Schizophrenia is a chronic mental health condition that affects how a person thinks, feels, and behaves. It can cause symptoms such as hallucinations (seeing or hearing things that aren’t there), delusions (false beliefs), disorganized thinking, and changes in movement or behavior. Addiction, also called substance use disorder, is a condition in which a person continues to use drugs or alcohol despite harmful consequences.
Research shows that schizophrenia and addiction often occur together. A 2022 study from the National Institute on Drug Abuse found that about 50% of people with schizophrenia will experience substance use disorder during their lifetime. This is significantly higher than the 16.5% prevalence rate in the general population.
The connection between schizophrenia and addiction is complex. People with schizophrenia may use substances like alcohol or cannabis as a way to cope with distressing symptoms, often called “self-medication.” However, substance use can make schizophrenia symptoms worse and interfere with treatment.
At Peak Path Health in Los Angeles, California, we understand the challenges faced by individuals with co-occurring disorders. Our team provides integrated dual diagnosis treatment that addresses both conditions simultaneously, recognizing that each person’s experience with schizophrenia and addiction is unique.
- Positive symptoms: These include hallucinations, delusions, and disorganized thinking or speech. These are called “positive” not because they’re beneficial, but because they’re additional experiences that people without schizophrenia don’t have.
- Negative symptoms: These involve reduced emotional expression, decreased motivation, and social withdrawal. These are called “negative” because they represent a loss of normal functions.
- Cognitive symptoms: These include problems with attention, memory, and executive functioning (the ability to understand information and use it to make decisions).
What is a Substance Use Disorder (SUD)?
- Using larger amounts of substances or for longer periods than intended
- Unsuccessful efforts to cut down or control use
- Spending significant time obtaining, using, or recovering from substance use
- Experiencing cravings or strong urges to use substances
- Continuing use despite physical or psychological problems caused or worsened by substances
When schizophrenia and substance use disorder occur together, they create unique challenges that require specialized treatment approaches. This dual diagnosis can lead to more severe symptoms, poorer treatment outcomes, and increased risks of homelessness, legal problems, and medical complications if not properly addressed.
How Common is the Co-occurrence of Schizophrenia and Addiction?
Certain substances are more frequently used by individuals with schizophrenia. Tobacco use is the most common, with research showing rates as high as 70% in people with schizophrenia, compared to around 14% in the general population. Alcohol use disorders affect approximately 25–35% of individuals with schizophrenia, while cannabis use disorder affects roughly 25%. Use of other substances, including stimulants and opioids, is less common but still elevated compared to the general population.
The high co-occurrence rates can be attributed to several factors, including shared genetic vulnerabilities, overlapping brain regions affected by both conditions, and self-medication attempts to alleviate schizophrenia symptoms or medication side effects.
Understanding these statistics helps inform treatment approaches and highlights the importance of addressing both conditions simultaneously. When we recognize how commonly these conditions co-occur, we can develop more effective screening processes and integrated treatment programs.
Can Drugs Cause or Trigger Schizophrenia?
Schizophrenia develops due to a combination of genetic, biological, and environmental factors. Research suggests that people with a family history of schizophrenia have approximately a 10% risk of developing the condition, compared to about 1% in the general population. This genetic predisposition creates vulnerability that can be influenced by environmental factors.
Certain substances can impact brain chemistry in ways that may unmask or accelerate the onset of schizophrenia in vulnerable individuals. This is particularly concerning during adolescence and young adulthood, when the brain is still developing and when schizophrenia typically first appears.
Cannabis, especially strains with high THC (tetrahydrocannabinol) content, has been linked to an increased risk of psychosis in vulnerable individuals. THC affects the endocannabinoid system in the brain, which plays a role in neurodevelopment and regulates neurotransmitters.
While cannabis use does not cause schizophrenia in most users, it may accelerate the onset of symptoms in those already at risk. For individuals with a family history of psychotic disorders, this information is particularly relevant when making decisions about cannabis use.
Alcohol does not cause schizophrenia, but it can significantly worsen symptoms in those who have the condition. Drinking alcohol excessively affects brain chemistry by:
- Altering levels of neurotransmitters like dopamine and glutamate
- Interfering with antipsychotic medications
- Impairing judgment and decision-making
- Increasing risk of medication non-compliance
For individuals with schizophrenia, alcohol use is associated with more frequent hospitalizations, increased symptom severity, and poorer overall outcomes. While the question “Does alcohol cause schizophrenia?” is common, the evidence indicates that alcohol is more likely to exacerbate existing symptoms rather than cause the condition itself.
Stimulants such as cocaine, methamphetamine, and amphetamines can induce temporary psychotic symptoms even in people without schizophrenia. This condition, called stimulant-induced psychosis, can include hallucinations, delusions, and paranoia similar to those seen in schizophrenia. Key differences between stimulant-induced psychosis and schizophrenia include:
- Stimulant-induced psychosis typically resolves within days or weeks after stopping the substance.
