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Half of the people diagnosed with schizophrenia will have a substance abuse problem at some point in their life. Often substance abuse predates the first psychotic episode. Marijuana can spark a first psychotic episode years before one normally would have occurred. There is some debate whether marijuana can spark a psychotic episode in people who otherwise wouldn't have had a psychotic episode. Although people claim to understand why substance abuse is so high amongst people with schizophrenia I think the truth is that nobody really knows.
Both schizophrenia and alcoholism have fairly strong genetic roots and unless one of the genes that causes schizophrenia happens to be one of the genes that causes alcoholism it really is a mystery, because schizophrenia is essentially random, and you certainly wouldn't see that much alcoholism in a random population without schizophrenia. You see all kinds of substance abuse in people with schizophrenia, with younger people preferring marijuana to alcohol. Substance abuse causes problems at the emergency wards of hospitals because prolonged substance abuse can produce a psychosis independent of a mental illness per se. The question becomes one of whether it is a psychotic episode caused solely by drugs or whether it is a psychotic episode by someone with schizophrenia or bipolar disorder that is aggravated by drugs. It's one reason early diagnosis and treatment is more difficult than one might think. In a first psychotic episode program in London, Ontario, 30% of patients in the program continue to have substance abuse problems that are interfering with their recovery from their psychotic episode. They are taking their medication but they are continuing to drink and use drugs. There is no doubt that a substance abuse problem exacerbates an underlying schizophrenia or bipolar disorder and diminishes the effectiveness of medication. When an individual has a dual diagnosis of schizophrenia and addiction they must not only agree with one diagnosis but two. That's a tall order. Dr. E. Fuller Torrey says that at any given time half the people with schizophrenia do not believe they have the illness. Although schizophrenia is treatable, you rarely achieve a complete recovery, and living with a disability, continued improvement is mostly dependent on compliance with medication. It's difficult to convince people to take medication if they don't agree that they have schizophrenia. Dr. Fuller Torrey also says that at any given time 40% of the people with schizophrenia and bipolar disorder are not receiving any treatment at all. They often lack insight, which is similar to the expression used in addiction, "denial". Go To Page: 1 2
The copyright of the article Schizophrenia and Substance Abuse in Schizophrenia is owned by . Permission to republish Schizophrenia and Substance Abuse in print or online must be granted by the author in writing.
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