Integrating Substance Use Disorders into Modern Mental Health Care: Emerging Risks and Interventions

Although addiction management is increasingly recognized as integral to mental health care, the broad physical and social harms of substance use disorders often go unaddressed, compromising long-term outcomes.

Clinicians in mental health settings frequently encounter patients whose psychiatric symptoms intertwine with substance use, yet protocols rarely extend beyond behavioral therapies.

Cannabis use disorder has been associated with a threefold relative increase in oral cancer risk compared to non-users—an observational finding that does not establish causality and occurs against a backdrop of low absolute incidence—and future studies should quantify absolute risk and explore underlying mechanisms.

Equally concerning is the prevalence of khat use among adolescents in regions such as Yemen and Ethiopia, where psychoactive leaf chewing is woven into cultural norms. An Ethiopian study detailed high rates of dependence, anxiety, and disruptions to academic performance, signaling a call to expand adolescent mental health strategies to address substance-related social and educational fallout.

Repetitive transcranial magnetic stimulation, while FDA-cleared for major depressive disorder, remains investigational for smoking cessation and is currently being evaluated in early-phase trials targeting neural circuits implicated in nicotine addiction. Systematic review and meta-analysis reported promising abstinence outcomes when combined with psychosocial support.

A UK study reported that adolescents who vape initiate smoking at rates comparable to peers in the 1970s—an observational association that may be influenced by confounding factors—and further longitudinal research is needed to clarify whether nicotine exposure from e-cigarettes directly lowers barriers to traditional cigarette use.

This underrecognized oncogenic association underscores the need for research-informed guidelines, and until formal recommendations are established, clinicians may consider incorporating oral cancer risk assessments into evaluations for patients with heavy cannabis use.

Addressing these intersecting challenges requires coordinated protocols for cancer screening in cannabis users, targeted adolescent interventions in khat-prevalent regions, integration of neurologically informed therapies like rTMS, and proactive policies to curb youth vaping. Embedding substance use disorder management within mental health care frameworks will enable clinicians to mitigate the full spectrum of harm and stay ahead of evolving substance use trends.

Key Takeaways:

• Addressing SUDs in mental health requires integrating cancer risk screening, especially for cannabis users.
• Therapies like rTMS offer promising smoking cessation strategies, showcasing innovation in addiction treatment.
• Teen vaping poses a renewed risk for traditional smoking, prompting reevaluation of public health strategies.
• Khat use among adolescents highlights the need for targeted interventions in socioeconomically impacted regions.