Can drugs cause schizophrenia

Contents

Causes


Schizophrenia

Increased risk

Genetics

Schizophrenia tends to run in families, but no single gene is thought to be responsible.

It’s more likely that different combinations of genes make people more vulnerable to the condition. However, having these genes does not necessarily mean you’ll develop schizophrenia.

Evidence that the disorder is partly inherited comes from studies of twins. Identical twins share the same genes.

In identical twins, if a twin develops schizophrenia, the other twin has a 1 in 2 chance of developing it, too. This is true even if they’re raised separately.

In non-identical twins, who have different genetic make-ups, when a twin develops schizophrenia, the other only has a 1 in 8 chance of developing the condition.

While this is higher than in the general population, where the chance is about 1 in 100, it suggests genes are not the only factor influencing the development of schizophrenia.

Brain development

Studies of people with schizophrenia have shown there are subtle differences in the structure of their brains.

These changes are not seen in everyone with schizophrenia and can occur in people who do not have a mental illness. But they suggest schizophrenia may partly be a disorder of the brain.

Neurotransmitters

Neurotransmitters are chemicals that carry messages between brain cells.

There’s a connection between neurotransmitters and schizophrenia because drugs that alter the levels of neurotransmitters in the brain are known to relieve some of the symptoms of schizophrenia.

Research suggests schizophrenia may be caused by a change in the level of 2 neurotransmitters: dopamine and serotonin.

Some studies indicate an imbalance between the 2 may be the basis of the problem. Others have found a change in the body’s sensitivity to the neurotransmitters is part of the cause of schizophrenia.

Pregnancy and birth complications

Research has shown people who develop schizophrenia are more likely to have experienced complications before and during their birth, such as:

  • a low birthweight
  • premature labour
  • a lack of oxygen (asphyxia) during birth

It may be that these things have a subtle effect on brain development.

Can Drug Use Cause Schizophrenia?

Researchers think schizophrenia is caused by a combination of genetic and environmental factors, but there is a lot left to learn about the specific genes that make a person at risk for schizophrenia and the environmental factors that trigger these genes. There is increasing evidence that illicit drug use, particularly marijuana, may be one of those environmental factors.

Schizophrenia and Marijuana

Evidence has been around for some time linking marijuana use to psychoses; the debate concerns the nature of the relationship. Here are some theories:

  • The gene that puts a person at risk for schizophrenia may also predispose him to use marijuana, sometimes called cannabis. A study of Swedish military enlistees found that cannabis use might increase the risk of schizophrenia by as much as 30 percent in people who are genetically susceptible.
  • People with psychotic symptoms may use cannabis to self-medicate.
  • Cannabis use triggers schizophrenia and other psychoses. Evidence is mounting to support this theory. For example, a recent review of studies that examined schizophrenia risk for cannabis users found that people who used marijuana by age 18 were more likely to develop schizophrenia than those who did not. Other studies report that people who have used marijuana more than 50 times were six times more likely to receive a schizophrenia diagnosis.

Schizophrenia and Other Drugs

Studies that have examined the relationship between schizophrenia and other drugs are less common. Alcohol is the substance most often abused by people with schizophrenia. While alcohol can cause a relapse of symptoms, there is no evidence to suggest that alcohol use causes schizophrenia. And stimulants, like cocaine and amphetamines, are linked to types of psychosis, while heroin users were actually at a lower risk for developing psychoses.

Can a Link Between Schizophrenia and Drug Use Be Proved?

Ken Duckworth, MD, medical director of the National Alliance on Mental Illness and an associate professor at Harvard Medical School in Boston, says that proving the link between schizophrenia and illicit drug use is tough.

To prove conclusively that marijuana use causes schizophrenia, a researcher would have to provide marijuana to a person at risk for schizophrenia. This is not legal, and it is unethical to knowingly expose a person to a hazardous substance. The researcher must also carefully control the person’s environment, eliminating exposure to other variables that are thought to cause schizophrenia. This is neither practical nor ethical.

Instead, researchers must rely on longitudinal or “cohort” studies that track a large group of people over the course of many years. Researchers periodically take medical histories and ask questions about drug use and life experiences. The data are subject to participants’ memory and willingness to disclose personal information, and the studies can take years. Despite limitations, evidence gleaned from these studies sheds light on new schizophrenia prevention strategies.

Schizophrenia Prevention?

Based on the study involving the Swedish military, the researchers speculate that as many as 13 percent of schizophrenia cases could be prevented if no one used marijuana. Other studies suggest that the greatest risk is to adolescents. Because the average age of schizophrenia onset is 20 years old, delaying drug use until early adulthood may also effectively minimize risk.

There are other environmental triggers for schizophrenia; avoiding drug use will not eliminate risk entirely. Besides, says Dr. Duckworth, not all people with schizophrenia have used illegal drugs.

But a definite risk exists. A person with a family history of schizophrenia should seriously consider the risk of mental illness when making decisions about recreational drug use.

How to Identify Substance-Induced Psychosis

According to the National Alliance on Mental Illness, psychosis refers to an episode in which an individual has a break from reality. This often includes but doesn’t require delusions, or false beliefs that are firmly held despite clear evidence to the contrary, and hallucinations. About 3 in every 100 people will experience at least one episode of psychosis in their lifetimes.

Drug-induced psychosis, also known as substance-induced psychotic disorder, is simply any psychotic episode that is related to the abuse of an intoxicant. This can occur from taking too much of a certain drug, having an adverse reaction after mixing substances, during withdrawal from a drug, or if the individual has underlying mental health issues. Though it’s not actually true that taking a certain kind of drug can suddenly trigger a severe mental illness where none had existed, mental illness is a predictor of substance abuse, and someone prone to psychosis can be triggered by becoming overly intoxicated.

Substance abuse is defined as any use of an illicit intoxicant, any use of prescription medication outside the direction of a doctor, or excessive use of legal substances such as alcohol. According to the Substance Abuse and Mental Health Services Administration’s (SAMHSA’s) National Survey on Drug Use and Health, 9.3 percent of individuals in the US age 12 over older needed treatment for a drug or alcohol problem in 2009. This does not include people who occasionally abuse drugs but are not considered to have a dependency issue. This amounts to 23.5 million people.

Drug and Alcohol Abuse

Psychosis can be caused by the abuse of hallucinogens or certain prescription medications. In rare cases, exceptionally sensitive people can experience psychosis as a side effect even when taking prescription drugs properly.

Medications known to include possible psychotic side effects include:

  • Muscle relaxants
  • Antihistamines
  • Antidepressants
  • Cardiovascular medications
  • Antihypertensive medications
  • Analgesics
  • Anticonvulsants
  • Antiparkinson medications
  • Chemotherapy agents
  • Corticosteroids

Any time psychotic symptoms appear when taking prescription medications, the individual or a loved one should contact a doctor immediately. It may be necessary to immediately stop taking the medication altogether. Psychosis can also become more likely when these medications are abused.

