|LETTER TO EDITOR
|Year : 2015 | Volume
| Issue : 3 | Page : 374-375
Dyslexia and substance abuse: The under-recognized link
Department of Psychiatry, National Drug Dependence Treatment Centre, All India Institute of Medical Sciences, New Delhi, India
|Date of Web Publication||17-Aug-2015|
E-24, West Ansari Nagar, AIIMS Residential Campus, All India Institute of Medical Sciences, New Delhi - 110 029
Source of Support: None, Conflict of Interest: None
|How to cite this article:|
Jhanjee S. Dyslexia and substance abuse: The under-recognized link. Indian J Psychol Med 2015;37:374-5
World Federation of Neurology defines dyslexia as a disorder of reading in the presence of average intelligence, conventional instruction, and socioeconomic status.  Dyslexia is the most common learning difficulty. Prevalence estimates vary widely and range from 6% to 17% of the school age population depending on the severity of reading difficulties.  Not much is known about the relationship between learning disabilities and substance abuse but what is known is that learning disabilities increase the likelihood of drug abuse.  Understanding this comorbidity is important as it may affect the severity of the clinical picture, specific treatments and interventions.
Many reasons are postulated about the association of substance abuse and learning disabilities. For one, risk factors for adolescent substance abuse are very similar to the behavioral and emotional consequences of learning disabilities. Emotional problems, low self-esteem, and problems in peer relationships as common associated features of dyslexia.  Thus, dyslexia may indirectly lead to substance abuse by generating the types of behavior that lead adolescents to abuse drugs. Another reason for the association is through the common comorbidities that both the disorders share. Dyslexia rarely occurs in isolation and attention deficit hyperactivity disorder (ADHD) is the most frequent psychiatric disorder associated with dyslexia. Across studies estimations of dyslexia among children diagnosed with ADHD range from 10% to 40%.  Children with both dyslexia and ADHD are at a phenomenally increased risk for substance abuse and legal convictions if they do not receive appropriate interventions.  Conversely, there is also some preliminary evidence to suggest that individuals in substance abuse treatment have a higher incidence of learning disabilities than the general population. 
The important question is what needs to be done about this. Perhaps it can be summarized as alert, prevent and treat. Greater emphasis needs to be placed upon the early identification of dyslexia  and it is important to alert clinical psychologists, psychiatrists, pediatricians, parents and school teachers that learning disabilities may increase the risk for substance abuse. It would be essential to provide early remediation treatment for this problem to prevent the behavioral adverse effects and subsequent increased risk of substance abuse. Children with dyslexia and other learning disabilities should be screened for substance abuse, and those who start abusing drugs must receive treatment to deal with both their problems which may require specialized treatment settings. However, currently there is a lack of appropriate prevention and treatment services, and there is strong empirical evidence to highlight that the needs of this population have rarely been addressed.  Finally, there is a lack of research that has explored substance abuse by people with dyslexia and other learning disabilities in general. Hence, there is an urgent need for tailored research in this area to determine etiology, pathways of development and appropriate preventive and treatment measures.
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