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Substance Abuse And Schizophrenia

Updated on September 7, 2014


It is not surprising that substance abuse can cause mental abnormalities. Drugs and alcohol are loaded with toxins and other substances that can cause damage to the brain and body. More importantly, drugs are known to change neurotransmitter receptors in the brain by replacing a particular chemical, (mostly dopamine). The end effect is the person’s dependence on the drug. For Schizophrenia, drugs are known to be one of the triggers to develop schizophrenic epoxides, and many schizophrenics have a high susceptibility to develop substance dependence.

Before We Begin, A Journey Into Schiophrenia

There are different types of Schizophrenia including:

  • paranoia based Schizophrenia which is the most common found and deal with feeling like somebody is after them, obsessed with conspiracies theories, and generally paranoid.
  • Disorganized which makes everyday life really hard for sufferers. They may not problems dressing themselves, bathing, brushing their hair, and be emotionally impaired, including the inability to show emotional response or emotionally unstable. They also have communicative problems that leave them awkward or unable to know social ques and what is acceptable and may have problems with their speech due to their disorganized thinking.
  • catatonic is a subtype that effects movement. The individual will show a decline in activity and can even stop moving and stand or sit like a statue, they may also due the opposite and speed up called catatonic stupor (webmd).This is a unique subtype because they can stay in a position which for most would be extremely painful for hours and not be in pain.
  • Undifferentiated-these are for individuals who have classic signs of Schizophrenia but does not fit into any of the subtypes.
  • Residual-individuals who no longer shows any symptoms of Schizophrenia

There are three stages of schizophrenia starting usually around late teens through their 20's for men and between their 20's and 30's for females. Many times, the disorder gradually appears but sometimes it can be suddenly to but mostly there are signs of the disorder developing. The three stages of schizophrenia is generally seen by those who gradually happens:

  • The First stage is Proromal Phase where it is really easy to misdiagnose because the symptoms are kind of weak still and get confused a lot of time for depression or an anxiety disorder. If the person is a teenager, many would confuse the signs as teenage hormone changes and emotional changes which happens during this time period of their lives so because of this, Schizophrenia is hard to pinpoint and is easily overlooked. The symptoms include withdrawing from friends and family. aggression, and odd behaviors that generally wouldn't be seen in the person before. All of which is very common for teenagers. This stage can last from a mere month to years.
  • Acute Stage is the next stage and is where most of them get diagnosed. Depending on which version of schizophrenia, they can show paranoia, hallucinations, delusions, or confusion and not making sense. In some schizophrenics like catatonic schizophrenia, the person may stand or sit still for long periods without moving, eating, drinking...
  • Remission stage is the last stage (does not mean its over, it can go right back to the acute stage at any time). At this stage, usually with medication, life will get back to almost normality but replayse can happen at anytime. In fact most relapse happen because they stop taking their medication which they need. Usually symptoms would start to get less intense like hallucinations but the feeling of isolation and depression may stay before the other more serious symptoms start to get more intense again. It may take years to stay in the remission state without relapsing or have any chance of relapsing.

Tips to avoid relapsing include:

  • Learning the first warning signs of a relapse. For instance if you realize every time you start to slip, you get a feeling of extreme goofiness that can last for hours, than you can possibly get help before completely relapsing
  • take medication regardless of how well you are doing-for most of time, if a Schizophrenic stays on their meds, they would relapse.
  • stay in therapy and talk regularly with your psychologist about any worry you have about the possibility of a relapse.
  • Make a list of anything that had triggered an episode before and learn what situations put you at the most risk of a relapse and if those situations come up, make sure you have a plan on how to stop any possibility of a relapse including making calls to your psychologist, making sure you take your meds before the event or place, and have people you trust there around you who know the warning signs and can help if they come up.

Can Substance Abuse Be A Cause of Schizophrenia?

The exact cause for Schizophrenia is not yet known but research has shown that substance abuse might play a part in the development of Schizophrenia. It was found that adolescents who have used cannabis with Catechol O-Methyltransferase Polymorphism (a chemical) is associated with a higher risk of developing psychosis in young adulthood (Green, Drake, Brunette, & Noordsy 2007). The study also found that substance abuse has been known to cause clinical complications including relapse (Green, Drake, Brunette, & Noordsy 2007).

