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Dual Diagnosis Drug Addiction and Schizophrenia: Treatment Center in Maryland
Schizophrenia is a chronic and severe mental health disorder that can affect how a person thinks, feels, and behaves. People with schizophrenia may seem like they have lost touch with reality and experience persistent, distressing symptoms like hallucinations, delusions, and disorganized thinking that can strain interpersonal relationships.
It’s common for people with schizophrenia to try to relieve their symptoms with the use of drugs or alcohol, which is known as self-medicating. This can start a cycle of dependence and addiction, leading to dual diagnosis – or a mental health condition and substance use disorder that occur together – and may complicate treatment. At The Freedom Center, we take a comprehensive approach to dual diagnosis treatment with schizophrenia and substance use disorder, addressing both simultaneously to support lifelong recovery.
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Key Points
- Dual diagnosis is the co-occurrence of a mental health disorder like schizophrenia and a substance use disorder.
- Schizophrenia symptoms, such as hallucinations, delusions, and cognitive problems, are often worsened by drugs or alcohol.
- Treating schizophrenia and substance use disorder requires an integrated approach with dual diagnosis treatment that addresses both conditions simultaneously.
What Is Schizophrenia?
Schizophrenia is a chronic mental health disorder characterized by disruptions in thought processes, perceptions, emotions, and social interactions. People who struggle with schizophrenia have difficulty distinguishing their thoughts and ideas from reality.
Though symptoms can vary with schizophrenia, they typically fall under delusional thinking, hallucinations, and disorganized thinking and speech.[1]
Delusions: False beliefs that don’t align with reality. Someone with schizophrenia may believe they are being watched, targeted, or persecuted without evidence, that disaster is imminent, or that external forces are controlling their thoughts. They may also believe they have extraordinary fame or that they’re destined for great things.
Hallucinations: Sensory experiences that feel real but are not. Hearing voices others cannot or seeing things that aren’t there are common hallucinations with schizophrenia. Though they aren’t real, they feel very real to the person affected.
Disorganized thinking or speech: Jumbled, illogical thoughts or speech patterns. Disorganized thinking or speech can make it difficult to communicate clearly because the words are irrelevant, incomplete, or hard to follow. This is often referred to as “word salad.”
Disorganized or unusual motor behavior: Unpredictable or inappropriate actions that affect daily activities, such as excessive movement or agitation with no cause. Their actions may seem odd or unrelated to what’s going on around them.
Negative symptoms: Symptoms that affect the ability to function in day-to-day life. This can include neglecting personal hygiene, losing interest in activities, avoiding eye contact, or withdrawing socially.
Other symptoms of schizophrenia may include a lack of interest or motivation, changes in sleep patterns, becoming socially withdrawn, diminished emotional expression, and a lack of personal hygiene.
Addiction and Schizophrenia
Schizophrenia and substance use disorder, or addiction, often co-occur. Though schizophrenia only affects 1% of the population worldwide, it’s estimated that 47% of patients with schizophrenia struggle with drug or alcohol use, compared to 16% of the general population.[2] Tobacco, alcohol, cannabis, and cocaine use disorders are most common among people with schizophrenia.
It’s not uncommon for people with schizophrenia to engage in substance abuse to manage depression, anxiety, or other symptoms of this mental health condition. This can cause a cycle of self-medicating symptoms, followed by worsening delusions or hallucinations, then a desire to use substances to relieve the distress. Some people may stop complying with mental health treatment as well, exacerbating their symptoms.
It also complicates diagnosis, since schizophrenia is sometimes mistaken for substance abuse because of similar symptoms that occur with substance use, withdrawal, or overdose.
Causes of Co-Occurring Schizophrenia and Addiction
The exact link between schizophrenia and addiction is unknown, but some research findings reveal possible causes.
- Brain Activity: The prevalent theory is that there’s an overlap in brain activity between schizophrenia and addiction.[3] Drug use can cause neural changes in some of the same areas of the brain that schizophrenia disrupts, worsening the condition. Another possible factor is that problems affecting the brain’s reward center, which are affected by schizophrenia, may contribute to the higher rate of addiction in people with existing schizophrenia.[4]
- Self-Medication: Another possible cause is self-medicating. People with schizophrenia may rely on drugs to relieve their symptoms and help them function more effectively in social situations or at work, which is a motivation to continue using substances. However, studies have had mixed outcomes. While self-medication may play a role for some individuals, it doesn’t account for the high rate of co-occurrence that may be due to shared vulnerabilities.
- Genetics: Both substance use disorder and schizophrenia have a genetic component. Schizophrenia and addiction are both highly heritable at 80% and 40-60%, respectively, especially when a first-degree relative is affected.[5,6] This may increase the likelihood of developing either condition.
- Trauma: The two conditions have other possible factors in common, such as childhood trauma, that can bring on symptoms of schizophrenia and contribute to the development of addiction.
Challenges with Dual Diagnosis Treatment for Schizophrenia and Substance Use
Treating people with both schizophrenia and substance use disorder can present some unique challenges. Considerable overlap between schizophrenia symptoms and the effects of drug use frequently leads to misdiagnosis and delayed treatment.
People with schizophrenia often struggle to adhere to the treatment plan for their condition, which may include prescribed antipsychotic medications. Once chronic substance use occurs, the likelihood of skipping doses or stopping treatment increases, which can cause a relapse or a psychiatric crisis.