When it comes to nonprescription intoxicants, the likelihood of psychotic symptoms appearing, and what that looks like, varies from substance to substance. For example, taking a large amount of cocaine all at once can cause psychosis in minutes. Psychosis from cocaine or amphetamine use typically produces persecutory delusions.

Hallucinogens can, of course, cause visual, auditory, and tactile hallucinations, but this is not the same as psychosis. However, an adverse reaction or taking too much of this kind of drug can also cause delusions and paranoia.

Once the individual is no longer aware that the hallucinations are not real, that’s when you have a break from reality and a serious problem.

This can happen with the use of hallucinogens such as LSD and psychotropic mushrooms, but psychosis can also occur with abuse of cannabis, especially when too large a dose has been taken.

Alcohol abuse can cause psychosis, but typically only after days or weeks of intense use. People who have a chronic alcohol abuse problem that has lasted for several years are also vulnerable to intense paranoia and hallucinations. This occurs due to the damaging effects of alcohol on the brain over time and due to a lack of thiamine (a vitamin B complex) in the body that can lead to Wernicke-Korsakoff syndrome.

Withdrawal

Substance abuse does not always lead to physical addiction, but it does increase the risk of developing this problem. The longer and more intense the abuse, the greater the risk. Physical addiction is characterized by the emergence of withdrawal symptoms when the individual stops taking the intoxicant in question. Depending on the type of substance abused, the length of time the abuse has gone on, and how much is typically taken at once, withdrawal can include psychosis.

The most commonly known substance-induced psychosis from withdrawal involves alcohol. Long-term alcohol addiction can significantly change the chemistry and even the structure of the brain, possibly producing a set of symptoms referred to as delirium tremens when the addicted individual stops consumption.

Symptoms of delirium tremens include:

  • Agitation/excitement
  • Irritability
  • Confusion/disorientation
  • Delirium
  • Sudden mood changes
  • Fatigue or stupor
  • Restlessness
  • Body tremors
  • Changes in mental functions
  • Decreased attention span
  • Sensitivity to light, sound, and/or touch
  • Seizures
  • Hallucinations

Delirium tremens is considered to be a medical emergency. The psychotic symptoms can be severe and require sedation, while the seizures can be directly life-threatening. About 1-5 percent of people who experience delirium tremens will die from it.

Psychosis can also appear during withdrawal in any individual who has suffered from a long-term addiction to many substances that significantly affect brain chemistry. This includes many amphetamines, opiates, and inhalants. These symptoms can last for hours or days, and it’s likely that the individual will need to be sedated or at least closely monitored during this period. When it comes to methamphetamine, psychosis can actually spontaneously reappear in people who have been clean of the drug for many years.

Psychosis in Mental Illness

There are a number of mental illnesses that can include psychotic episodes as a symptom. Schizophrenia is often the first illness that comes to mind when people think of psychosis, however, not every type of schizophrenia includes psychotic symptoms. Paranoid schizophrenia is characterized by both hallucinations and delusions, though how disruptive this depends on how severe the condition is. People with bipolar disorder can also experience psychosis. This typically occurs during severe manic periods. Psychosis can also appear in people with major depressive disorder, which can result in a diagnosis of psychotic depression. Unfortunately, this disorder has a high mortality rate due to the intense suffering combined with psychotic episodes. Other disorders that have psychosis as a symptom include delusional disorder and schizoaffective disorder. Plus, it can present in degenerative brain diseases like Parkinson’s disease, Huntington’s disease, and dementia.

Brain tumors, cysts, or untreated HIV or syphilis can also cause psychosis. When an individual has a mental illness that already has the potential to include psychosis, drug abuse can more easily lead to this symptom. It can be tricky to determine whether the drug abuse triggered the psychosis or whether the early effects of psychosis led to drug abuse. At the same time, certain substances can interact with antipsychotic medications, causing them to become less effective or ineffective, triggering a psychotic episode.

Another difficulty is the spiraling nature of drug abuse that triggers psychosis. Due to the fact that psychosis is such a disruptive event that can cause so many problems, individuals dealing with one of these mental illnesses may turn right back to substance abuse to cope.

This is a common problem when people are suffering from severe mental illnesses that are more difficult to treat than standard mood disorders. Plus, especially in people with schizophrenia and major depressive disorder, self-care can be incredibly difficult.

With bipolar disorder, manic episodes come with reduced impulse control. This can result in excessive consumption of drugs or alcohol. Consumption of stimulants make the mania worse, and that spiral can eventually result in psychosis. On the other side of the spectrum, bipolar patients in a depressive state may turn to alcohol or stimulants to self-medicate.

Substance-Induced Psychosis Treatment Options

Psychosis is merely a symptom, not a condition in and of itself. It is typically very temporary, resolving in a couple of hours or days at most. However, it’s a very serious symptom that often requires emergency medical intervention. One in five people with a history of psychosis will attempt to kill themselves.

In the case of substance-induced psychosis, the obvious cure is to stop abusing any substance; however, the reality is often more complicated. Addiction can make it difficult to stop, and withdrawal symptoms are virtually unavoidable after long-term substance abuse. Mental illness symptoms can become unbearable to the point that afflicted individuals self-medicate, or a loss of impulse control can blow any resolve to abstain.

The answer to substance-induced psychosis is an effective treatment. There are plenty of options for drug and alcohol addiction treatment. Medically supervised detox can easily prevent the more severe symptom of psychosis through the use of common medications or by tapering off the substance rather than quitting cold turkey. Once the initial detoxification is completed, psychosis should not be an issue. However, relapse and the subsequent necessity for another detox can increase the chances that psychosis will appear as a symptom during withdrawal. Because of this, it’s important to follow detox with a complete rehabilitation program. This can be set at an inpatient facility or be an outpatient program; both types of care should involve therapy and/or support group meetings to learn the skills necessary to live a clean life. After several weeks of that, continuing to attend support group meetings or group therapy significantly reduces the chance of relapse.

In the case of pre-existing mental illness, proper treatment is essential to ensure that the afflicted individual does not feel the need to self-medicate. Thankfully, there are many possible medications to try for those living with depressive disorders and bipolar disorder. Mood stabilizers like lithium can prevent the intense manic states that can lead to psychosis. New antidepressants are being developed that are not intoxicating or addictive, and it’s often just a matter of finding the right medication for the individual to make major depressive disorder manageable.

