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Treating Schizophrenia and Drug Addiction

Schizophrenia is a chronic mental disorder that can be fairly severe. People diagnosed with schizophrenia will experience problems related to their thinking, feelings, and behavior.

Most notably, people with schizophrenia may have a hard time distinguishing reality from imagined scenarios and events. The disorder isn’t common, but it can be disabling, especially when it is left untreated. People who have schizophrenia may also experience other mental health problems such as paranoia, anxiety, and depression.

Substance use disorders can also play a role in complicated psychotic disorders like schizophrenia. As with other mental health problems, there are a variety of significant links between substance use disorders and schizophrenia including genetics and psychological factors. Both disorders can have their roots in genetic factors.

According to studies, having parents or grandparents with substance use disorders increases your likelihood of experiencing an addiction at some point in your lifetime.

When the two disorders occur at the same time, they can worsen each other, and become interdependent. For that reason, someone with a substance use disorder that has co-occurring schizophrenia will need treatment that addresses both issues.

Learn more about schizophrenia, and how it can be addressed alongside addiction treatment. 

What Is Dual Diagnosis?

Dual diagnosis is a type of addiction treatment that is specifically designed to treat both substance addiction and co-occurring mental health problems like schizophrenia. There is significant overlap between mental health problems and addiction for a variety of reasons. Both share similar causes like genetics, environment, and development. But there are cases where one disorder can lead to another.

It can be difficult, however, to pinpoint which disorder came first. In some cases, drug use can trigger pre-existing or dormant mental health problems. More commonly, mental health issues lead to a phenomenon called self-medicating, which is when a person uses a drug to treat the symptoms of a mental health problem without consulting a doctor. Self-medicating can quickly lead to psychological dependence, as people believe they need the drug to feel normal. Frequent use then leads to chemical dependence and addiction.

In the past, mental health disorders were treated separately from substance use problems or not at all. In some cases, people would be turned away from substance abuse treatment if psychological issues become too difficult to manage. Treating addiction can be incredibly challenging if a serious mental illness like schizophrenia is left unaddressed.

Because the two disorders are interdependent, it may be extremely difficult to make progress in treatment. If you do complete treatment, schizophrenia may trigger a relapse soon after. At the same time, if schizophrenia is treated without addressing a substance use disorder, drug use can worsen or trigger a relapse of symptoms.

Treatments that address both issues simultaneously are ideal. That way, progress can be made without one disorder holding the other back. 

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Do Drugs Cause Schizophrenia?

It’s unclear whether certain drugs can lead to schizophrenia or if they trigger the disorder in people who are predisposed to it. But certain substances seem to have an adverse effect on the disorder. A few drugs that can potentially worsen or trigger schizophrenia are:

 

There is some debate over whether or not cannabis can complicate schizophrenia or not. But most evidence seems to support the idea that marijuana can worsen psychotic symptoms. It may also increase the risk factors for developing schizophrenia, especially in adolescents.

 

Powerful stimulants like cocaine and methamphetamine can cause a condition called stimulant psychosis, which causes symptoms that are similar to schizophrenia. Stimulant psychosis is usually temporary, but it can cause complications in people that are predisposed to psychotic disorders. Cocaine abuse among people with schizophrenia can also increase their risk of suicide.

Certain psychedelics can be dangerous for people with schizophrenia. Drugs that cause hallucinations or altered consciousness can cause complications for people with schizophrenia.

Alcohol is a common substance people use to self-medicate. If depression or anxiety accompanies schizophrenia, it can become even more likely for someone to abuse alcohol.

Does Schizophrenia Cause Substance Use Disorders? 

Schizophrenia, like other mental illnesses, may lead to substance use disorders when people attempt to treat their symptoms with drugs or alcohol. It may not always be a conscious decision, however. Some people start to use drugs and alcohol socially and then find that it’s a way to unwind or forget their troubles. After a while, they start to feel like they need chemical substances to feel normal, which can lead to physical and psychological dependence and addiction. However, psychoactive substance use disorders typically only serve to make

schizophrenia symptoms and other mental health problems worse.

Again, schizophrenia and substance use disorders have many common risk factors, including genetics and environmental factors. It’s possible for both disorders to develop simultaneously or separately.

Man with vertigo sitting down

The Severity of the Disorder

Schizophrenia is a complicated mental health problem that we are still learning about. Because it’s so complex, it often requires a specialist to treat it effectively. Mild schizophrenia, or a condition that has been treated and stabilized, can be treated in an addiction treatment facility.

In many cases, schizophrenia and substance use disorders are interdependent, feeding off each other’s mental health issues, which worsens both disorders. If other mental health problems like depression, anxiety, or paranoia are also present, it can further complicate things. There are a variety of treatment options for schizophrenia, including antipsychotic medications, psychosocial therapies, and coordinated specialty care, which is a holistic approach that is similar to addiction treatment.

However, it’s important to note that a severe case of schizophrenia may require highly intensive care from a specialist, and may not be treatable in the context of an addiction treatment center.

However, if you enter an addiction treatment program with severe schizophrenia, clinicians may refer you to the help you need. Once your condition is stabilized, you can begin to address your substance use disorder in addiction treatment, while continuing to work through schizophrenia. 

Simultaneously Treating Schizophrenia and Drug Addiction 

Dual diagnosis treatment is a complex process and, like all addiction treatment, it needs to based on your individual needs rather than trying to fit you into a standardized plan. No two treatment plans should look identical, especially when co-occurring mental health issues are involved. When you first enter treatment, you will go through an intake and assessment process that is designed to find the best level of care for your needs. You also will have a chance to sit down with your therapist to create a customized treatment plan.

Addiction treatment and schizophrenia can be treated with some of the same therapy options. Psychotherapies have shown to help both disorders including behavioral therapies like cognitive behavioral therapy (CBT). For addiction, CBT can be instrumental in identifying high-risk situations that can lead to a relapse. It can also help to form relapse prevention strategies. For schizophrenia, CBT can help to identify schizophrenia symptoms and their triggers.

Sources

Arseneault, L., Cannon, M., Witton, J., & Murray, R. M. (2018, January 02). Causal association between cannabis and psychosis: Examination of the evidence | The British Journal of Psychiatry. Retrieved from https://www.cambridge.org/core/journals/the-british-journal-of-psychiatry/article/causal-association-between-cannabis-and-psychosis-examination-of-the-evidence/71BA37D16485F186CE7B6B785E5B69A4

PsyhCentral. (2020, January 17) Schizophrenia and Substance Abuse. Carmosino, A. Retrieved from https://psychcentral.com/lib/schizophrenia-and-substance-abuse/

Bevilacqua, L., & Goldman, D. (2009, April). Genes and Addictions. Retrieved from https://learn.genetics.utah.edu/content/addiction/genes/

Fergusson, D. M., Horwood, L. J., & Ridder, E. M. (2005, March). Tests of causal linkages between cannabis use and psychotic symptoms. Retrieved from https://www.ncbi.nlm.nih.gov/pubmed/15733249

Kingdon, D., M.D. (2006, June 20). The ABCs of Cognitive-Behavioral Therapy for Schizophrenia … Retrieved from http://www.psychiatrictimes.com/schizophrenia/abcs-cognitive-behavioral-therapy-schizophrenia

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