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Dual Diagnosis – The Connection Between Addiction and Schizophrenia

schizophrenia and addiction

This is the fourth article in our series on Dual Diagnosis.

Schizophrenia is a complicated, severe psychiatric disorder often associated with psychotic episodes, persistent delusions, wild behavior, and hallucinations. Other symptoms include bizarre distortions of reality, an absence of emotions and disorganized speech. Simply put, the disease is a dissociation between the person’s perceptions and the reality. These individuals experience internal feelings that aren’t balanced with the perceptions of the outside world.

Related: Dual Diagnosis – The Connection Between Addiction and Mental Illnesses

Hallucinations are a common symptom and can appear as auditory hallucinations – hearing voices, visual hallucinations – seeing things that aren’t there, or having delusional beliefs, mainly religious. These patients often think they have a special role in the world, that a higher power sends them, or that other people plot to harm them.

Therefore, it’s very common for people suffering from this disease to start abusing substances, which increases the negative symptoms. Unfortunately, these patients suffer from the disease their whole life. If left untreated, it can lead to unemployment, homelessness, injury, addiction, and even suicide. A person with dual diagnosis needs simultaneous treatment for the substance abuse and the mental disease.


According to the World Health Organization, about 24 million people in the world meet the criteria for schizophrenia. Also, the disease affects both genders equally, with the symptoms beginning usually in the teens to early adulthood.

In addition, the National Institute on Alcohol Abuse and Alcoholism states that “alcohol use disorder is the most common co-occurring disorder in people with schizophrenia”.

Alcohol Use Disorder and Schizophrenia

According to NIDA, schizophrenia is often in comorbidity with other mental illnesses as well as with substance abuse. Aside from nicotine, alcohol is the most common substance of abuse. The factors that contribute for this disease to appear are unknown. However, it’s thought that both biological and psychological factors cause the co-occurrence.

Scientists think there are three biological  factors that contribute to the co-occurrence including:

  • Self-medication. People use alcohol to self-medicate and relieve the symptoms of antipsychotic medication. Unfortunately, they create the opposite effect.
  • There is also the connection between the underlying neuropathological abnormalities in the brain, those that characterize schizophrenia, and dopamine. It’s thought that they “facilitate the positive reinforcing effects of substance use”.
  • Vulnerability to substance abuse. It’s believed that people with schizophrenia develop substance abuse problems because they are especially vulnerable to the substances’ negative physiological effects.schizophrenia and homelessness

Related: The Connection Between Anxiety and Addiction

When it comes to the psychological and environmental factors, people with schizophrenia use drugs and alcohol to relieve life pressure, poverty, boredom, and limited opportunities.

Studies that gathered data at one period at a time showed that schizophrenia is common with people that have a poor quality of life. These patients refuse to go to treatment, and even if they accept, they usually relapse and get back to their addiction. Also, almost half of the patients suffering from schizophrenia have some kind of substance abuse problem during their lifetime.

Types of Schizophrenia:

  • Paranoid. The person behaves suspiciously of others and shows delusional fears about people persecuting or harming him or her. These patients show anger and can easily get aggressive and violent.
  • Catatonic. The person withdraws from reality, is unresponsive, and shows abnormal physical movements.
  • Disorganized. The person suffers from persistent psychotic episodes, is unable to communicate clearly and is delusional.
  • Residual. The patient doesn’t show psychotic symptoms but may show some other schizophrenic symptoms.
  • Undifferentiated. In this type of schizophrenia, the patient shows different symptoms from different types of the disease.

The Connection Between Schizophrenia and Substance Abuse

Studies show that there is a connection between schizophrenia and marijuana abuse. However, the origins of the disease aren’t fully understood. When a person suffering from schizophrenia undergoes a brain scan, it shows neurological abnormalities.

schizophrenia and addictionMany times, people use cannabis to self-medicate and relieve the psychotic symptoms. It’s extremely common for a person that has a genetical predisposition to schizophrenia to be also predisposed to cannabis abuse. This drug affects the neurotransmitters that regulate stress and arousal in the brain. Cannabis shortly builds up to high levels in the body as it’s hard to metabolize. So, once that happens, there is a high risk for the person developing depression or schizophrenia. This imbalance in dopamine and glutamate intensify the symptoms of the disease. So during a stressful situation, the symptoms intensify, and the individual experiences a high-risk behavior, intense psychotic episodes, even suicide attempts.

Therefore, it’s recommended for people that have a family history of this disease or any other mental illness to avoid consuming any kind of street drugs. This will help them reduce the risk of getting the disease for 50-80%. Also, when the disease occurs, several types of drugs make the symptoms worse, including cocaine, and amphetamines – aside from cannabis.

Drug and alcohol abuse is especially present with people that don’t receive any treatment. Also, many of the symptoms that experience the patients who detox from drugs and alcohol are similar to schizophrenia. Consequently, cocaine, heroin, and alcohol withdrawal cause episodes of hallucinations and delusional thinking at heavy users.

schizophrenia and treatmentTreatment

Before diagnosing, the person needs to go to detox. Detox cleans the drug from the patient’s body, making it easier for the professional to diagnose it. People suffering from dual diagnosis sometimes experience the same symptoms from both conditions, which makes it harder to diagnose. During diagnosing it’s important to differentiate between the actual mental illness and substance-induced psychosis. Schizophrenia can’t be cured,  just like addiction, it lasts for life. However, its symptoms can be controlled with consistent therapy, medication, and a support system. The treatment combines therapy approaches for both diseases and includes:

  • Cognitive behavioral therapy
  • Stress reduction therapies
  • Psychiatric medication. Psychiatric medication is the most important part of therapy.
  • Motivational therapy
  • Family therapy. It serves as education for family members and helps improve the individual’s chances of recovery.
  • 12-Step recovery programs
  • Anti-addiction drugs
  • Individual and group counseling
  • Learning life skills

For more information please call our Addiction Treatment Helpline at (844) 439-4765. This is a Free and completely confidential call. We are available 24/7. In many cases, your health insurance company will cover 100% of the treatment cost. So please call now.

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