It’s very often beneficial for people with mood disorders like these to attend Cognitive Behavioral Therapy (CBT) or a similar form of therapy. The goal of CBT is to train clients toward more adaptive thought patterns, teach them new behavioral skills that can strengthen impulse control, and help them find healthier ways to cope when things get tough.For those with more severe mental illnesses that have psychosis as a common symptom, there are a number of antipsychotic medications that can be used, and these individuals are often also put on antidepressant or anti-anxiety medication. Just like with the other disorders, it often takes some time to find the right drug or combination of drugs to make symptoms manageable.

For people with schizophrenia, group therapy with others dealing with schizophrenia is often more beneficial than individual therapy due to the support they can find in those who can truly empathize with them.

This can help them stay on track with taking their medications, which is very important due to the fact that only about 25 percent of people with chronic medical conditions report full adherence to their drug treatment during a 12-month period. Family therapy can also be essential as high stress can trigger psychotic episodes and the urge to self-medicate.

In spite of common stereotypes, people with schizophrenia can live normal lives. With medication, they might still have occasional minor hallucinations, but they are able to recognize that they’re not real, avoiding psychosis.

Comparing Schizophrenia with Drug-Induced Psychosis

What are Schizophrenia and Drug-Induced Psychosis?

Schizophrenia

According to the National Institute of Mental Health, schizophrenia is a chronic mental health disorder that is characterized by:

  • Hallucinations
  • Delusions
  • Unusual or dysfunctional thoughts
  • Physical agitation
  • Difficulty focusing
  • Reduced feelings of pleasure
  • Difficulty comprehending information and making subsequent decisions
  • Problems with working memory

Symptoms of schizophrenia typically arise between the ages of 16 and 30, but in rare cases, children may also exhibit symptoms of the disorder. There are a few risk factors that make some individuals more susceptible to the condition than others. These include genetic factors, environmental factors, and brain chemistry. The Schizophrenia and Related Disorders Alliance of America reports that schizophrenia affects approximately 1.1 percent of the global population, and 3.5 million people in the United States have been diagnosed with it.

Although illicit drugs affect the brain differently, they all affect it in some way, and taking too much of any one drug or combining certain substances can result in a psychotic reaction. Drugs that can cause psychosis include alcohol, amphetamines, hallucinogens, marijuana, cocaine, sedative-hypnotics, and opioids.

Psychosis, which essentially means the inability to differentiate between thoughts, perceptions, and reality, is also a symptom of some mental illnesses, like schizophrenia. This article will compare and contrast drug-induced psychosis with symptoms of schizophrenia and explore why both are inextricably linked in some individuals.

Drug-Induced Psychosis

Drug-induced psychosis is characterized by hallucinations and delusions, which occur because of the effects the drugs have on the brain. The hallucinations are typically visual, and the delusions cause a shift in the individual’s consciousness that makes it hard to distinguish between what is real and what is not.

Some individuals take certain substances solely because of their hallucinogenic properties, while others experience hallucinations or delusions as a negative side effect of a drug they used for a different purpose. For example, psychedelics are a group of drugs within the hallucinogen category that people take in order to experience hallucinations. LSD, magic mushrooms, and mescaline are all examples of psychedelic drugs. Cocaine, on the other hand, can also induce hallucinations, but users rarely take it for that reason.
According to the National Survey on Drug Use and Health, roughly 1.2 million people over the age of 12 were current hallucinogen users in 2014.

How Long Do Symptoms Last ( Schizophrenia & Drug-Induced Psychosis)?

Schizophrenia

Schizophrenia requires ongoing treatment, and for many individuals, the intensity of their symptoms will peak and subside throughout their entire lives. The four stages of schizophrenia are:

  1. Prodromal: In this stage, symptoms are easy to miss. Individuals will typically experience symptoms that are common to other mental illnesses, like depression and anxiety disorders. In addition, young adults going through puberty can experience many of these same symptoms, and the condition may go undiagnosed. This phase can last anywhere from a few days to a few years.
  2. Acute: During the acute, or active, phase of schizophrenia, individuals will experience hallucinations, delusions, and confusing thoughts. These symptoms are similar to those of drug-induced psychosis. The acute phase can develop gradually or suddenly and may require hospitalization if symptoms cause a severe psychotic episode. The acute phase usually lasts for 4-8 weeks.
  3. Remission: With treatment, symptoms can get better, and individuals enter the remission phase.
  4. Relapse: For people with schizophrenia, relapse is common. They start the cycle all over again, but symptoms may get less intense over time. Some individuals experience fewer relapses as they age until symptoms subside altogether, while others need consistent treatment and maintenance throughout their entire lives.

The duration of each drug-induced psychosis period varies among individuals, and the timeframe depends on a variety of factors. In most cases, the symptoms do not last for more than a few days, and for many people, the duration is much shorter than that. For example, the effects of magic mushrooms typically last 3-6 hours, while the side effects of LSD can last 6-14 hours.

Is there a cure for schizophrenia?

Though some individuals may eventually stop relapsing after entering the remission phase, schizophrenia is a lifelong disorder for most, and there is no documented cure. Antipsychotic medication is the primary treatment because it can help reduce symptoms while enabling individuals to function normally. Various types of therapy are also used to treat schizophrenia and to help those suffering from it learn how to cope with the worst of their symptoms.

Is there a cure for Drug Induced Psychosis

There is no cure for drug-induced psychosis because it is not a disease in the traditional sense. Drug-induced psychosis subsides as the body metabolizes the substance that caused it in the first place; however, there are some drugs that can cause psychosis symptoms for days, months, and even years after an individual stops taking them. With heavy use, cocaine, amphetamines, and sometimes alcohol can cause psychosis symptoms that persist well into sobriety.

The Challenge of Co-occurring Disorders

According to a report originally published in JAMA Psychiatry, people who have severe mental health disorders like schizophrenia are more likely to develop a substance use disorder than those who do not. Diagnosing co-occurring disorders and devising effective treatment plans are challenging when both of the disorders present with the same symptoms.

The Australia Government’s National Drug Strategy suggests that healthcare professionals can distinguish between schizophrenia coupled with substance abuse and drug-induced psychosis alone by monitoring symptoms after an individual finishes the withdrawal stage. They can also look for the existence of prodromal symptoms of schizophrenia, including subtle personality changes, angry outbursts, odd thought patterns, and reclusiveness, prior to substance use.

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Drug-Induced Psychotic Symptoms

  1. What is Psychosis?
  2. Examples of Psychotic Symptoms
  3. Drugs That Can Cause Psychosis
  4. DSM-V Criteria for Drug/Medication-Induced Psychotic Disorder
  5. Treatment for Drug-Related Psychosis

Psychosis Due to Drugs

Many recreational and prescription drugs can induce psychotic symptoms that can mimic serious psychiatric disorders.

