Living with Schizophrenia and Addiction
Table of Contents
Schizophrenia is a very misunderstood mental illness. There are multiple misconceptions about this chronic brain disorder and the reality of living with it. The cultural perception of schizophrenia typically involves the image of severely disabled schizophrenic patients troubled by psychosis, split personality, and violence—however, not all patients living with schizophrenia experience these symptoms.
It is increasingly important to promote mental illness acceptance and education. The more people understand mental health conditions, the better they can support friends, family members, and community members with schizophrenia.
Living with schizophrenia can feel lonely. People who have the condition may feel like they have a severed connection with people around them or like they experience something no one else understands. Some are plagued by voices that distract them or make them feel put down. The stigma today surrounding schizophrenia also makes it more difficult to live with this disorder.
The Truth About Schizophrenia
Schizophrenia is defined as a chronic brain disorder in the Diagnostic and Statistical Manual of Mental Disorders (DSM-5).1 It affects less than one percent of the population in the United States.
Schizophrenia is a complex disease. Not all people with the condition have split or multiple personalities and they may only experience some psychotic symptoms. Many people with schizophrenia are not any more violent or dangerous than the rest of the population. Most people with schizophrenia can live in their own homes or group homes and live functional lives.2
A person with schizophrenia can exhibit multiple psychotic symptoms including:
- Hallucinations
- Disorganized speech
- Delusions
- Difficulty thinking
- Memory problems
- Catatonia
- Flat affect
- Disorganized thought processes
- Lack of motivation
The range and severity of symptoms can greatly vary from one person to another based on several factors. Substance abuse cannot cause schizophrenia, but it can act as an environmental trigger. People with genetic vulnerabilities to the disorder may develop an active case after extended substance use.
People living with schizophrenia often find it difficult to distinguish what is imaginary from reality. They may find it difficult to respond to social situations appropriately. The delusional symptoms of the disorder can be frightening for both the person and any surrounding individuals. Relationships, work, cognition, and social interaction are all areas that can be adversely affected by schizophrenia.
Is Schizophrenia Linked to Substance Abuse?
Another common clinical reality for mental health patients is the coexistence of schizophrenia and addiction. Patients with schizophrenia are more vulnerable to developing substance use disorders (SUD) than those in the general population. Nearly half of the people suffering from schizophrenia have a history of substance use disorders (SUD).3
People with schizophrenia may turn to substances as a means of self-medication. They may try to control their symptoms, such as anxiety or hallucinations, or try to manage the consequences of negative emotional states that seem to hinder them in social settings.4
Factors of Schizophrenia and Addiction
One possible explanation for the high prevalence of schizophrenia and addiction co-occurring together is related to the mesolimbic dopamine (DA) pathway. The DA is the rewarding mechanism of the brain activated during drug abuse, but it also occurs in positive schizophrenia symptoms, possibly making it more appealing. However, chronic drug use could enhance the negative symptoms of schizophrenia.
Genetic and environmental factors that contribute to schizophrenia can also be linked with addiction. Both conditions are genetically complex and can be inherited. Other factors that may contribute to schizophrenia and addiction include psychosocial factors such as poverty, unemployment, limited education, and peer influence.
It is important to address patients with schizophrenia and SUD because substance use is associated with poorer clinical outcomes and increased mortality risk.5 Heavy smoking in schizophrenia patients is linked with increased morbidity. Furthermore, patients who use drugs or alcohol are at greater risk for overdose and poisoning.
Living with Schizophrenia and Nicotine Addiction
It is common for people with schizophrenia to also battle nicotine addiction. More than 80% of people with schizophrenia are dependent on nicotine compared to the rate of 25% of the general population. Patients with the disorder tend to smoke high-tar cigarettes and extract more nicotine per cigarette than those without the disorder.6
People with schizophrenia and nicotine addiction find it more difficult to quit smoking than other people due to the additional challenges they face. Some neurobiological processes may be to blame since some of the psychiatric symptoms of schizophrenia may be relieved by nicotine, making it hard to let it go.7
Coping Skills for Nicotine Addiction
Nicotine is highly addictive. It reaches the brain within about ten seconds when a person smokes and improves mood, decreases stress, anger and relaxes muscles while reducing appetite. Nicotine withdrawal symptoms are difficult, but a person with schizophrenia can quit.
Learning to cope with nicotine addiction and schizophrenia may take time but is possible. Learning to avoid triggers by removing all tobacco products from the home can help a person to lessen some cravings for nicotine withdrawal. Eating healthy snacks or chewing gum during a craving, deep breathing, cutting down on alcohol and exercising can also help in addition to pursuing professional help.
Living with Schizophrenia and Cannabis Use
Another drug those with schizophrenia may be drawn to is cannabis. Studies show that as much as 50% of schizophrenia patients have reported cannabis abuse.8 Entering a different and more relaxed mental state can appeal to those suffering from disturbing schizophrenic issues.