- Symptoms are often more closely related to paranoia and less likely to include disorganized speech or negative symptoms.
- There is a clear temporal relationship between substance use and symptom onset.
However, for individuals with a genetic predisposition to schizophrenia, stimulant use may trigger the onset of the disorder or lead to more persistent psychotic symptoms. This has led to ongoing research into the question of whether drug use can cause schizophrenia in vulnerable populations.
Hallucinogens like LSD, psilocybin mushrooms, and MDMA can cause perceptual distortions and altered thinking that may resemble some aspects of psychosis. These effects are typically temporary and resolve as the substance leaves the system.
Research has not established that hallucinogens directly cause schizophrenia. However, like other substances, they may potentially trigger the onset of symptoms in predisposed individuals or worsen existing symptoms in those with schizophrenia.
Why People With Schizophrenia Often Develop Substance Use Disorders
The relationship between substance use and schizophrenia remains an active area of research. While current evidence does not support the idea that drugs cause schizophrenia in most people, substances can play a significant role in triggering or exacerbating symptoms in vulnerable individuals.
One of the most widely accepted explanations for the high rates of substance use among people with schizophrenia is the self-medication hypothesis. This theory suggests that individuals use substances to alleviate specific symptoms or medication side effects.
- Symptom relief: Some substances temporarily reduce hallucinations, anxiety, or depression associated with schizophrenia.
- Medication side effects: Substances may help manage uncomfortable side effects from antipsychotic medications, such as restlessness or emotional blunting.
- Social discomfort: Substances can temporarily reduce the social anxiety and discomfort that often accompany schizophrenia.
While self-medication may provide short-term relief, it typically worsens symptoms over time and can interfere with prescribed treatment.
Schizophrenia and addiction affect similar brain circuits, particularly those involving dopamine. Dopamine is a neurotransmitter (brain chemical) involved in reward, motivation, and pleasure.
- Shared brain pathways: Both conditions affect the brain’s reward system, making people with schizophrenia potentially more sensitive to the reinforcing effects of substances.
- Genetic factors: Some genetic variations may increase vulnerability to both schizophrenia and addiction.
- Brain structure differences: Certain brain abnormalities associated with schizophrenia may also contribute to impulsivity and difficulty regulating substance use.
These biological factors help explain why traditional substance use treatments may need modification for individuals with schizophrenia.
Social circumstances often contribute to substance use among people with schizophrenia:
- Social isolation: Substance use may serve as a way to connect with others or cope with loneliness.
- Poverty and housing instability: Limited resources and unstable living situations can increase exposure to environments where substance use is common.
- Unemployment: Lack of structured daily activities and purpose can contribute to substance use.
- Stigma: Experiencing discrimination and stigma related to mental illness can lead to substance use as a coping mechanism.
Understanding these root causes allows clinicians to address both disorders holistically through integrated care.
Environmental factors also play a significant role in the development of substance use problems:
- Availability: Easy access to substances increases the likelihood of use.
- Peer influence: Social networks that include people who use substances can normalize and facilitate use.
- Trauma history: Many individuals with schizophrenia have experienced trauma, which is also a risk factor for substance use.
- Lack of alternative coping skills: Without effective coping strategies, substances may become a primary method of managing distress.
Understanding these overlapping factors helps explain why integrated treatment approaches that address both conditions simultaneously are most effective for people with co-occurring schizophrenia and substance use disorders.
Signs and Symptoms of Schizophrenia and Addiction
Schizophrenia is a mental health condition that affects thinking, emotions, and behavior. Substance use can change how the brain works, which may either hide or mimic some signs of schizophrenia. This can lead to delays in identifying either condition.
Family members and healthcare providers need to be aware of the various ways these co-occurring conditions can present. Early identification leads to more effective treatment and better outcomes.
- Changes in daily routine: Sudden shifts in sleep patterns, eating habits, or personal hygiene
- Unpredictable actions: Behavior that seems out of character or difficult to understand
- Neglected responsibilities: Declining performance at work or school, or failure to meet family obligations
- Unusual movements: Repetitive actions, restlessness, or slowed movements
- Risk-taking behaviors: Engaging in dangerous activities or illegal behavior to obtain substances
- Hallucinations: Seeing, hearing, feeling, or smelling things that aren’t there
- Delusions: Strong beliefs that aren’t based in reality, such as believing one is being followed or that thoughts are being controlled
- Disorganized thinking: Difficulty organizing thoughts or connecting them logically
- Mood changes: Rapid shifts between different emotional states or inappropriate emotional responses
- Paranoia: Extreme and irrational distrust of others
- Sleep disturbances: Insomnia, excessive sleeping, or irregular sleep patterns
- Appetite changes: Significant weight loss or gain
- Physical coordination: Problems with balance or motor skills
- Physical health decline: Frequent illness or worsening of existing health conditions
- Substance-specific signs: Physical indicators related to specific substances (such as track marks, bloodshot eyes, or unusual odors)
- Social withdrawal: Reducing contact with friends and family
- Relationship problems: Increasing conflicts with loved ones
- New social circles: Spending time with people who use substances
- Isolation: Avoiding social situations entirely
- Communication changes: Speaking less or in ways that are difficult for others to understand
Understanding how these symptoms interact is crucial for proper diagnosis and treatment. For example, cannabis use might temporarily reduce anxiety but could worsen hallucinations. Similarly, alcohol might briefly improve mood but ultimately increase depression and interfere with antipsychotic medications.