Drug-induced psychosis has been associated with suicidal thoughts, dangerous and violent behavior, hospitalization, and arrests.

Because treatment modalities can vary, it is important to distinguish whether psychotic symptoms are substance-induced or caused by other factors .

What is Psychosis?

Psychosis is a condition characterized by delusions and hallucinations, and is commonly associated with mental illness.

  • Delusions occur when a person believes something outside of what is really going on despite any external argument or contradiction to such beliefs.
  • Hallucinations are perceptions (primarily visual and auditory, but sometimes tactile and scents) of things that aren’t actually present.

After long periods of use, some drugs can cause psychotic symptoms which mimic those experienced by individuals with schizophrenia, bipolar disorder, or other mental illnesses involving psychosis .

Examples of Psychotic Symptoms

Hallucinations

  • Auditory: Hearing internal or external voices. Sometimes the voices may be arguing with each other or may tell the person what to do.
  • Visual: Seeing things that aren’t really there. For example: shadows, people, or other perceptual abnormalities.
  • Tactile: Feeling sensations that aren’t really occurring. For example: feeling bugs crawling on the skin.
  • Olfactory: Smelling an odor around you that cannot be confirmed by others .

Delusions

  • Erotomanic: A person with this type of delusion will believe someone (usually a famous person) is in love with him/her. Stalking is not uncommon in these cases.
  • Grandiose: A person with delusions of grandeur will have an over-inflated sense of self-worth and power. He may believe he has some special type of talent or has made a grand discovery.
    Jealousy: These delusions usually involve believing that a spouse or significant other has cheated even if there is no evidence this is the case.
  • Persecution: A person with persecution delusions may believe someone (often an authority figure) is spying on them and planning to do harm.
  • Somatic: A somatic delusion occurs when a person believes he has a health problem, or some other bodily complaint, when no real symptoms are present .

Other symptoms of psychosis may include:

  • Disorganized speech.
  • Incoherent thoughts.
  • Lethargy.
  • Emotional changes (lack of emotion, difficulty expressing emotion, etc.).
  • Antisocial behavior.
  • Erratic behavior (sometimes violent and/or dangerous).

Drugs That Can Cause Psychosis

Heavy, long-term use of many substances can result in psychotic symptoms. However, certain drugs are more likely to cause psychotic symptoms than others. These include:

Methamphetamine

The use of methamphetamine can lead to paranoia, persecution delusions, and auditory and visual hallucinations.

One common hallucination is the feeling of bugs crawling on one’s skin. These symptoms might subside after stopping use, but they can also persist for weeks or longer, and may increase one’s susceptibility for developing future psychosis. Even after long periods of abstinence, psychotic symptoms may return in periods of stress .

Cannabis

Cannabis use has long been associated with psychotic symptoms. The first evidence came from the Swedish Conscripts Study of 45,570 military inductees who were followed-up for 15 years.

The results showed that those who had used cannabis by the age of 17 were 2.4 times more likely to develop schizophrenia than non-users. The risk of schizophrenia rose to 6 times that of non-users for heavy cannabis users (more than 50 times at initial interview) .

Cocaine

Up to 50% of cocaine users will show some symptoms of psychosis after use. The risk increases with needle or freebased use.

Persecution delusions and tactile hallucinations are common. Psychotic symptoms can persist days, months, and sometimes years after use has stopped .

Amphetamine

Amphetamine (Speed) can cause psychotic symptoms similar to methamphetamine and cocaine after repeated use .

Alcohol

Alcohol can cause delusions, mental confusion, disorganized speech, and disorientation. Typically, these symptoms subside upon sobriety.

Alcohol is one of the most commonly abused substances among individuals with schizophrenia, although diagnosis usually precedes use .

Psychedelic drugs (e.g., LSD, PCP, etc)

These drugs can induce temporary effects that mimic psychosis. However, these symptoms typically cease when the drug wears off.

For most people, psychotic symptoms will not be present after first use. It is only after repeated use that psychotic symptoms become more prevalent and long-lasting .

Club/recreational drugs (e.g., ecstasy)

Ecstasy can cause psychotic symptoms, antisocial behavior, and panic attacks. Persistent psychosis has been reported after a single use in some people .

Prescription meds (e.g., ketamine)

Ketamine users typically exhibit a variety of symptoms that mimic psychosis including delusions, cognitive impairments, disordered thinking, and incoherent speech .

DSM-V Criteria for Drug/Medication-Induced Psychotic Disorder

Substance-induced psychotic disorder is diagnosed by the presence of delusions and/or hallucinations that are determined to be caused by the use of a psychoactive substance. Most psychotic symptoms unrelated to drugs continue even after complete abstinence from a particular substance.

Symptoms of drug-induced psychosis will typically wear off when use is stopped. However, frequent and prolonged use can result in years of psychotic symptoms, making it difficult to differentiate from other psychiatric disorders such as schizophrenia.

A diagnosis of drug-induced psychosis is only made when psychotic symptoms are severe and go beyond the normal psychological symptoms of drug withdrawal.

According to the Diagnostic and Statistical Manual of Mental Disorders (DSM-V), meeting the following criteria is necessary for diagnosis :

  • The symptoms are not better explained by a psychotic disorder (schizophrenia, bipolar, etc.) that is not medication induced.
  • Evidence from medical examination, lab results, and patient history that psychotic symptoms developed during substance use, or within one month of withdrawal from a substance known to cause psychotic symptoms.
  • Presence of delusions and/or hallucination
  • Psychotic symptoms do not occur only during an episode of delirium.
  • Symptoms are causing significant distress and/or impairment in one’s daily life and ability to function.

It is important to determine whether psychotic symptoms are drug-induced or caused by an organic biological factor, trauma, a separate medical condition, or any other variables in order to initiate the proper course of treatment .

  • First, the patient must stop using the drug.
  • If symptoms continue, and the patient feels he is a threat to himself or those around him, he should call 911.
  • Medically assisted detox may be needed for some patients.
  • Psychiatric hospitalization in an inpatient facility is a common treatment regimen for severe psychotic symptoms.
  • Antipsychotic medication is often prescribed.
  • Outpatient treatment may include medication, and individual and group therapy.

What causes schizophrenia?

No single cause of schizophrenia has been identified, but several factors have been shown to be associated with its onset.
Men and women have an equal chance of developing this mental illness across the lifespan, although the onset for men is often earlier.

Genetic factors

A predisposition to schizophrenia can run in families. In the general population, only one percent of people develop it over their lifetime, but if one parent has schizophrenia, the children have a 10 percent chance of developing the condition – and a 90 percent chance of not developing it.

