How Morphine Abuse Can Mask Antisocial Personality Disorder

How Morphine Abuse Can Mask Antisocial Personality Disorder

Antisocial personality disorder (ASPD) is not fully understood. However, statistical evidence points to a possible correlation between ASPD and substance abuse. One study concluded that 40 to 50% of individuals with a substance abuse disorder meet the criteria for ASPD, while roughly 90% of those diagnosed with ASPD also have a co-occurring substance abuse disorder (Messina, Wish and Nemes, 1999).

What Is Antisocial Personality Disorder?

According to Psychology Today, “antisocial personality disorder is characterized by a pattern of disregard for and violation of the rights of others.” As with other personality disorders, ASPD occurs along a spectrum of varying degrees of intensity depending on the individual patient. The terms “psychopath” and “sociopath” have been used to describe people with ASPD, although there is sharp disagreement over the exact meanings and appropriate uses of these terms.

The exact causes of ASPD are still unknown, but the condition is thought to result from a complex combination of genetic, psychological and social factors.

There is no clinical diagnostic for ASPD; rather, diagnosis is based on reported experiences of behavior. A diagnosis of ASPD is not made on patients younger than eighteen years of age; however, for a diagnosis to exist the person must have displayed signs of conduct disorder prior to age eighteen. Behavior exemplary of conduct disorder in a child that may indicate a risk for ASPD includes cruelty to animals and fire starting.

Characteristics of persons with ASPD include the following:

  • Failure to conform to social standards; persons with ASPD are often in trouble with the law
  • Deceitfulness
  • Impulsivity
  • Irresponsibility
  • Irritability and aggressiveness; persons with ASPD are often violent
  • Reckless disregard for the safety of others
  • Lack of remorse for misdeeds

Morphine and its Relation to ASPD Diagnosis and Treatment

Since the exact causes of ASPD are not known, it is impossible to establish a clear cause and effect relationship between morphine use and ASPD. However, evidence does suggest a connection between ASPD and drugs such as morphine that alter serotonergic function in the brain. J.F.W. Deakin of the University of Manchester’s Neuroscience and Psychiatry unit cites several studies that have established a link between ASPD and decreased serotonin levels, as well as studies that have found a link between decreased serotonin levels and impulsivity and aggressiveness, which are both criteria for diagnosing ASPD.

Like many other drugs of abuse, morphine alters levels of serotonin in the brain. With repeated use of morphine, the brain is unable to produce adequate levels of serotonin on its own. While this is unlikely to be enough in and of itself to cause ASPD, it may be enough to trigger or aggravate ASPD in someone who has other key elements in place to develop the disorder.

As far as masking ASPD and thereby making it difficult to diagnose and treat, it may be that increased serotonin levels due to use of morphine inhibit characteristics of ASPD while the person is under the influence of the drug.

Treating ASPD and Co-Occurring Morphine Addiction

Persons with ASPD are notoriously hard to treat. Co-morbid conditions such as morphine addiction only compound the problem. ASPD patients may be denied psychotherapy until they overcome addiction, and may be asked to leave addiction treatment due to their disruptive behavior (Messina et al, 1999). The best approach is long-term psychotherapy with a specialist trained in treating ASPD specifically. If you would like help finding treatment for ASPD and morphine addiction, call our toll-free 24 hour helpline.