Schizophrenia and Substance Abuse

For some people, the struggle of having one disorder is exacerbated when they develop a second one. Unfortunately, this exact situation happens frequently with mental health disorders and drug and alcohol addiction. Whether the mental disorder comes first or the substance use disorder does, it’s important that both conditions are treated together. Schizophrenia is just one of many mental illnesses that often co-occurs with drug and alcohol addiction. 

What is Schizophrenia? 

Schizophrenia is a brain disorder developed by about one percent of adults, an estimated two million people in the US. Individuals who have schizophrenia are often unable to distinguish the imaginary from reality. They may struggle with responding in an emotionally appropriate manner to social situations, which can result in problems with relationships at home, school, and work. 

The exact cause of schizophrenia is still unknown at this time, but there are some factors to which researchers and medical professionals believe it is linked: 

• Brain chemistry and structure – The imbalances of certain brain chemicals, including glutamate, dopamine, and serotonin, are linked to schizophrenia. The imbalances impact how the brain reacts to stimuli and may lead to hallucinations and hypersensitivity. The brain structure of people with schizophrenia has been found to have differences from healthy brains as well, including increased or decreased activity in some brain regions, enlarged ventricles, and decreased gray matter. 
• Genetics – Schizophrenia tends to be hereditary. It develops in about ten percent of people who have a first-degree family member who also has the condition. 
• Environment – Some researchers believe that certain environmental factors, when combined with a genetic predisposition, may play a part in developing schizophrenia. These factors are thought to include various health-related problems that occur at birth, like exposure to viruses, infections, and malnutrition. 

What is Substance Abuse? 

Substance use disorder, also known as addiction, occurs when an individual repeatedly uses a substance, drugs or alcohol, in a harmful way, despite negative consequences. Addiction is a chronic, progressive brain disease that typically involves relapses. It affects the pleasure center of the brain, leading to compulsive use and drug-seeking behaviors. There are multiple reasons a person may become addicted to drugs or alcohol. Some of the common factors include: 

• Genetics – Family environment and peer influences are usually accepted as the most important factors that influence an individual’s substance use. Genetic factors and psychopathology tend to play a bigger role in the transition to abuse and addiction. 
• Trauma – Traumatic events of any type can significantly affect an individual’s physical and emotional health, which in turn, can lead to drug or alcohol use as a means of coping. Childhood trauma, including parental separation, verbal abuse, sexual abuse, and witnessing violence, may make individuals more likely to abuse substances later in life. 
• Environment – Environmental factors may also contribute to developing addiction. These factors include social or peer pressure, parental drug or alcohol use, poor parental supervision, exposure to drugs and alcohol, and poor coping skills. 
• Stress – Interpersonal conflicts, death of a family member, loss of a relationship, loss of a child, loss of one’s livelihood, and other situations are common stressors. While stress alone doesn’t cause addiction, when it is combined with other factors, it can quickly lead to the development of a drug or alcohol problem. 

The Link between Schizophrenia and Substance Abuse

The coexistence of schizophrenia and substance abuse isn’t uncommon. Rather, nearly half of the individuals who have schizophrenia have also struggled with addiction to drugs or alcohol. People with schizophrenia may be more vulnerable to developing a substance abuse problem because they turn to drugs or alcohol as a way to self-medicate. They may attempt to control symptoms, like anxiety and hallucinations, or to manage the negative emotional states that make social settings uncomfortable or embarrassing for them. 

Treatment for Co-Occurring Disorders 

Anytime there are co-occurring disorders (a mental disorder and substance use disorder), the best approach for treatment is integrative. This type of treatment allows medical and addiction professionals to address the mental and substance use disorders at the same time, often lowering costs for the individuals while creating more positive outcomes. Integrated treatment considers both disorders as primary concerns and treats both simultaneously.

Inpatient Treatment for Schizophrenia and Substance Abuse

Schizophrenia and drug or alcohol addiction must be treated together. If an individual is able to stop using substances, but fails to get the mental health treatment they need, it’s almost guaranteed that they will relapse with drugs or alcohol before long. Conversely, if an individual is given mental health treatment, but doesn’t stop using drugs or alcohol, they aren’t likely to adhere to that treatment. This is why it is so important to address both conditions at the same time. 

The first step of co-occurring disorder treatment is usually a detox program, to ensure the person is monitored and treated during the withdrawal period. After detox and evaluation, most people with co-occurring disorders are encouraged to attend an inpatient treatment program that may include: 

• Individual cognitive behavioral therapy
• group therapy/peer support
• life and coping skills training
• addiction education
• 12-step meetings
• psychiatric care and medication management
• relapse prevention techniques
• family involvement
• aftercare

Covering the Cost of Schizophrenia and Substance Abuse Treatment 

Many people who decide to look for help with mental illness and substance abuse have concerns about how much treatment will cost. In fact, the cost of rehab is often the biggest deterrent for going. However, that shouldn’t be the case. Addiction treatment for co-occurring disorders is available in multiple different levels of care, at a very wide range of costs. It’s possible to spend more than $1,000 per day for luxury treatment, but there are also low-cost and free options. Cost shouldn’t be a deterrent for getting the treatment you need. 

With Insurance 

If you do have medical insurance, your plan’s behavioral health benefits will help cover some of the cost of your treatment program. You can call your insurance provider to see just how much your specific plan will cover, or you can have the treatment center you want to attend call and check for you. 

Without Insurance 

If you don’t have medical insurance, you still have options. Nearly all cities have some type of treatment facility that is affordable for everyone. You can look for free or low-cost rehabs in your area. Alternatively, you can look for a drug and alcohol treatment center that allows individuals to set up payment plans, or one that offers sliding scale pricing. Some California rehab programs offer scholarships and financial aid. It may take more research, but you can find the help you need that is also within your budget. 

Final Thoughts about Schizophrenia and Substance Abuse

Even though both addiction and schizophrenia are both designated as chronic, progressive diseases, many individuals who have these disorders have been able to turn their lives around to live fulfilling, productive lives. The biggest key to achieving remission in these two conditions is effective treatment that integrates both conditions, giving equal attention and resources to addiction recovery and mental health treatment. 

Every individual who struggles with co-occurring disorders is unique, but the cognitive and social challenges posed by schizophrenia can be particularly demanding. Treatment should be individualized for each person, supporting them at every phase of the rehabilitation process. A multidisciplinary team of knowledgeable and supportive professionals will help provide the motivation and resources needed for long-term recovery.