Biochemical factors

Certain biochemical substances in the brain are believed to be involved in schizophrenia, especially a neurotransmitter called dopamine. One likely cause of this chemical imbalance is the person’s genetic predisposition to the illness. Complications during pregnancy or birth that cause structural damage to the brain may also be involved.

Family relationships

No evidence has been found to support the suggestion that family relationships cause the illness. However, some people with schizophrenia are sensitive to any family tension, which for them may be associated with recurrent episodes.

Stress

It is well recognised that stressful incidents often precede the onset of schizophrenia. These may act as precipitating events in vulnerable people.
People with schizophrenia often become anxious, irritable and unable to concentrate before any acute symptoms are evident. This can cause problems with work or study and relationships to deteriorate. Often these factors are then blamed for the onset of the illness when, in fact, the illness itself has caused the stressful event. It is not, therefore, always clear whether stress is a cause or a result of schizophrenia.

Alcohol and other drug use

Harmful alcohol and other drug use, particularly cannabis and amphetamine use, may trigger psychosis in people who are vulnerable to developing schizophrenia. While substance use does not cause schizophrenia, it is strongly related to relapse.
People with schizophrenia are more likely than the general population to use alcohol and other drugs, and this is detrimental to treatment.

A considerable proportion of people with schizophrenia have been shown to smoke, which contributes to poor physical health.

Schizophrenia risk increased with alcohol, drug abuse

The question of whether drug abuse increases the risk of developing schizophrenia and other mental illnesses has been a hotly debated topic for decades. New research from Denmark that includes data from more than 3 million individuals takes an in-depth look at the conundrum.

Share on PinterestThe relationship between drug abuse and schizophrenia is complex.

There has been a wealth of research on the impact that alcohol, cannabis, and other drugs might have on the risk of developing schizophrenia and other psychiatric disorders.

However, it is a difficult area to study, and previous research has been controversial and often contradictory.

As one example, many earlier studies could not take into account co-abuse; in other words, people who abuse a number of compounds.

Dr. Stine Mai Nielsen and Prof. Merete Nordentoft, from Copenhagen University Hospital, Mental Health Center in Denmark, recently embarked on one of the largest studies of its type.

Their findings, presented at this year’s International Early Psychosis Association (IEPA) meeting in Milan, Italy, add another piece to the puzzle.

Schizophrenia and drug abuse

To dive into this question, the team of investigators used data from 3,133,968 individuals born between 1955-1999 from nationwide Danish registers. In all, they identified more than 200,000 cases of substance abuse and over 21,000 schizophrenia diagnoses.

Data was analyzed using a range of statistical measures; they also controlled for a number of factors including gender, urbanity, other psychiatric diagnoses, co-abuse, parents’ immigration to Denmark, parents’ economic status, and psychiatric history.

The team found that abuse of any substance increased the risk of developing schizophrenia. The increased risks were as follows:

The authors concluded:

“We present a large scaled population-based cohort study analyzing a wide variety of substances. Our results illustrate a robust association between almost any type of substance abuse and an increased risk of developing schizophrenia later in life.”

Although the results are clear, an age-old problem with the research remains: it is impossible to prove whether the abuse caused the schizophrenia or vice versa. It is a possibility that someone who is predisposed to schizophrenia is more likely to abuse drugs; similarly, individuals could be susceptible to both developing schizophrenia and substance abuse.

The authors note that the relationship between mental illness and drug abuse is likely to be incredibly complex.

Parental drug-taking and schizophrenia

In a second leg of the study, the same group of researchers at Copenhagen University Hospital, led by Dr. Carsten Hjorthøj, opened the question of parental role. They wanted to identify whether parental substance abuse influenced the risk of schizophrenia.

Parental drug abuse was split into two categories – diagnosed before birth and after. Schizophrenia diagnoses were taken from Denmark’s Psychiatric Central Research Register.

Both maternal and parental cannabis, whether diagnosed before or after birth, increased the risk of schizophrenia in the offspring. For mothers, it was associated with a sixfold increase and for the father a 5.5-fold increase.

For alcohol, maternal abuse diagnosed before the birth of the infant was associated with a 5.6 times increase in schizophrenia risk, but if diagnosed after the birth, this dropped by roughly 50 percent. Similarly, in fathers, pre- and post-birth risk were 4.4 times and 1.8 times, respectively.

The authors explain the potential reasons for the difference between cannabis and alcohol use:

“Secondhand exposure to cannabis is apparently linked to schizophrenia. While it is easy to be exposed to secondhand smoke, with other substances, such as alcohol, there is no secondhand exposure, which could explain the much lower associations observed after birth for these substances.”

Although, as mentioned earlier, these studies can not definitively tease apart cause and effect, they are sure to add fuel to the fiery debate. Whether drugs cause schizophrenia or whether someone who is susceptible to schizophrenia is more likely to abuse drugs, unpicking the relationship and gaining insight into who may be most at risk is vital for early intervention and more successful treatment.

Learn how aerobic exercise might relieve schizophrenia symptoms.

What Is Stimulant-Induced Psychosis?

In the early part of the 20th century, modern-day illicit drugs were once used to treat a variety of mental illnesses and ailments. Famous writers, doctors and notable figures took drugs to supposedly heighten their understanding of the world and everything in it.

Further research in the decades that followed showed that many of these drugs once used actually had a multitude of negative side effects for the user.

Drugs like cocaine, cannabis, and hallucinogens can cause mental health problems and, when paired with a pre-existing mental illness, can exacerbate the symptoms of such illnesses. Some drugs, when taken frequently for long periods of time, can actually manifest as psychotic symptoms indicative of schizophrenia and bipolar disorder, according to the Australian Government’s National Drug Strategy.

Psychosis in general is considered to be an illness accompanied by delusions and/or hallucinations. Usually these hallucinations occur outside of the user’s understanding and scope of cognition. Hallucinations are primarily visual, and their effects can be elevated with the use of certain psychedelic drugs. Delusions, on the other hand, are shifts in the user’s reality in such that he or she believes something outside of what is really going on.

Symptoms of Drug-Induced Psychosis

When a drug user has a mental illness prior to drug use, it may be hard to identify symptoms that are exclusively due to the drug use itself. Most symptoms, if the condition is unrelated to drugs, will continue after abstinence from the drug. The opposite is true for drug-induced psychosis; the schizophrenic-like effects will more or less subside after the drug wears off. However, this is not true for all drug users as frequent and prolonged use can cause side effects that last up to years after use discontinues.

