Schizophrenia & Substance Use Disorder | Symptoms, Risk Factors, & Treatment

Manish Mishra, MBBS

Medically Reviewed By: Manish Mishra, MBBS

on July 27, 2023

Schizophrenia is a confusing and frightening mental illness that can produce severe symptoms of psychosis. This can sometimes lead to self-medication and, in turn, drug or alcohol addiction, which can complicate recovery and treatment efforts.

Schizophrenia is often misunderstood both by those who are diagnosed with it and by the general population at large. The same is true of substance use disorders (alcohol/drug addiction), a condition in which a person’s use of mind-altering substances becomes chronic, compulsive, and harmful.

Unfortunately, these conditions sometimes present together as co-occurring conditions that can have negative effects on a person’s overall mental and physical health when left untreated.

Fortunately, professional dual diagnosis treatment options are available at Ohio Recovery Center to address both schizophrenia and substance use disorder together.

Symptoms Of Schizophrenia

Schizophrenia is a long-term mental health condition and psychotic disorder in which a person sometimes struggles to distinguish their own internal thoughts and delusions from the reality around them. 

Onset of schizophrenia usually occurs between 16 and 30, and is more common among males than females.

Diagnosis of schizophrenia is based on criteria laid out in the Diagnostic and Statistical Manual of Mental Disorders, Fifth Edition (DSM-5), and focuses on a person’s symptoms, either self-reported or conveyed by friends and family members. 

Schizophrenia symptoms generally include:

  • hallucinations, or hearing or seeing things that are not real
  • delusions, or holding to unusual or bizarre beliefs that are not based in reality
  • paranoia, or believing that one is being targeted, watched, or preyed upon by others
  • difficulty experiencing or displaying positive emotion
  • disorganized thinking and speech
  • a loss of interest in typical everyday activities and responsibilities
  • avoiding friends and acquaintances

Those who experience schizophrenia, especially if they do not receive effective treatment, are at high-risk for suicidal thoughts and actions, anxiety disorders, depression, homelessness, victimization, social isolation, and substance use disorder.

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Symptoms Of Substance Use Disorder

Substance use disorder (SUD) is a behavioral disorder associated with long-term symptoms that can include:

  • drug cravings
  • loss of motivation
  • sleep dysfunctions
  • mental health decline, often including worsening anxiety and depression
  • malnutrition and unusual weight gain or loss
  • lasting negative changes to behavior and personality
  • financial and/or legal problems
  • other long-term health effects specific to the particular substance being abused and the method of abuse (e.g. cirrhosis of the liver, various forms of cancer, cardiovascular disease, memory disorders, psychotic symptoms, skin infections, lung damage, etc.)

It is important to note that a person who engages in substance abuse does not necessarily have a substance use disorder. 

The condition is instead diagnosed when substance use becomes unmanageable, causes distress or harm in daily life, and produces physical or psychological withdrawal symptoms when attempting to stop using the substance.

Risk Factors For Co-Occurring Schizophrenia & SUD

Schizophrenia and SUD are related to one another as mutual risk factors and comorbidities, producing increasingly severe long-term negative consequences for a person’s overall physical and mental health and stability, especially in the absence of an effective treatment program.

The specific cause or causes of schizophrenia remain unknown, though it is believed that certain genetic factors, variations in brain chemistry, and environmental factors, can all contribute. 

These environmental factors may include childhood trauma, certain early viral infections, malnutrition, and early substance abuse involving mind-altering substances such as:

  • alcohol
  • psychedelic drugs
  • cannabis
  • amphetamines / methamphetamine
  • cocaine
  • opioid drugs
  • benzodiazepines

Likewise, a person’s risk of developing a substance use disorder has been linked to factors including genetic predisposition, traumatic childhood experiences, early patterns of drug or alcohol abuse, and psychiatric disorders. 

Mental disorders like schizophrenia can increase substance abuse as a form of escape and self-medication against mental distress and other negative symptoms.

Dual Diagnosis Treatment For Schizophrenia & Addiction

Dual diagnosis treatment is a specialized approach to recovery care for those who are struggling with both a substance use disorder and a mental health disorder, as co-occurring disorders are often intertwined in complex ways requiring both to be properly addressed.

Treatment for schizophrenia/SUD centers on a combination of medication, psychotherapy (including behavioral therapy), peer support, and other professional care options.

Psychotherapy/Behavioral Therapy

Cognitive behavioral therapy (CBT) and other forms of psychotherapy can help participants better understand their thoughts, feelings, and behaviors related to substance use and mental health symptoms.

The goal of CBT is to make positive changes to these thoughts and feelings as well as build up positive coping skills and strategies.

Psychotherapy and other primary mental health services may be provided in an inpatient setting, especially when addiction treatment services are also offered.


Antipsychotic medications are commonly prescribed to schizophrenic patients. These medications can improve mental control and well-being, even if they do not resolve psychotic episodes or other symptoms entirely and frequently produce side effects.

Likewise, medications are available to support recovery from alcohol use disorders and opioid use disorders, and other medications such as antidepressants may be administered as part of a dual diagnosis treatment program.

Other Peer & Professional Support

Support groups provide participants with a safe and supportive environment to share their experiences and learn from others with similar challenges for both during and after treatment.

Professional aftercare and supportive services are likely required to help those with schizophrenia navigate the challenges of daily life while also continuing to avoid relapsing alcohol or drug abuse in the months and years to come.

Ohio Recovery Center (ORC)

At ORC, we provide leading primary mental health services and addiction recovery treatment, including:

If you or a loved one are facing both schizophrenia and problematic alcohol or drug use, please reach out to our team today.

  1. Dialogues in Clinical Neuroscience
  2. National Alliance on Mental Illness (NAMI)
  3. National Institute on Mental Health (NIMH)
  4. Substance Abuse and Mental Health Services Administration (SAMHSA)

Written by Ohio Recovery Center Editorial Team

© 2024 Ohio Recovery Center | All Rights Reserved

* This page does not provide medical advice.

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