Mental health and substance abuse issues often go hand-in-hand. Physicians must be able to treat both as a collective diagnosis, rather than individually, because the issues of one disorder will often contribute to the other. Additionally, these issues may exist at a higher rate among certain populations, which should also be taken into consideration when treating. This is a topic that The Times of India reported on in their own country, but the issues are relevant globally.
The National Institute for Research in Tuberculosis conducted a survey was initially meant to show which behaviors among MSMs make them more prone to HIV. Their findings on mental and substance abuse issues among this population was very enlightening. They found that more than 50% of the MSM population that was surveyed were prone to having depression and 28% had a high level of alcohol use. These issues were present because of the contributing negative factors that exist within the Indian MSM population. Many have low self-esteem, no family support, and are prone to bearing disapproval from their country's society as a whole. With these heavy burdens weighing them down, they often turn to substance abuse or are apt to show signs of mental health issues as a result.
What does this teach us about medicine? That we cannot treat within a vacuum. Physicians must take into account a patient's social background, as well as their medical background. If they have mental health issues coupled with substance abuse issues, they are likely contributory to one another. Is there a reason they have these disorders? Is their home life a factor? By delving further into a patient's history, physicians can not only treat the surface problems, but also the reasons behind them. That will help ensure a positive health outcome for the patient, as well as a positive patient/physician relationship. It's a team effort, so learn more about your patient.