Early symptoms of psychosis are gradual and progress as the individual ages and/or drug use continues. Aside from delusions and hallucinations, here are some things to look for:

  • Changes in emotion: no emotional response, difficulty expressing feelings, flat affect (appearance or no emotional expression)
  • Lethargy; lack of motivation
  • Socially withdrawn
  • Incoherence in thought and actions; disorganized speech
  • Violent behavior; erratic, sometimes dangerous, actions

What Substances Increase the Risk for Drug-Induced Psychosis?

Because drugs cause interruptions in the absorption and release of brain chemicals like serotonin or dopamine, the internal structure and function of the brain changes as use continues.

With heavy, long-term use, nearly any drug can cause symptoms of psychosis in the user. A few, however, tend to be more closely correlated with drug-induced psychosis than others.

Cocaine and Amphetamines

These stimulants can contribute to psychotic symptoms that can last days, months, and years after the drug use stops. Long-term use is attributed to loss of memory and problems with concentration. In a study noted in the Journal of Psychiatric Practice, about one-half of cocaine users showed psychotic symptoms after use. When freebased or used with a needle (intravenously), the risk for these experiences increases.

Delusions attributed to alcohol can cause disorientation, disorganized speech and mental confusion. In most cases, these effects go into remission when sobriety occurs. In comorbid patients with schizophrenia, alcohol is also one of the most widely abused substances, along with marijuana and cocaine.

Hallucinogens

Psychedelic drugs like phencyclidine (PCP) and lysergic acid diethylamide (LSD) affect the user in a way that mimics actual psychosis, according to the U.S. National Library of Medicine. These drugs, however, are not shown to induce psychosis with the first use. The symptoms are more prevalent after repeated use of the drug over a period of time.

Due to the nature of mental illness and drug use, it is important to first determine if the symptoms are caused by the substance or have materialized due to other reasons, such as genetics or traumatic events. Without a proper diagnosis, treatment may appear to be ineffectual in the long- or short-term.

Foundations Recovery Network has specialized facilities that can help you obtain a proper diagnosis and find the treatment that best targets the overall problem. Let us help with the recovery process. Our knowledgeable team is here for you, so call us today at 615-490-9376 to find the best treatment for you.

The Link Between Marijuana, Psychosis, and Schizophrenia: Alarming or Exaggerated?

In the past few years, marijuana has become more widely available and its use more accepted. Twenty-five states and Washington D.C. have now legalized it in some form. Still, concerns remain about marijuana’s effects. One growing but not well-recognized health problem is that marijuana can induce psychosis – particularly when the marijuana ingested is highly potent or when the individual is susceptible to developing psychotic disorders such as schizophrenia.

Schizophrenia is just one type of psychotic disorder and it is one of the most chronic, severe, and debilitating forms of mental illness. Like marijuana-induced psychosis, its symptoms include paranoia, delusions and hallucinations. Distinguishing between schizophrenia symptoms and a marijuana-induced psychosis is sometimes difficult, but the differences are significant. Schizophrenia is usually diagnosed in young adulthood, and generally results in permanent and pervasive disability. Marijuana-induced psychosis is typically temporary and less severe, and the prognosis for a full recovery is much better.

Can marijuana really cause schizophrenia?

A number of studies, both new and old, establish a connection between the timing of the onset of schizophrenia and marijuana use. Yet whether marijuana use can actually cause this illness is less clear. While marijuana use has increased recently, as has its potency, the number of individuals diagnosed with schizophrenia in the past few years has remained constant (at about 1 percent).

According to Dr. Nora Volkow, the Director of the National Institute on Drug Abuse at the National Institutes of Health, individuals with schizophrenia are at greater risk of marijuana use because they tend to self-medicate their developing or existing symptoms with marijuana. She states that even though marijuana is in reality making these symptoms worse, many individuals with early symptoms of schizophrenia believe that it helps them cope with the uneasy feelings typical of the disorder. She says that while marijuana can bring on psychotic symptoms, it does not seem that its use is actually causing schizophrenia.

Yet others believe that marijuana use isn’t a form of self-medication for those with schizophrenia – but is the cause of the schizophrenia itself. In one study, which looked at data over many years, researchers found that marijuana use significantly contributed to schizophrenia, even when other major factors that are usually thought to lead to schizophrenia (like family history of the disorder and other drug use) were considered. These researchers suggest that the biological interaction between the chemicals in marijuana and certain chemicals in the brain could potentially cause the illness.

The Dramatic Impact of Marijuana on the Adolescent Brain

While marijuana use doesn’t appear to be the primary cause of severe mental illness, it can still have a damaging impact on adolescent brains, as well as speed up the onset of psychotic disorders in those who are susceptible. Researchers have shown the many ways in which marijuana affects the brain, and how those who use marijuana regularly, particularly young people, are at higher risk of mental health problems. In fact, it’s widely accepted that the damage from adolescent marijuana use can have profound and long-lasting effects on their developing brains.

Even for otherwise healthy individuals, using marijuana at a young age (13-24 years old) contributes to the loss of the cortical lining – the protective lining in the brain. This “cortical thinning” can have dramatic consequences, impairing attention, memory, and the ability to process the visual world.

It has yet to be proven that cortical thinning is directly related to schizophrenia or other forms of psychosis. Nonetheless, for individuals at high risk for schizophrenia, or who already are diagnosed with it, marijuana use clearly makes symptoms worse. One study showed that cortical thinning was greater in the first five years of using marijuana among those with schizophrenia compared with healthy individuals who used marijuana. For individuals with or at risk for schizophrenia – whose brain functioning is already impaired – marijuana’s damage is, in effect, compounding the problem.

Why Does it Matter?

Though marijuana-induced psychosis usually has temporary effects, it still poses a danger to young people, especially if they are vulnerable to developing a psychotic illness. One study found that individuals who used marijuana regularly at age 18 were six times more likely to develop schizophrenia as adults.

Adolescents with early symptoms of schizophrenia face even greater risks from marijuana use, especially since they and their caregivers are often unaware that these symptoms indicate schizophrenia; rather, the symptoms are frequently misinterpreted as depression. Additionally, adolescents with a predisposition for schizophrenia who use marijuana develop their illness more quickly, and tend to have poorer outcomes.

The cost to young lives experiencing or vulnerable to severe mental illness is tremendous. There must be a more concerted effort to educate the public, and young people especially, about the particularly serious risks to mental health posed by regular marijuana use.