How About how Substances Affect Those With Schizophrenia

There is a lot of information on how substance abuse affects patients with Schizophrenia. In the British Journal of Psychology, a study in North America found that schizophrenics are especially susceptible to the negative affects of drug abuse (Smith & Hacker 1994). In another study it was found that 50% of schizophrenics have co-occurring substance abuse with alcohol and cannabis as the drug of choice (Green, Drake, Brunette, & Noordsy 2007). In Psychopharmacology, it was found that schizophrenics with alcohol or drug abuse showed signs of lower academic achievements and vocabulary skills than schizophrenics without substance abuse (Schnell, Koethe, Daumann, Gouzoulis- mayfrank 2009).

It Also Leads to A Higher Chance of Suicide

Substance abuse has been known to trigger suicide or suicide attempts in adolescents with schizophrenia. In a study with178 participates with schizophrenia and schizoaffective disorder with co-occurrence substance dependence found that adolescents with LSD had the highest rates of tried suicide attempts (Shoval, Sever, Sher, Diller, Apter, Weizman, & Zalsman 2006). Alcohol and MDMA (Methylene-Dioxy-Methylamphetamine) ranked number two amongst suicidal schizophrenic adolescents. Surprisingly drugs like cocaine, opiates, and amphetamines showed no difference between those who were suicidal and ones who were not.


Main Types of Substance Abuse Found

Even through, Schizophrenics could abuse any type of drug from alcohol to Meth and everything in between there are some really common drugs that schizophrenics seem to abuse more than the others:

  • The number one drug used is Nicotine, usually because of cigarettes. The average population of the United States has a 25-30% Nicotine addiction problem but it triples for the schizophrenic population(PsychCentral). Of course, the average population is a lot larger than the schizophrenic population. The problem with Nicotine is that it can affect anti-psychotic drugs that schizophrenics depend on and can also be hard to stop due to the withdrawal symptoms causing worsening episodes.
  • Alcohol is the second must popular drug that schizophrenics are addicted to. Many times they believe that the alcohol subdues the episodes and can make them calmer. They also use it as a way to forget about their problems.
  • Marijuana has also been found to make schizophrenic episodes come more often or be worse than if they were not on the drug. In fact a person who has a Marijuana addiction has almost triple a chance of developing schizophrenia than non-marijuana smokers.
  • Cocaine is another main drug found among schizophrenics, like Marijuana the more a teenager or young adult abuses it, the more likely they will develop Schizophrenia. If taken by a schizophrenic, it will make symptoms worse and prolong episodes.


Substance abuse has been known to be involved in a lot of disorders and schizophrenia is no different. Substance abuse is known to be a cause in schizophrenia and has a great negative effect on Schizophrenics including lower cognition abilities and higher chances of depression and suicide rates. Unfortunately many schizophrenics who have drug or alcohol dependency do not get help for their substance abuse. Substance abuse could make the schizophrenic patient stop taking their mood medications, can trigger psychosis, and of course can make a schizophrenic stop seeking psychological help for their disorder. Many schizophrenics are unable to know how the drugs affect them negatively and because of that they need to be singled out for intense monitoring.


Green, Alan I., Drake, Robert E., Brunette, Mary F., & Noordsy, Douglas L. (2007). Schizophrenia and Co-Occurring Substance Use Disorder. The American Journal of Psychiatry, 164(3), 402-8.

Schnell, T., Koethe, D., Daumann, J., & Gouzoulis-Mayfrank, E.. (2009). The role of cannabis in cognitive functioning of patients with schizophrenia. Psychopharmacology, 205(1), 45-52.

Shoval, Gill, Sever, Johnathon, Sher, Leo, Diller, Robyne, Apter, Alan, Weizman, Abraham & Zalsman, Gil . (2006). Substance Use, Suicidality, and Adolescent-Onset Schizophrenia: An Israeli 10-Year Retrospective Study. Journal of Child and Adolescent Psychopharmacology, 16(6), 767-75.

Smith, J., Hucker, S. (1994). Schizophrenia and Substance Abuse. The British Journal of Psychology 165:13-21.

Webmd(2014), Schizophrenia Health Center,


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