Although some studies suggest that cannabidiol, a non-psychoactive compound from the cannabis plant, may be able to reset the brains of people with schizophrenia, chronic marijuana use has been linked with an increased risk of psychiatric problems.
How Cannabis Affects the Brain
Cannabis has many chemicals that can affect the brain, including THC. This substance causes the sought-after “high” associated with marijuana. Cannabis consumption can be tempting to those with schizophrenia, but it comes with several additional risks due to THC and other compounds. Cannabis use can put one at greater risk for developing anxiety, paranoia, and psychosis – especially in patients with schizophrenia or bipolar disorder.9 Links have also been found with cannabis use and depression, financial problems, lower life satisfaction, and other issues that people with schizophrenia are already at risk for.
Quitting cannabis use can be difficult but with the right help, it is possible. Learning to cope with stress, depression, anxiety, and other symptoms of schizophrenia in a healthy way is the best avenue.
Living with Schizophrenia and Cocaine Addiction
Cocaine use with schizophrenia is another common clinical finding, with 23% of schizophrenia patients reportedly dealing with cocaine-related substance abuse at some point during their lives.
Cocaine use can mimic or exacerbate positive symptoms of schizophrenia, including abnormal motor behavior, hallucinations, disorganized thinking, and delusions. Cocaine use can also prompt negative symptoms such as a lack of emotion and motivation. Side effects of cocaine use with schizophrenia can include an inability to focus and impaired memory.
Cocaine Psychosis
Cocaine use can also lead to a condition known as cocaine psychosis. Because patients with schizophrenia are already predisposed to psychosis, using cocaine is risky. Alongside heightened symptoms of schizophrenia, cocaine psychosis can encourage violence, rage, and suicidal or homicidal ideations. It is important for anyone struggling with cocaine addiction and schizophrenia to stop using the drug right away.
In addition to pursuing treatment for schizophrenia and addiction, it is important to have a support system of family and friends to help a person stay sober. It is also beneficial for recovery patients to find new ways to distract themselves from triggering thoughts, including exercising or taking on new hobbies.
Living with Schizophrenia and Opioids
Up to 50% of patients diagnosed with schizophrenia have used opioids, which are a narcotic substance that acts as a depressant on the central nervous system. Patients may use opiates to offer a temporary fix of euphoria and well-being – something very appealing to those battling with the difficult symptoms of schizophrenia. But opioid use can lead to addiction and can also cause psychosis. People who struggle with opioid addiction and schizophrenia are at risk for severe side effects including decreased heart rate, respiratory depression, or fatal overdose.
Pursuing schizophrenia treatment for co-occurring opioid addiction is imperative for a person’s overall well-being. There are many coping skills a person can employ to improve recovery and distract from cravings, including exercise, listening to music, eating a healthy snack, or talking with someone.
Treating Schizophrenia and Addiction
Schizophrenia treatment and addiction treatment typically involve a combination of treatment methods, including psychotherapy, medications, rehabilitation education, and self-help groups.
Typically, the first means of treatment for a person battling substance addiction with schizophrenia is detox. This is the process of removing drugs from a person’s system. Detox helps a clinical team better distinguish the true symptoms of a person’s schizophrenia from drug use symptoms.
Types of Treatment Options
Schizophrenia medications, which are typically antipsychotic medications, are often prescribed to help with symptoms. In some patients, it takes a few rounds of testing different drugs before the right schizophrenia medication is found for that patient.
Various therapies are offered to address any underlying causes of a patient’s co-occurring schizophrenia and addiction, including cognitive-behavioral therapy (CBT). CBT helps a patient identify certain behaviors or harmful ways of thinking that could contribute to both conditions. CBT also teaches patients to manage their persistent symptoms. Motivational interviewing is another common therapeutic technique used for substance use disorder. Motivational interviewing teaches patients to strengthen their motivation and commitment to a particular goal.
Recovery from schizophrenia and addiction is possible. Treatment centers are the best place for a person to get on the path to addiction recovery and schizophrenia management. Our team at Arrow Passage Recovery can help you take control of your life. Our compassionate treatment professionals are ready with open arms to face the difficulties of schizophrenia and addiction with you.
Resources
- https://www.psychiatry.org/psychiatrists/practice/dsm
- https://www.psychiatry.org/patients-families/schizophrenia/what-is-schizophrenia
- https://www.ncbi.nlm.nih.gov/pmc/articles/PMC2669586/
- https://journals.lww.com/addictiondisorders/Abstract/2011/09000/Protocols_of_Dual_Diagnosis_Intervention_in.6.aspx
- https://pubmed.ncbi.nlm.nih.gov/18308910/
- https://www.ncbi.nlm.nih.gov/pmc/articles/PMC5811491
- https://www.nature.com/articles/1395914
- https://www.ncbi.nlm.nih.gov/pubmed/17541112
- https://www.ncbi.nlm.nih.gov/pmc/articles/PMC2669586/#bib10