Max Dorfman, MA

Max is a Science Writer at Center on Addiction

Schizophrenia Among Drug and Alcohol Addicts: Treatment and Statistics

Schizophrenia is a severe neurological disorder that causes a break between the individual’s experience and the surrounding world. Although it is often referred to as a form of mental illness, schizophrenia is more accurately defined as a group of serious neurological disorders that alter the individual’s sense of reality. The delusional beliefs, hallucinations, disorganized thoughts, and strange personality traits of schizophrenia can be frightening, both for the individual who experiences them and surrounding loved ones. Because it interferes with thought processes, behaviors, and communication, schizophrenia can leave individuals profoundly impaired in the areas of work, relationships, social interaction, and cognition. Hospitalization, unemployment, homelessness, and suicide attempts are common repercussions of this disease. Most people who are diagnosed with schizophrenia experience the first symptoms in their teenage years. According to PLOS Medicine, approximately 15.2 persons per every 100,000 suffer from schizophrenia worldwide each year. The early onset of the disorder, combined with the persistence and severity of symptoms, make the social impact of this disease considerable, even though the prevalence is fairly low. The rate of substance abuse among these individuals is higher than in the general population, and drugs and alcohol are often used as a way to cope with the debilitating effects of the disease. Treatment for schizophrenia combined with addiction requires an intensive focus on addressing the symptoms of this serious mental illness, combined with a deep compassion and understanding of the effects of the disease.

Schizophrenia is now seen not as a single neurological condition, but rather a cluster of conditions. Several forms of the disorder have been identified, based on the individual’s dominant symptoms:

  • Paranoid: Paranoid schizophrenia is the most common form of the disorder. This subtype is characterized by delusional beliefs about being persecuted, threatened, or controlled by other people or by inhuman forces. Individuals with this type of schizophrenia may obsess over strange conspiracy theories, fear that they are being hunted, or hear voices that tell them to harm themselves or others. They often isolate themselves socially and may be hostile, irritable, or perpetually fearful of others.
  • Disorganized: Chaotic thought patterns, strange speech, and odd emotional reactions are the hallmarks of disorganized schizophrenia. Hallucinations and delusions are usually less predominant, and bizarre behaviors are more pronounced. People with this form of schizophrenia may have trouble taking care of themselves, holding a job, or interacting normally with others. Writing, speaking, and other means of self-expression may come across as incomprehensible or extremely eccentric.
  • Residual: Individuals who no longer display obvious symptoms of schizophrenia, but who have been affected by the disorder in the past, have residual schizophrenia. Although they may no longer experience profound delusions or hallucinations, people with residual-type schizophrenia may retain less debilitating symptoms of the disease.
  • Undifferentiated: This subtype refers to individuals who have symptoms of the disorder that cannot be clearly defined according to the other subtypes. For instance, they may have disorganized speech combined with occasional hallucinations or delusional beliefs, but to a milder degree than individuals who clearly meet the diagnostic criteria.

How to Identify the Signs of Schizophrenia

The word “schizophrenia” comes from two Greek words meaning “split mind.” The term was coined by Professor Paul Eugen Bleuler, a psychiatrist who studied the disease. According to the Indian Journal of Psychiatry, Bleuler defined schizophrenia as a splitting of the processes involved with emotion, cognition, behavior, and communication. People with schizophrenia may experience the world in ways that are not reflected in their behaviors, and they often lack the ability to communicate those experiences to other people in a way that can be understood. Delusional beliefs, hallucinations, and paranoid fears may make them too frightened to communicate their experiences to others or even to take part in mainstream society.

Schizophrenia affects every aspect of an individual’s mind and personality. One of the most obvious warning signs is the presence of psychosis, or experiences that conflict dramatically with reality as experienced by others. The symptoms of schizophrenia can be loosely categorized according to whether they affect sensory experience, thoughts and learning, or social interaction and communication:

  • Sensory symptoms: Visual hallucinations (seeing things that aren’t there) or auditory hallucinations (hearing voices telling the individual what to do or other sounds that aren’t audible to others).
  • Cognitive symptoms: Inability to understand or utilize language in comprehensible ways, disorganized thinking, difficulty learning in conventional ways, and false beliefs about grandiose achievements or persecution
  • Behavioral symptoms: Self-isolation and social withdrawal, neglect of personal hygiene, fear of eating or drinking, fear of touching or being touched by other people, pressured speech, lack of motivation, loss of interest in jobs or favorite activities, inability to relate to others in socially accepted ways, wild or unpredictable behavior, and lack of impulse control
  • Emotional symptoms: Loss of emotional affect, flat facial expression, emotional responses that don’t make sense, lack of empathy with others, and inexplicable mood changes

According to the National Alliance on Mental Illness, schizophrenic symptoms appear for the first time in most people in their teens or 20s; however, the average person with schizophrenia does not receive help for at least 8.5 years. Schizophrenia is more common among males than females, and symptoms often manifest during key transitions or losses in a young person’s life, such as going to college, experiencing the loss of a close relative, or living through the breakup of a family. Individuals who have seemed happy and normal may become increasingly eccentric and odd, displaying incomprehensible behavior and talking in strange ways. Some of the early signs may include:

  • Bizarre changes in speech or handwriting
  • Sudden loss of interest in favorite activities or friendships
  • Neglect of grooming and hygiene
  • An intense focus on negative or destructive thoughts
  • Isolation from friends and family
  • Loss of ability to control impulses
  • Lack of awareness in the surrounding world
  • A flat facial expression
  • Failure to finish projects or meet commitments
  • Inability to focus on any one topic for very long

A complete medical exam and psychiatric evaluation can help to determine whether an individual is suffering from schizophrenia or another neurological disorder.

Because substance abuse is often a side effect of schizophrenia, a person who shows the red flags of serious mental illness should also be evaluated for chemical abuse or dependence.

Understanding the Roots of Schizophrenia

Neurologists, psychiatrists, and biologists are still researching the origins of schizophrenia. There are several popular theories about the roots of this disease; however, many researchers agree that in any given person, schizophrenia may come from a combination of sources:

  • Brain chemistry: Imbalances in certain neurotransmitters, or chemicals that allow communication between the brain, nerves, and vital organs, are involved in schizophrenia. In particular, dopamine and glutamate have been identified as neurochemicals that play a role in the thought patterns and behaviors of people with this disorder. According to the Proceedings of the National Academy of Sciences, one of the most popular theories about the origins of schizophrenia is the dopamine hypothesis, which associates schizophrenia with higher than normal levels of dopamine, a neurotransmitter that affects mood, cognition, sensory experience, metabolic activity, and other important functions.
  • Brain structure: Imaging studies of human brains have been used to identify structural differences between the brains of individuals with schizophrenia and those without the disorder. These structural differences frequently occur in the frontal lobe.
  • Heredity: The neurobiological features that contribute to the risk of developing schizophrenia may also have a genetic component. The National Alliance on Mental Illness states that several genes, rather than a single gene, are involved in this complex disorder, which is 10 percent more likely to occur among close relatives and 50 percent more likely in the case of twins.
  • Environmental factors: A tendency toward schizophrenia may begin even before birth. Complications with pregnancy, maternal exposure to drugs or toxins, and fetal malnutrition may contribute to schizophrenia. Later in life, some researchers propose that viruses, industrial chemicals, chaotic home environments, or traumatic life experiences can set the stage for schizophrenia.

