Schizophrenia Home > Schizophrenia and Substance Abuse

Schizophrenia and substance abuse often go hand in hand. People who have schizophrenia tend to abuse alcohol and/or drugs more often than the general population. The most common form of substance abuse in people with schizophrenia is an addiction to nicotine. Research has found that nicotine can interfere with the effectiveness of antipsychotic medications, so patients who smoke may need higher doses of their medication.

An Overview of Schizophrenia and Substance Abuse

Some people who abuse drugs show symptoms similar to those of schizophrenia, and people with schizophrenia may be mistaken for people who are high on drugs. While most researchers do not believe that substance abuse causes schizophrenia, people who have schizophrenia tend to abuse alcohol and/or drugs more often than the general population.
 
Substance abuse can reduce the effectiveness of treatment for schizophrenia. Stimulants (such as amphetamines or cocaine), PCP, and marijuana may make the symptoms of schizophrenia worse, and substance abuse also makes it more likely that patients will not follow their treatment plan.
 

Schizophrenia and Substance Abuse: Nicotine

The most common form of substance abuse in people with schizophrenia is an addiction to nicotine. People with schizophrenia are addicted to nicotine at three times the rate of the general population (75-90 percent versus 25-30 percent).
 
Research has revealed that the relationship between smoking and schizophrenia is complex. People with schizophrenia seem to be driven to smoke, and researchers are exploring whether there is a biological basis for this need. Several studies have found that smoking, in addition to its known health hazards, interferes with the action of antipsychotic drugs. People with schizophrenia who smoke may need higher doses of their medication.
 
Quitting smoking may be especially difficult for people with schizophrenia, since nicotine withdrawal may cause their psychotic symptoms to temporarily get worse. Smoking cessation strategies that include nicotine replacement methods may be better tolerated. Doctors who treat people with schizophrenia should carefully monitor their patient's response to antipsychotic medication if the patient decides to either start or stop smoking.
 
Written by/reviewed by:
Last reviewed by: Arthur Schoenstadt, MD
Last updated/reviewed:
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