Understanding Dual Diagnosis: Schizophrenia and Substance Abuse
When treating dual diagnosis issues like schizophrenia in conjunction with substance abuse, you have to account for the full scope of underlying factors, including past trauma, lifestyle, environment, patterns of addictive behaviors, and the type of schizophrenia diagnosis.
What Does Dual Diagnosis With Schizophrenia Mean?
Dual diagnosis simply means that someone has been diagnosed with a psychological issue as well as substance or alcohol addiction. While it may take more time to identify the full scope of the problems at the root of dual diagnosis, it can still be successfully treated and healed, just like any mental issue we treat.
Dual diagnosis isn’t rare. Up to half of people struggling with a psychological issue also abuse drugs or alcohol, and schizophrenia is no exception. One study estimates that as many as half of people diagnosed with schizophrenia may also suffer from a comorbid drug or alcohol addiction. While young males with lower education status are more prone to dual diagnosis with schizophrenia, it can affect anyone.
When treating dual diagnosis together with schizophrenia, you first have to get the addiction issues under control, or at least treat addiction together with schizophrenia, before you can get to the root of psychosis. Most often, addiction in individuals with schizophrenia develops over time as a form of self-medication and coping but can also arise from imbalances in the brain’s chemistry.
Because individuals may be coping with a multitude of issues, including past trauma, stress, anxiety, brain chemistry imbalances, and comorbid mental diagnoses, treatment needs to take a holistic approach to understanding and healing each of these areas if long-term recovery is to be achieved.
No matter the type of addiction, evidence shows that the dual diagnosis of schizophrenia and substance or alcohol abuse are inextricably linked. Treatment has to address both the addiction and psychotic symptoms to achieve the best possible outcomes.
The Relationship Between Schizophrenia and Alcohol Use
A recent study found that people diagnosed with schizophrenia and schizoaffective disorder are three times more likely to fall into heavy alcohol use when compared to the general population. Individuals struggling with a dual diagnosis of schizophrenia and alcohol addiction experience worse outcomes. It increases the chances of depression, suicidality, medication nonadherence, chronic physical problems, homelessness, aggression, violence, incarceration, and hospitalization.
People with schizophrenia often develop an alcohol addiction because alcohol acts as a depressant on the central nervous system, dulling the senses and making individuals less aware of their psychotic symptoms. However, long-term alcohol use can also cause psychotic symptoms like hallucinations, which may be mistaken for symptoms of schizophrenia.
Since alcohol is physically addictive, it can trigger psychotic states during withdrawal. That’s why it’s critical to make a careful diagnosis when an individual’s issues are suspected to be related to schizophrenia and alcohol use.
The team at PCH can help you understand the relationship between schizophrenia and addiction in complex cases of dual diagnosis. Our Treatment Program
How Drugs and Schizophrenia Affect Dual Diagnosis
As with alcohol use, drug use in individuals diagnosed with schizophrenia generally leads to poorer treatment outcomes. Substance use can trigger psychotic symptoms and lead individuals to ignore, defer, or resist treatment. Individuals diagnosed with schizophrenia and substance addiction are more likely to experience illness or injury, require emergency services, and be incarcerated.
One study found that 47 percent of subjects with a lifetime schizophrenia diagnosis also met the criteria for some form of substance abuse. More studies need to be conducted to better understand the links between schizophrenia and specific drugs, but preliminary research has provided a general understanding of the connections with marijuana and cocaine.
Schizophrenia and Marijuana
Studies have shown a pattern between marijuana use and the increased risk of developing psychosis and experiencing psychotic states. Marijuana use during adolescence may double the risk of developing schizophrenia as an adult, and heavy use can accelerate or exacerbate the onset of psychotic symptoms in individuals with schizophrenic tendencies.
Schizophrenia and Cocaine
Individuals diagnosed with schizophrenia who also abuse cocaine have a higher risk of suicide, tend to be less compliant with treatment, and face an increased risk of hospitalization when compared to patients without a cocaine addiction. Cocaine addiction often develops in conjunction with schizophrenia when it becomes a form of self-medication for imbalances in the brain or to counteract the adverse side effects of antipsychotic medications.
Can Drug Use Cause Schizophrenia?
We’re often asked if drug use can cause schizophrenia. While drug use can certainly amplify or expedite the onset of psychotic symptoms, there’s no evidence that it’s the primary cause of schizophrenia. Many individuals who use drugs do not end up developing schizophrenia, and the ones who do were already predisposed due to environmental, familial, and genetic factors. However, long-term use can cause some people to experience forms of psychosis. That’s why it’s critical to account for the full scope of factors, including past drug use, family history, and past trauma, when making an accurate schizophrenia diagnosis.
Is PCH Right for You?
Are you or someone you care about struggling with addiction alongside schizophrenic tendencies? Successful treatment needs to account for both issues to achieve long-term well-being, and PCH has the experience to help heal both areas of life. When you’re ready to learn more, take a look at our approach to treating schizophrenia and dual diagnosis. If you’re ready to take the next steps, find out if PCH is right for you.