Are the "addiction-related" problems of substance abusers really related?

The "addiction-related" medical, social, and psychological problems of substance abusers are often considered by-products of prolonged alcohol or drug abuse which will be generally improved following achievement of abstinence. As a test of this view, measures of problem severity in six areas commonly related to addiction were intercorrelated in 460 alcoholic and 282 drug addicted male veterans. Both before and after treatment, the low intercorrelations in each sample indicated little relation between the severity of alcohol or drug use and the severity of the other problem areas. Intercorrelations among residualized admission to follow-up change scores were similarly low, also showing the lack of a general relationship between improvement in substance abuse and improvement in other areas. However, there was one exception: improvement in psychological function was clearly related to general improvement in most other areas, including chemical abuse, indicating the potential importance of psychologically oriented therapy in substance abuse treatment. Most of the evidence suggests that addiction may be a common pathway for a variety of specific disorders, rather than a general, progressive disease.