Some people who use drugs use them to manage symptoms of mental health problems they feel. Others abuse substances to completely block out and not feel the symptoms altogether. Substance abuse and schizophrenia go hand in hand and are to be taken seriously.

Patients’ Stories

There are many stories from people who struggled for years, not knowing they had schizophrenia. Several abused substances to quell the voices, hallucinations, and other disturbing signs of schizophrenia. James, from South Africa, is one. He relates how he abused heroin for 15 years to silence the symptoms of his bipolar depression.

When he started to hear voices and hallucinate, he further abused the drug to silence the noise and visions. At one point, he even lived with a dealer. Later, after spending some time in jail and getting professional help, he was able to sustain a sober, drug-free life.

A patient who wrote about living with schizophrenia for the National Alliance on Mental Illness conveyed how he tried to “run away” from the disease and its symptoms to no avail. This patient was later admitted to an outpatient treatment center where they obtained the help needed to manage his symptoms.

What Is Schizophrenia?

Schizophrenia is a chronic and serious mental disorder that affects how someone thinks, feels, and behaves. It affects roughly 1 percent of the U.S. population. People who have schizophrenia may feel like they have lost touch with reality or have hallucinations or delusions. Symptoms can be disabling and disturbing, subtle or severe. However, it is essential to know more about schizophrenia and how it and substance abuse coincide.

Schizophrenia Symptoms

There are three categories of symptom types: positive, negative, and cognitive, according to the National Institute on Mental Health.

Positive: These symptoms are not usually seen in other people who do not have schizophrenia — hallucinations, delusions, dysfunctional thinking, movement disorders. A break, in reality, is present, and they firmly believe what they see or hear despite evidence to the contrary.

Negative: These symptoms take away a feeling or ability that is present with other people but is now not there. One symptom of schizophrenia is the “Flat Affect,” which is a reduced expression of the face and voice. People who exhibit flat affect also exhibit a reduced feeling of pleasure in life, have difficulty beginning and completing tasks or activities and speak less. Also, withdrawing from social situations, lack of hygiene, lack of concern for self or others are other symptoms.

Cognitive: Changes in memory that can be subtle or severe, depending on the person. Symptoms are a poor ability to understand and apply information to make decisions, trouble focusing or paying attention and problems with using information immediately learned.

Schizophrenia coupled with substance abuse is called a dual diagnosis or co-occurring substance use disorder. It is usually more common than not. Strong statistics are identifying the percentages of people with schizophrenia using substances to either self-medicate to alleviate negative symptoms or cope with other symptoms.

Take into consideration:

To understand the connection between substance abuse and schizophrenia, it’s important to know how substances affect someone with this mental health issue.


People with a mental health disorder buy 44 percent of the cigarettes purchased in the U.S. Seventy percent of people with schizophrenia are nicotine-dependent. Nicotine can cause a relapse of symptoms such as hallucinations, delusions, and disorganized speech. When this occurs, people with schizophrenia who smoke may require higher doses of antipsychotic medication because smoking can interfere with the effects of the medication.


Alcohol is easily available and affordable. As previously mentioned, about one-third of people with schizophrenia develop an alcohol use disorder at some time in their lives. Usually, alcohol dependence or abuse starts before the onset of symptoms. It is often reported that schizophrenic people abuse alcohol to blunt the effects of their symptoms.


Cannabis is a popular substance to use throughout the country, even though it is not legal in many states. It has been proven that cannabis can worsen or accelerate the psychotic symptoms of certain mental health disorders. A study found that 53 percent of people who experienced their first episode of psychosis had a cannabis dependence. The compound THC (tetrahydrocannabinol) in marijuana is the chemical that produces psychosis in people using cannabis. Extended use of cannabis can exacerbate schizophrenic psychotic episodes.


Cocaine is used to ease the adverse symptoms of schizophrenia and dysphoria. It has been reported that almost 50 percent of people with this mental health disorder also have a co-occurring substance abuse disorder after the initial diagnosis of psychosis, and cocaine is the main culprit.

People with schizophrenia usually have higher rates of impulsiveness and disinterest in social contact (social anhedonia) than people not diagnosed with it. This can lead to impulsive drug use, which gives the person a heightened sense of satisfaction not found in everyday situations. The more pleasure someone feels from using substances, the more likely they will abuse them.

Treating Substance Abuse and Schizophrenia

It is essential to not only treat substance abuse but the mental health disorder also. To do this, substance abuse treatment centers need to conduct a complete assessment of the incoming patient. A dual diagnosis will be made, and a treatment plan will be created that takes both disorders into account. Different types of therapies will be employed such as cognitive behavioral therapy and alternatives like yoga, guided imagery, and more. These are all beneficial and work well for the dually diagnosed patient with schizophrenia.

Benefits of a Dual Diagnosis

There are useful benefits in being treated with co-occurring disorders.

Educated and experienced mental health professionals are on hand to work through the issues a dually diagnosed patient has. They are well-versed in the intricacies of schizophrenia and know how to handle the different types of symptoms and what triggers them.

person holding a sheet of paper with two symmetrical silhouettes of faces cut out“It is more efficient to treat both disorders at the same time. Medical and mental health professionals work together to help the patient get sober and find the best methods to stay sober.

They also strive to find the most beneficial medication to balance the mental health symptoms.”

When these two teams work together to help the patient with both the substance abuse and mental health disorder, it is more efficient than treating only one disorder at a time.

The patient obtains information and practices exercises in learning how to cope with life stresses, mental health symptoms, substance abuse triggers, and also learns how to have stronger, healthier relationships.

Treatment Options for the Dually Diagnosed

Misconceptions about people with schizophrenia exist despite the awareness campaigns designed to combat them. Don’t let that discourage you from seeking help when substance abuse piques the symptoms of schizophrenia. The seasoned and qualified staff at Delphi Behavioral Health Group are available 24 hours a day, seven days a week to work with you to become free from addiction and find a healthy balance managing schizophrenia. Whether you need a residential inpatient program or an outpatient program, we can accommodate you. You can reach out to us online or on the phone at any time.

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