The symptoms of schizophrenia can be heartbreaking to watch, and the impact of a loved one’s addiction adds another layer of complexity to an already challenging situation. It is common to feel powerless in the face of your loved one’s struggles with these co-occurring conditions, but the team at St. Joseph Institute wants you to know that help is available. Your loved one can get treatment for their substance use disorder and develop the coping skills they need to effectively manage their mental health. 

Understanding the Link Between Substance Use and Schizophrenia

Substance Use Disorders, (formerly called substance abuse) is common among individuals with schizophrenia. Research suggests that approximately 40-50% of people with schizophrenia also have a substance use disorder. In comparison, less than 10% of the general adult population meets the diagnostic criteria for a substance use disorder.

Some of the reasons why people with schizophrenia are more likely to suffer from substance use disorders include: 

• Self-medication. Some people with schizophrenia may use substances as a way to temporarily blunt their symptoms or deal with the unpleasant side effects of antipsychotic medication. They may also perceive Substance Use Disorders as a coping mechanism that alleviates the distress or frustration associated with having a serious mental illness.
• Genetic risk factors. Schizophrenia may increase vulnerability to Substance Use Disorders because shared genetic and neurochemical abnormalities contribute to both conditions.
• Environmental Influences. Being surrounded by peers who engage in substance use may increase the likelihood of a person with schizophrenia developing a drug or alcohol addiction. Additionally, the societal stigma and marginalization commonly experienced by individuals with schizophrenia may contribute to increased misuse of substances as a way to cope with discrimination and exclusion.

How Substance Use Disorders Worsens Schizophrenia Symptoms

Not all people with schizophrenia experience the same symptoms, and the presentation of symptoms can differ over time. However, some of the common symptoms include:

• Hallucinations. Imagining things that are not actually present, such as hearing voices when no one is speaking.
• Delusions. Holding beliefs that are not based on reality, such as the idea that one is being unfairly persecuted by those around them.
• Disorganized thinking and speech. Difficulty organizing thoughts or expressing them coherently.
• Abnormal motor behavior. Displaying unusual movements or repetitive gestures
• Diminished emotional expression. Appearing emotionally flat or lacking in facial expressions.
• Loss of interest or motivation. Decreased enthusiasm or interest in activities that were previously a source of pleasure.
• Social withdrawal. Avoiding social interactions altogether or choosing to spend less time engaging with others.
• Anhedonia. Being unable to find joy in previously pleasurable activities.
• Impaired memory. Difficulty remembering and retaining information.
• Attention deficits. Struggling to focus or maintain attention on tasks.
• Poor executive functioning. Having problems planning, organizing, problem-solving, and making decisions.

Many addictive substances, including stimulants, depressants, and hallucinogens, alter the levels of dopamine and other neurotransmitters in the brain. Since schizophrenia is associated with an underlying dopamine imbalance, substance misuse can worsen this imbalance and lead to an increase in schizophrenia symptoms.

Substance Use Disorders can also exacerbate schizophrenia symptoms by interfering with the effectiveness of antipsychotic medications used to treat the condition. For example, alcohol and certain drugs may reduce the efficacy of antipsychotics, making it harder to control symptoms.

Treatment Options for People With Schizophrenia and Substance Use Disorders

Recovery is always possible, no matter what challenges your loved one has faced in the past. Even though addiction is considered a chronic illness, people with substance use disorders can live full and productive lives when they have access to appropriate treatment. However, addressing Substance Use Disorders in individuals with schizophrenia can be challenging due to the complexity of managing both conditions simultaneously. 

Integrated care, which involves treating both substance use disorders and schizophrenia concurrently, is crucial for optimal outcomes. At St. Joseph Institute, collaborative treatment teams consisting of psychiatrists, psychologists, addiction specialists, and other healthcare professionals work together to develop treatment plans that set clients up for a successful recovery journey. 

Recommended treatment may include:

• Medication. Medication-assisted treatment is commonly utilized to manage both substance use disorders and schizophrenia. Antipsychotic medications such as aripiprazole, asenapine, brexpiprazole, lurasidone, olanzapine, paliperidone, quetiapine, and risperidone are prescribed to manage symptoms of schizophrenia, helping to alleviate hallucinations, delusions, and disordered thinking. Medications for substance use disorders depend on the specific substance being miused. For example, buprenorphine, methadone, and naltrexone are often used to treat opioid use disorders.  
• Therapy. Therapy plays a vital role in addressing the psychological and behavioral challenges associated with substance use disorders and schizophrenia. For example, cognitive-behavioral therapy (CBT) focuses on modifying distorted thinking patterns, managing cravings, and developing healthy coping skills. 
• Strengthening family and social support systems. Family and social support systems play a crucial role in the treatment process. Providing families with the opportunity to learn more about the research into substance use disorders and schizophrenia fosters empathy and helps them manage the impact of their loved one’s illness without harming their own sense of well-being. 
• Creation of a relapse prevention plan. A plan to avoid relapse may involve identifying triggers, creating strategies to manage stress, and establishing healthy coping mechanisms. Regular monitoring and check-ins with healthcare professionals may also be recommended to help identify potential setbacks early on and adjust the treatment plan accordingly.

We encourage you to contact our admissions representatives to learn more about how the Pennsylvania residential Substance Use Disorder treatment center at St. Joseph Institute may be able to help your loved one move towards a brighter future.