If you notice these signs in yourself or someone you care about, a professional evaluation can help determine whether a dual diagnosis is present and what treatment approach would be most helpful.
Schizophrenia and Addiction Treatment
Integrated treatment means addressing both schizophrenia and addiction at the same time, by the same treatment team, in the same program. This approach recognizes that these conditions interact and influence each other, rather than existing as separate problems.
Research consistently shows that integrated treatment leads to better outcomes than sequential treatment (treating one condition first, then the other) or parallel treatment (treating both conditions but with separate providers who don’t coordinate care). Key elements of effective integrated treatment include:
- Comprehensive assessment that identifies all symptoms and how they interact
- Treatment planning that addresses both conditions simultaneously
- Cross-trained clinicians who understand both mental health and substance use disorders
- Consistent messaging about recovery across all members of the treatment team
At Peak Path Health, we use an integrated approach within our drug and alcohol treatment programs because research shows it reduces hospitalization rates, decreases substance use, improves psychiatric symptoms, and enhances overall quality of life.
Our residential treatment program at Peak Path Health provides a structured, immersive environment where clients can focus entirely on recovery. With 24/7 clinical supervision, personalized therapy sessions, and holistic support, our residential programs are ideal for individuals who need intensive care and stability while addressing both mental health and substance use challenges. Residential treatment ensures clients receive the guidance, safety, and tools necessary to build a strong foundation for long-term recovery.
At Peak Path Health, our dual diagnosis treatment program is designed for individuals facing both a mental health disorder, such as schizophrenia, and a substance use disorder. By providing integrated care that combines psychiatric support, medication management, and evidence-based therapies, we address both conditions simultaneously. This approach not only improves treatment outcomes but also reduces relapse risk, helping clients achieve lasting recovery in a supportive environment.
Medications play a crucial role in treating schizophrenia and can also help with substance use disorders. However, managing medications for people with co-occurring mental disorders requires special consideration.
Our psychiatric team tailors medication plans to each client’s needs. Antipsychotic medications may help stabilize mood and thinking, while medications for addiction, such as buprenorphine or naltrexone, can help reduce cravings. Long-acting injectable options are sometimes available for individuals who struggle with medication adherence.
Antipsychotics are the primary medications for schizophrenia. They work by regulating dopamine and other neurotransmitters in the brain. For people with co-occurring substance use disorders, several factors can influence medication selection:
- Some newer antipsychotics (second-generation) may help reduce cravings and substance use in addition to treating psychotic symptoms
- Medication side effects need careful monitoring, as they can lead to increased substance use if uncomfortable
- Long-acting injectable antipsychotics can improve consistency when medication adherence is challenging
When prescribing these medications, providers must consider potential interactions with antipsychotics and adjust dosages accordingly.
Several evidence-based therapies have proven effective for people with co-occurring schizophrenia and substance use disorders:
- Cognitive Behavioral Therapy (CBT): Helps individuals identify harmful thought patterns and replace them with healthier coping mechanisms.
- Dialectical Behavior Therapy (DBT): Focuses on mindfulness, distress tolerance, and emotional regulation.
Motivational Interviewing (MI): Builds internal motivation for lasting recovery. - Family Therapy: Involves loved ones in treatment to strengthen communication and support.
- Group Therapy: Provides a supportive environment for connection and accountability.
At Peak Path Health, these therapeutic approaches promote long-term stability and recovery.
Aftercare and Long-Term Support
- Peer support and relapse prevention planning
- Life skills training and vocational support
- Connection to community resources
Our goal is to help clients achieve long-term recovery and independence.
Treatment is Available for Schizophrenia and Addiction in Los Angeles, CA
Contact us today to learn how our schizophrenia and addiction treatment program in Los Angeles, CA, can help you or your loved one find stability and hope for the future.
Vana Agopian is a Licensed Clinical Social Worker with a unique background bridging entrepreneurship, advocacy, and clinical care. Drawn to a service-driven path, she developed therapeutic services in schools and supported children with autism through ABA therapy. She went on to serve seven years with Los Angeles County, specializing in child safety assessments, crisis intervention, and multidisciplinary collaboration. In the private sector, she has provided individual therapy, clinical assessments, and treatment center support.
Vana specializes in attachment theory, trauma-informed care, holistic healing, and family engagement. She holds a Master of Social Work and a Bachelor’s in Political Science and Law, and is bilingual in English and Armenian.
Her leadership ensures clients at Peak Path Health receive culturally competent, compassionate, and recovery-focused care.
