Drug Abuse and Schizophrenia

Schizophrenia is a characteristically severe form of mental illness that produces symptoms such as delusional states of mind, hallucinations, and a loss of normal emotional expressiveness, motivation and/or thinking skills. Along with several other illnesses, it belongs to a group of mental disorders known as psychotic disorders. People who abuse drugs sometimes develop symptoms that closely resemble the symptoms of schizophrenia, and in some cases, drug abuse may actually set the stage for the onset of the disorder. In people who already have schizophrenia, drug use/abuse can worsen the illness’s effects in several different ways.

Schizophrenia Basics

Schizophrenia affects roughly 1 percent of the US population, according to the National Institute of Mental Health. In order to receive a diagnosis for the disorder, affected individuals must develop at least two of several classic symptoms within a 30-day timeframe. In addition to delusions, hallucinations and decreases in thinking skills, motivational levels, and emotional responsiveness, these symptoms include incoherent or easily sidetracked speech, extremely chaotic behavior and catatonic states that produce either excited, aimless body movement or a rigid, unresponsive lack of body movement. Some people also receive a schizophrenia diagnosis when they exhibit only extreme delusional states or hallucinations that center on conversations with nonexistent people (i.e., “voices”). In addition to a one-month period of ongoing symptoms, affected individuals must also experience more generalized effects of the disorder for at least half a year. Most schizophrenics first experience symptoms of the disorder at some point between the middle of adolescence and their very early 30s. While men and women develop schizophrenic symptoms in roughly equal numbers, men typically experience their first symptoms at an earlier age than women. The disorder rarely appears in children under the age of 16, and unaffected adults over the age of 45 also have low risks for its later onset. Known factors in the development of schizophrenia include genetic inheritance, structural abnormalities in the brain, unusual alterations in the levels of certain key brain chemicals, and the lack of adequate nutrition during fetal development.

Drug Abuse as a Cause of Schizophrenia

Nearly half of all diagnosed schizophrenics in the United States abuse drugs or alcohol. This rate is roughly four times the rate of drug and alcohol abuse found in the larger population. Despite these statistics, most doctors and mental health researchers don’t think that drugs can actually trigger the onset of the disorder. However, some evidence suggests that a causative relationship exists between the use of certain drugs and schizophrenic symptoms. For instance, some people with genetic risk factors for schizophrenia may develop active cases of the disorder as a result of using LSD or some other form of hallucinogenic drug. Marijuana use/abuse may also play a factor in the onset of schizophrenia in some individuals, according to a study published in 2011 in the Journal of Neuroscience and a second study published in 2012 in the journal Current Pharmaceutical Design. The main active ingredient in marijuana, called tetrahydrocannabinol or THC, exerts a strong effect on two different structures in the brain-the prefrontal cortex and hippocampus-that play an essential role in the human ability to make judgments and form or access memories. These same brain structures show signs of disorganization and altered function in people with schizophrenia. When mentally healthy people smoke or ingest marijuana, they experience similar disorganization and altered function, and subsequently develop temporary versions of several symptoms commonly associated with schizophrenia. Over time, the brain effects of the drug may increase the likelihood that the disorder itself will develop, especially in individuals with other significant schizophrenia risks.

Drug Abuse as a Hindrance to Schizophrenia Treatment

Several drugs are known to worsen the severity of existing schizophrenia symptoms, including cocaine, amphetamines, and marijuana. Use of these drugs during schizophrenia treatment can seriously reduce the effectiveness of that treatment and delay or prevent any real improvement in an affected individual’s mental health. Even worse, schizophrenic drug abusers are significantly more likely than other schizophrenics to skip their treatments or forego their treatment plans altogether. In order to successfully treat people with schizophrenia who abuse drugs, doctors must first acknowledge the existence of both problems, then devise treatment plans that effectively address these problems. Treatment for schizophrenia typically involves use of antipsychotic medications and certain forms of psychotherapy. Treatment for drug abuse also includes the use of medications and forms of therapy that include cognitive behavioral therapy (CBT), contingency management, and multidimensional family therapy. Medications used in drug treatment vary according to the nature of the drug being abused.

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