In addition, some of the challenges that come with schizophrenia, such as low executive function and poor attention span, make it difficult to follow a structured treatment plan or engage in therapy. There’s a stigma around both schizophrenia and addiction as well, which can cause people to avoid seeking help and decrease their motivation for treatment.
Dual Diagnosis Treatment for Schizophrenia and Substance Use Disorder
It can be difficult to treat schizophrenia on its own, but treating dual diagnosis schizophrenia and substance use disorder is even more challenging. However, recovery is possible with integrative approaches that provide structure and support through a variety of therapies.
Depending on the substance involved, medical detox may be the first step in treatment to manage the symptoms of withdrawal and ensure the client is as safe and comfortable as possible during periods of worsening schizophrenia symptoms. Once the client is stable, they may enter a residential treatment program or partial hospitalization program (PHP) to receive intensive support and care in the early stages of recovery. Intensive outpatient programs (IOPs) and outpatient programs may be an option for people who don’t need round-the-clock care and support.
These levels of care provide the appropriate treatment environment for each client’s unique needs and treatment goals. While each treatment plan is individualized, some common therapies for schizophrenia and addiction include:
Individual therapy: This therapy offers one-on-one counseling sessions to uncover behavioral patterns, past experiences, and current challenges.
Group therapy: This type of therapy brings together other clients who are struggling with similar difficulties to share ideas, provide support, and develop coping strategies in support groups.
Family therapy: Family therapy treats the family as a unit to heal past pain, resolve conflicts, and develop better communication.
Cognitive behavioral therapy (CBT): CBT is a type of behavioral therapy that focuses on identifying and modifying unhelpful thought patterns and behaviors to improve mental health and well-being.
Dialectical behavior therapy (DBT): DBT is a type of behavioral therapy that helps clients manage intense emotions, improve interpersonal relationships, and develop coping skills for successful recovery.
If you or a loved one is ready to get help but finances are holding you back, give us a call. We can work with your health insurance provider.
If you or a loved one is ready to get help but finances are holding you back, give us a call. We can work with your health insurance provider.
We Can Help You Manage Your Mental Health Symptoms And Substance Abuse Struggles
One conversation with one of our understanding receptionists will give you peace of mind that you’re in good hands. Through unique individualized treatment, we get to the root of your struggles by listening to your story. We base each step of your recovery meticulously on the details you share regarding your background, struggles, and personal symptoms. Contact The Freedom Center now to get top-notch training and therapy to overcome your schizophrenia and substance abuse struggles.
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All content produced by The Freedom Center undergoes a detailed evaluation process to ensure accuracy and quality. We only work with medical professionals and individuals with extensive experience in the field, and all content produced undergoes a review process to ensure accuracy. Our goal is to be a reliable resource the recovery community can turn to for information they can trust.
Frequently Asked Questions About Drug Addiction and Schizophrenia
Powder cocaine is a hydrochloride salt that’s usually snorted or dissolved and injected.
Crack cocaine is a crystalized form that’s smoked. Crack produces a faster, more intense high, but also wears off quickly, leading to more frequent use. [11]
Both forms are highly addictive, but crack is often associated with a quicker path to dependence due to how rapidly it enters the bloodstream and affects the brain.
Finishing rehab doesn’t mean the journey ends.
At The Freedom Center, the team will help each person develop a personalized recovery plan that lasts. That might include alumni support, sober living connections, and continued therapy.
The goal is that everyone leaves with a roadmap—and a support system—to stay sober and thrive in real life after their time at The Freedom Center.
No, schizophrenia can’t be cured. It’s a lifelong condition, but many people can enjoy fulfilling, healthy lives with integrative treatment plans that include social support, therapies, appropriate medications, and a sense of routine and structure. Early intervention promotes the best outcomes.
Sources
[1] Mayo Foundation for Medical Education and Research. (2024, October 16). Schizophrenia. Mayo Clinic. Retrieved from https://www.mayoclinic.org/diseases-conditions/schizophrenia/symptoms-causes/syc-20354443#:~:text=Extremely%20disorganized%20or%20unusual%20motor,to%20be%20diagnosed%20with%20schizophrenia on 2025, April 21.
[2, 3] Khokhar, J. Y., Dwiel, L. L., Henricks, A. M., Doucette, W. T., & Green, A. I. (2018, April). The link between schizophrenia and substance use disorder: A unifying hypothesis. Schizophrenia research. Retrieved from https://pmc.ncbi.nlm.nih.gov/articles/PMC6094954/ on 2025, April 21.
[4] Winklbaur, B., Ebner, N., Sachs, G., Thau, K., & Fischer, G. (2006). Substance abuse in patients with schizophrenia. Dialogues in clinical neuroscience, 8(1), 37–43. https://doi.org/10.31887/DCNS.2006.8.1/bwinklbaur on 2025, April 21.
[5] Consultant360.com. (n.d.). Retrieved from https://www.consultant360.com/exclusives/nearly-80-schizophrenia-risk-genetic on 2025, April 21.
[6] Popescu, A., Marian, M., Drăgoi, A. M., & Costea, R.-V. (2021, May). Understanding the genetics and neurobiological pathways behind addiction (review). Experimental and therapeutic medicine. Retrieved from https://pmc.ncbi.nlm.nih.gov/articles/PMC8014976/ on 2025, April 21.
