Is There a Connection Between Schizophrenia and Substance Use?

Posted on April 12, 2022

man with schizophrenia using drugs to cope

A serious mental disorder, schizophrenia cannot be prevented. It requires lifetime treatment to manage the combination of hallucinations, delusions, and disordered thinking and behavior it causes. When left untreated, schizophrenia can be disabling, impairing a person’s ability to function day to day.

Unfortunately, it’s common for someone with schizophrenia to also struggle with a substance use disorder. Known as a co-occurring disorder or dual diagnosis, this has often been thought to occur because people with schizophrenia turn to drugs or alcohol to manage some of their mental health symptoms. New research indicates that the genetic components of schizophrenia, particularly within the neural systems, may make an individual more vulnerable to addiction.

What is Schizophrenia?

Schizophrenia affects about 1% of the population, but almost half of those with the disorder (47%) have a serious problem with alcohol or drug use. By contrast, within the general population, only 16% of people have significant issues with addiction.

Women and men seem to have schizophrenia in about equal numbers, but men will exhibit symptoms earlier. Men typically first experience symptoms in their early to mid-20s, while symptoms start for women during their late 20s. Teens can show signs of the disorder, but those symptoms may be easily confused with the typical development of teens. Rarely is schizophrenia diagnosed in someone over 45.

Signs of Schizophrenia

The most common signs of schizophrenia are delusions, hallucinations, disorganized thinking, speech, and behavior. Delusions are beliefs that have no basis in reality, while hallucinations involve seeing and hearing things that are not real.

Disorganized thinking and speech cause a person’s communication to be impaired, often causing their speech to be out of order or jumbled. Disorganized behavior is exhibited in a variety of ways, from being unable to complete tasks to an unwillingness to follow instructions to unpredictable agitation.

Additionally, someone with schizophrenia may find it hard to function normally. This can result in an inattention to personal hygiene, being unable to look someone in the eye, withdrawing socially, or not being able to experience pleasure.

Treating Schizophrenia and Substance Abuse

The best way to handle a dual diagnosis of schizophrenia and substance abuse is by treating both conditions at the same time. This begins with the person stopping their use of all drugs and alcohol. Treatment for schizophrenia and addiction typically involves psychosocial therapy to help manage the mental health disorder, the substance use disorder, and any medication the person takes for both conditions.

The most common medications prescribed for someone with schizophrenia are antipsychotics. They seem to help those with the condition by regulating dopamine, the brain’s neurotransmitter, to better control symptoms experienced during schizophrenia. Because antipsychotics can have negative side effects, many with schizophrenia may be reluctant to take the necessary medicine. The person may try different medications or may adjust their regiment to find the lowest dosage with the fewest side effects that work.

Behavioral therapy and support groups also play an important role, particularly when addressing substance use disorders. Studies indicate that treating both conditions at the same time provides the most effective outcome for the person. Possible behavioral therapies that may be used to address substance use disorder and mental health challenges include:

  • Cognitive Behavioral Therapy (CBT), which helps the person modify their unhealthy behaviors.
  • Dialectical Behavior Therapy (DBT), which focuses on reducing self-destructive behaviors such as cutting or outbursts.
  • Assertive Community Treatment (ACT), which often works well for someone with schizophrenia and a co-occurring substance use disorder because it emphasizes outreach and a highly individualized approach.
  • Contingency Management (CM) or Motivational Incentives (MI), which reward individuals for practicing healthy behaviors.

A person who has schizophrenia may not recognize that they have a problem. Often friends and family members must try to talk to the person and encourage them to seek help. If the person poses a danger to themselves, loved ones have the option of contacting emergency first responders that will be able to have the person evaluated by a mental health professional.

Getting help for schizophrenia is important. According to the World Health Organization (WHO), people with this mental health condition are two to three times more likely to die early. This is often linked to physical illnesses, including cardiovascular, metabolic, and infectious diseases. The WHO also shares that while about 50% of people in mental facilities have a diagnosis of schizophrenia, many of those with the condition do not receive the necessary mental health treatment they need.

As a licensed mental health and substance abuse intensive outpatient program (IOP) in Scottsdale, Arizona, Rising Phoenix offers a safe, welcoming, and nurturing environment where clients are embraced throughout their recovery process.

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