It might surprise some, and come as no shock to others, that people living with mental illness are more than seven times likelier to use marijuana than people who don’t have mental illness. That is the result of a Canadian study appearing in Comprehensive Psychiatry, reviewing United States data. Specifically, more than 4% of mentally ill participants reported using marijuana at least weekly, compared to 0.6% of participants that did not have a mental illness.

The chief problem with the fact, according to head of addiction medicine at Kaiser Permanente West Los Angeles Medical Center, Dr. Escobedo, is that marijuana use can worsen symptoms of mental-health conditions. Escobedo said some people with mental illness use marijuana because they say it helps them sleep. But using marijuana to do that simply reinforces using the drug in a common “continuous cycle”. With mental illness, it’s important to think in the long term and drugs like marijuana only address short term symptoms and feelings.

“In the short term when you are dumbed out or drugged up, you may not notice your symptoms,” said Escobedo. “But in the long term, it always makes them worse.”

The use of illegal street drugs to curb mental-health symptoms is often referred to as “self medication,” and is seen as an effort to control or minimize otherwise distressing thoughts or feelings. The Canadian study found that of mentally ill people reporting at least a weekly basis, the rates were quite high for those diagnosed with bipolar disorder, personality disorders and substance use disorders (a substance use disorder is an addiction to, dependence on, or abuse of alcohol or drugs).

The combination of a mental illness and a substance use disorder is known as Dual Diagnosis (also known as “co-occurring disorders”). Research strongly indicated that to recover fully, a person suffering with a dual diagnosis needs treatment for both problems — focusing on one does not ensure the other will go away. Dual diagnosis services should integrate assistance for each condition, helping people recover from both in one setting, at the same time.

Unfortunately, despite much research that supports its success, mental health services tend not to be well prepared to deal with patients having both afflictions. Often only one of the two problems is identified. If both are recognized, the individual may bounce back and forth between services for mental illness and those for substance abuse, or they may be refused treatment by each of them. Fragmented and uncoordinated services create a service gap for persons with co-occurring disorders.

Providing appropriate, integrated services will not only allow for their recovery and improved overall health, but can ameliorate the effects of disorders on family, friends and society at large. Hopefully, more treatments and better understanding are on the way.

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