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Beach House Rehab Center » Blog » Schizophrenia and Drug Use
There is an in inextricable link between mental illness and substance abuse—particularly schizophrenia and substance abuse. Although schizophrenia is generally classified under the umbrella of mental illness, it is actually a neurological disorder of serious import and clinical significance. The disorder, which is characterized by auditory and visual hallucinations, disorganized thought processes, delusional beliefs, and highly eccentric personality traits, is debilitating for those afflicted with it and overwhelming for family members and friends. Schizophrenia causes cognitive distortions and maladaptive behaviors that interfere in healthy social and professional functioning and frequently leads to psychiatric hospitalization, homelessness, unemployment, suicide ideation or attempts, and alienation from important relationships. As a result, approximately half of those suffering from schizophrenia concurrently abuse alcohol and drugs.
Schizophrenia is considered an early-onset disorder, with the majority of patient’s first experiencing symptoms in their teens. Although the prevalence of schizophrenia is considered relatively low in the general population, co-occurring substance abuse disorders (SUDs) are higher than average. For many schizophrenic patients, the devastating effects of the disorder lead to a variety of unhealthy coping mechanisms—the most common being substance abuse. The simultaneous treatment of schizophrenia and substance abuse is notoriously difficult and requires a nuanced, multidimensional approach that includes aggressive symptom management combined with genuine compassion.
Within the general cluster of symptoms that define schizophrenia, individual variations (or sub-types) appear that help clinicians better understand and treat the disorder. For example, paranoid schizophrenia is the most common expression and is characterized by delusional thinking and beliefs. Paranoid schizophrenics are often haunted by thoughts and feelings involving persecution, emotional or physical threats, imprisonment, and loss of control by other humans or even aliens. In some cases, paranoid schizophrenia is also defined by highly imaginative but implausible conspiracy theories and self-proclaimed relationships with immaterial beings. The dialogue and behavior associated with extreme paranoid schizophrenia can resemble the script of a science-fiction movie, and those suffering from its effects may become aggressive, erratic and socially isolated due to their debilitating fear of others. Other dominant expressions of schizophrenia include:
Regardless of which dominant expression schizophrenia takes, signs and symptoms are divided into four main quadrants. This helps simplify the often painstakingly detailed, tedious process of disentangling a complex equation of interwoven symptoms. The quadrants are, in no particular order:
Smoking is, by far, the most commonly abused substance associated with schizophrenia. In fact, people suffering from schizophrenia are addicted to nicotine at triple the rate of the average person. While approximately 25 percent of the general population is addicted to nicotine, the number is between 75 and 90 percent for schizophrenics. As with alcohol, the relationship between schizophrenia and smoking is highly complex and theorized to be the result of the additional burden of physical, emotional and psychological stress shouldered by those suffering from the disorder. Unfortunately, nicotine may interact unfavorably with the antipsychotic medications used to treat schizophrenia, and nicotine withdrawal can cause a gradual worsening of symptoms.
Alcohol is the second most widely abused substance associated with schizophrenia. According to the National Institute on Drug Abuse (NIDA), approximately one-third of schizophrenics become an alcoholic within their lifetime. Many researchers, scientists and clinicians attribute this high prevalence of alcoholism to the complex web of “biological, psychological and environmental factors” that negatively affect schizophrenics on a daily basis. This frequently causes schizophrenics to self-medicate in response to their considerable challenges and creates a vicious cycle.
Sadly, schizophrenia and alcoholism are difficult to treat in tandem and usually result in suboptimal treatment outcomes. Concurrent schizophrenia and alcoholism are also associated with:
Polysubstance drug abuse involving mind-altering substances such as potent opiates and illicit street-drugs (in addition to alcohol and cigarettes) can have a dramatically negative effect on schizophrenia. Even in individuals with relatively normal genetics and a strong physical constitution, polysubstance drug abuse can take a crippling toll. With regard to schizophrenia, specifically, the disorganized thought patterns, auditory and visual hallucinations, erratic behaviors, and communication difficulties react with far greater volatility to the presence of mind-altering substances and create long-term damage.
The already disjointed, neurologically dysfunctional brain of a schizophrenic is not designed to withstand the assault of hard-core substances. Although “typical antipsychotic” medications such as Haldol and Proxilin, and “atypical antipsychotic” medications such as Seroquel and Risperdal can be very effective in alleviating certain symptoms of schizophrenia—they interact badly with mind-altering substances and run the risk of producing serious, potentially fatal, complications. For this reason, it is imperative that individuals suffering from schizophrenia refrain from any unnecessary drug use.
In addition to whatever primary medications are used to treat schizophrenia, a variety of evidence-based Food and Drug Administration (FDA) pharmacological interventions are available to treat co-occurring substance abuse disorders (SUDs). Empirical research suggests that professional, medically managed treatment— although not always effective—can provide lasting relief from concurrent schizophrenia and drug addiction. In such environments, highly qualified clinicians and licensed medical professionals unite to provide state-of-the-art care. During treatment, a variety of behavioral therapies are incorporated into the protocol including:
Being hit with a concurrent diagnosis of schizophrenia and substance abuse can be extremely daunting. It is common for individuals and families suffering from both to feel hopeless and overwhelmed. However, despite these totally normal, understandable feelings, there is a multitude of available treatment options—with many including customizable, comprehensive care. Help is just a phone call away.
For more about schizophrenia and drug use, check out these related articles:
Sources:
Dialogues in Clinical Neuroscience. Substance abuse in patients with schizophrenia. March, 2006.
Schizophrenia Research. Substance use in youth at risk for psychosis. March, 2017.
The Journal of Psychosis and Related Disorders. Substance Use Disorders in Schizophrenia—Clinical Implications of Co-Morbidity. May, 2009.
Current Opinion in Psychiatry. Schizophrenia and substance abuse: Is schizophrenia forgotten? May, 2017.
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