Substance abuse does not cause schizophrenia, but the chronic, excessive misuse of alcohol or drugs can increase the frequency and severity of psychotic episodes. In particular, drugs like cannabis, LSD, and other hallucinogenics have been linked with schizophrenic episodes. Stimulants like cocaine have also been implicated in the psychotic thought patterns and hallucinations of schizophrenia.

Statistics on Schizophrenia and Substance Abuse

The rate of substance abuse is 50 percent higher among individuals with schizophrenia than among the general population, according to Schizophrenia Bulletin. The journal identifies the most commonly abused legal and illegal drugs among schizophrenic patients as alcohol, nicotine, cocaine, and marijuana. Substance abuse can intensify the severity of schizophrenic symptoms, increase the number of psychotic episodes, and increase the risk of outcomes like hospitalization, incarceration, and suicide attempts.

Although schizophrenia can have a dramatic effect on an individual’s thoughts, speech, and behavior, it is not always easy to identify these effects as signs of schizophrenia, especially in people with substance use disorders. Alcohol or drug abuse can mask the symptoms of schizophrenia, and vice versa. Substance abuse and schizophrenia may have the following symptoms in common:

  • Unpredictable moods and behaviors
  • Withdrawal from social situations
  • Delusional beliefs about oneself and others
  • Auditory or visual hallucinations
  • Disorganized thoughts
  • Rapid, pressured speech
  • An odd or inappropriate emotional affect
  • Poor judgment and high-risk behaviors
  • Lack of concentration

The side effects of chemical addiction can mask the symptoms of schizophrenia; by the same token, the symptoms of schizophrenia may make it difficult to identify a problem with drugs or alcohol. Treatment of schizophrenia combined with a substance use disorder — a condition known as a dual diagnosis — is complicated by the paranoia, disordered thought patterns, and communication difficulties caused by schizophrenia.

People with schizophrenia may use alcohol or drugs as a way to cope with their symptoms, which can be extremely disturbing and emotionally painful.

Alcohol and marijuana, both central nervous system depressants, can have a sedative effect on an overactive mind fraught with hallucinations or delusional beliefs. Stimulants such as cocaine, amphetamine, and methamphetamine can help the mind feel more focused, at least temporarily, and may help to sustain feelings of grandiosity and elation in high-energy phases of the disorder.

Getting Help for a Loved One

Because of the delusional beliefs, emotional blunting, and chaotic thought processes of schizophrenia, talking to a loved one about this disorder can be extremely challenging. It is important to remember that although schizophrenia is a chronic, usually lifelong disorder, its symptoms are treatable, and its negative consequences are preventable. With the right combination of medications, psychosocial services, and recovery services, people with schizophrenia can reduce their behavioral and neurological symptoms while learning how to overcome the effects of drug or alcohol abuse.

The ideal time to start a conversation with a loved one who displays signs of schizophrenia is early in the disease process, when symptoms are not acute and the individual is not under the influence of alcohol or drugs. Intervening in addictive behaviors may be difficult or even impossible if the individual is in the midst of a severe psychotic episode. In extreme cases, hospitalization may be required to stabilize the individual and bring symptoms to a manageable level before the recovery process can begin. The transition can then be made from an acute hospital setting to a detox center or inpatient rehab program.

The Harvard Review of Psychiatry states that early detection and treatment of schizophrenia increase the chances of remission, or a significant relief of symptoms. Studies of schizophrenic patients undergoing treatment show that the sooner psychotic episodes are addressed, the greater the likelihood of a positive outcome. Although it may be uncomfortable or embarrassing to talk to loved ones about treatment, getting them into rehab promptly may make the difference between whether or not treatment is effective.

Approaches to Treatment

Although psychiatric medication cannot cure schizophrenia, it can make it easier for these individuals to function in society and lead healthier lives. Antipsychotic drugs can help reduce the severity of hallucinatory experiences and delusional beliefs, which allows these clients to experience the world more normally and relate to others in more satisfying ways.

Older antipsychotic medications, known as “typical antipsychotics,” have been used since the mid-20th century to improve treatment outcomes for schizophrenic patients. These medications include:

The newer medications used to treat schizophrenia, also known as “atypical” or “second generation” antipsychotics, generally have milder side effects — for example, the newer medications are less likely to cause abnormal body movements — and act on the brain in different ways. Some of the most widely used atypical antipsychotics include:

The consequences of schizophrenia can leave a person’s life chaotic and disorganized. Psychosocial interventions may include case management, family therapy, support groups, occupational counseling, and financial or legal resources. To address the psychological and behavioral disturbances of schizophrenia, and the maladaptive coping mechanisms of addiction, treatment must include a combination of intensive mental health services and recovery services, such as the following:

  • Individual therapy: One-on-one therapy sessions with a licensed mental health professional
  • Group therapy: Therapeutic meetings in which individuals share their experiences and discuss coping strategies in recovery
  • Family Systems Therapy: An approach to family recovery that treats the illness as a condition that affects the entire household, not just the individual patient
  • Cognitive Behavioral Therapy (CBT): A modality that teaches clients how to transform self-defeating thought process and behaviors into more positive, self-affirming ones
  • Trauma therapies: Modalities such as Seeking Safety and Eye Movement Desensitization Reprocessing (EMDR) where clients seek to resolve past traumas and heal from unprocessed emotional pain

Substance abuse treatment can take place on an inpatient or outpatient basis. Intensive residential treatment is often recommended for individuals with a dual diagnosis of schizophrenia and chemical dependence. In the structured environment of an inpatient facility, clients can focus exclusively on their recovery without the distractions and triggers of the outside world. After completing an intensive residential program, the client can then move on to a partial hospitalization program (PHP) or outpatient treatment.

Extensive support will be required as the client makes the transition from rehab back to the community. Sober living programs provide a safe, supportive setting where individuals in recovery can practice their coping skills and prepare to integrate back into the community.

Looking to the Future

Even though schizophrenia and addiction are considered to be chronic, progressive illnesses, many individuals with these disorders have been able to live productive, satisfying lives. The key to reaching a state of remission in both conditions is an integrated program that devotes equal energy and resources to mental health treatment and substance abuse recovery. Each individual in recovery has unique needs, but the social and cognitive obstacles posed by schizophrenia can be especially challenging. Treatment should be tailored to the individual’s needs and must support the client at every stage of the rehab process. From medical detox through rehab and aftercare, a multidisciplinary team of supportive professionals should provide the necessary motivation and resources for recovery.

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