Question
Is it possible to diagnose schizophrenia in a person with substance abuse problems? Or does the person have to get clean first?
Answer
Chronic substance abuse can be associated with symptoms of serious mental illness such as schizophrenia. But it can be difficult to determine if the drug abuse is causing symptoms of schizophrenia, or if the schizophrenia is prompting the drug abuse. Some research suggests a link between use of a specific drug, such as marijuana, and development of schizophrenia in individuals who have an underlying predisposition to the disease.
People with schizophrenia are at greater risk of substance abuse. The reason for this isn't clear. But they may use alcohol or drugs to try to relieve or decrease symptoms of the illness. Unfortunately, substance abuse can actually increase symptoms and complicate treatment.
It's critical to accurately diagnose and treat substance abuse and mental illness. If symptoms of mental illness are caused by substance abuse, they usually diminish within weeks after the person stops taking the substance. But it may take up to six months for all of the effects of the substance to go away. Sometimes the effects of drug use never fully disappear. Some people who have taken the hallucinogen LSD experience flashbacks for the rest of their lives. Ecstasy is another drug that may cause long-term mental effects.
It's not always possible to delay treatment for mental symptoms to see if they'll go away when the person stops using the substance. The distress caused by the mental symptoms and the risk of harm to self or others may require prompt treatment with medication and counseling. It's often helpful for the person to work with a professional with expertise in both substance abuse and mental illness.
Last Updated: 12/07/2005