In a SAMHSA Advisory notification, SAMSHA states:  “ Eating disorders (ED’s), which cause serious health problems and can be fatal, frequently co-occur with substance use disorders (SUDs).  There are numerous psychosocial consequences of EDs (e.g., problems with family, friends, school, or work; lowered perceived happiness).  When SUDs and EDs co-occur, the consequences, assessment, treatment and recovery are more complicated for both disorders than for either disorder alone.”

“Although researchers have called for integrated treatment of SUDs and EDs, few programs provide such treatment. An analysis of National Treatment Center data found that of 351 publicly funded SUD treatment programs surveyed, only 16 percent offered treatment for co-occurring EDS. Furthermore:

• Only half of the programs screened for EDs
• Only 14 percent of those that did screen used a standardized instrument
• Only 3 percent had formal referral arrangements with ED providers. “

What is the relationship between EDs and SUDs?

Clinical and community studies have reported high co-occurrence of EDs among women with SUDS (substance use disorder):

• Gadalla and Parin found that women with either an SUD or an ED were four times as likely to develop the other disorder as were women who had neither disorder.
• Gilchrist and colleagues examined the co-occurrence of EDs and SUDs and reported that 14 percent of women with a SUDs had AN (Anorexia Nervosa) and 14 percent had BN (Bulimia Nervosa).

Hodson and colleagues found that men and women with EDs had significant higher rates of co-occurring SUDS.

Piran and Robinson looked at the relationship between EDs and SUDs and found that:

• As EDs became more severe, the number of different substances used increased.
• Severe BED (Binge Eating Disorder) was consistently associated with alcohol use.
• Attempts to lose weight by purging (with or without binge eating) were associated with stimulant/amphetamine and sleeping pill abuse.

“People often use food and substances to help them cope. A person in recovery from an ED often uses substances to cope with the stress or recovery. Similarly, a person in recovery from an SUD may use disorders eating to cope with or to compensate for the lack of chemical reinforcement. “ Co-occurring behavioral health disorders, particularly anxiety and mood disorders are common in people with EDs and SUDS.”

“As with recovery from SUDs, recovery from EDs can be a long process with periods of relapse and recovery. Relapse to one disorder may affect a client’s recovery from the other.”  Treatment for both of these disorders is needed and Relapse prevention counseling is critical to recovery from both disorders.