Substance Abuse Among Bipolar Teens

According to a new study published in this month’s issue of the Journal of the American Academy of Child and Adolescent Psychiatry, approximately 1 in 3 teens with bipolar disorder developed substance abuse problems.  The time frame noted between diagnosis and the first reported indication of substance abuse issues was four years.  The study also noted additional risk factors that were predictors who among this group of teenagers who have bipolar disorder were the most likely to develop substance abuse.
bipolar disorderA group of researchers, led by Dr. Benjamin Goldstein of both the University of Toronto and the University of Pittsburgh, examined 167 youth with bipolar disorder between the ages of twelve and seventeen.  These youths were studied to document both the frequency of first-time onset of substance abuse and possible predictors that lead to first-time substance abuse.  Data was pulled from the Course and Outcome of Bipolar Youth (COBY).  Participants were interviewed an average of seven times over the span of four years in order to not only examine the symptoms, but to observe the functioning, stressors and treatment over this time period.

The results of the study found that 32% of the youths in the Course and Outcome of Bipolar Youth study developed dependence issues with alcohol and drugs.  The average span between the start of the study and first onset of dependence was 2.7 years.  The single strongest predictor noted in the study regarding future substance abuse and dependence issues among bipolar youth is the repeated experimentation with alcohol.  Results also showed that experimentation with cannabis among bipolar youth was also a strong indicator of future dependence issues.

There were five other factors that were present at the start of the study that were also noted as being strong predictors of future substance abuse among bipolar youth.  Those factors were oppositional defiant disorder, panic disorder, a family history of substance abuse, lack of family cohesiveness, and the absence of antidepressants in the treatment regimen.   Among those bipolar youth with three or more of those above mentioned risk factors, just over half (54.7%) went on to develop substance abuse issues while the incidence of substance abuse issues in those bipolar youth with two risk factors or less was 14.1%


The Course and Outcome of Bipolar Youth (COBY) study was funded by the National Institute of Mental Health and is the largest longitudinal study of children and young adults with bipolar disorder.  The study involved culling data from subjects at three different testing sites.  Those sites used for the COBY study included Brown University, UCLA and the University of Pittsburgh.  This longitudinal study will continue to follow these teens as they enter their twenties and thirties.

The results thus far regarding this longitudinal study is that experimental use of drugs and alcohol by teens with bipolar disorder is akin to playing with fire.  Results also show there seems to be a window of two to three years in which preventive strategies can be put into place in order to halt the possibilities of development of substance abuse issues in this population.