnaires assessing high-risk alcohol and drug use situations psychiatric symptomatology, and psychological symptoms that trigger substance use. Although the alcohol and drug groups did not differ significantly in the frequency of self-reported high-risk situations for substance use, effect size analyses suggest that six of eight comparisons would demonstrate statistically significant differences with a larger sample size. Both groups reported using substances most frequently when feeling anxiety or depressive symptoms rather than psychotic symptoms. Although preliminary, these results have relevance for the treatment of dually diagnosed persons, particularly for behavioral treatment interventions such as coping skills training and stimulus control techniques.