Substance Use

Alcohol and/or street drugs are rarely the primary cause of a long-standing psychosis. However, drugs may trigger psychosis in an individual who is vulnerable to developing psychosis. Certain drugs like cocaine and crystal meth may directly produce psychosis but this usually goes away when the effects of the drug wear off. In persons who have developed psychosis, using alcohol and/or street drugs may worsen their symptoms, increase the chances of relapses, and impair the protective effects of antipsychotic medications.

Drug use can complicate the treatment of the person with psychosis because they may be more difficult to engage in treatment programs, vocational programs, or therapy. There are also potential financial, legal, health, housing, interpersonal, and family problems associated with a person with psychosis using street drugs and/or alcohol.

The term “concurrent disorder” refers to the combination of a major mental illness and a substance abuse disorder.

Even if a person does not have a substance use disorder, he or she may still use drugs and suffer because of the negative interactions between drugs and psychosis. The rate of significant drug use among persons with psychosis is often found to be around 50%.

A person with psychosis may use drugs and/or alcohol for many of the same reasons as other persons.  For example:

  • To relieve boredom or negative mood states (e.g. an attitude adjustment)
  • To feel pleasure
  • To act as a member of a social group
  • To deal with the side effects of medication
  • To temporarily relieve symptoms of the illness

Some family members may neglect to mention their relative’s drug or alcohol abuse to health care professionals because they believe it is a symptom that will clear up once the person receives treatment for the mental illness.

What You Can Do

If possible, discuss with your family member’s mental health professional, doctor, etc. and consult on how you can help your family member or friend who is using alcohol and/or drugs.

  • Talk to your family member and ask in a straight-forward, matter of fact way if they are using alcohol and/or drugs. However, denial of alcohol and/or drug use is no guarantee that your family member is not using substances.
  • Avoid judgmental and/or blaming statements. Be willing to listen to them and ask questions that will help you to understand why they are drinking or using drugs.
  • Encourage them to find other ways to deal with stress, boredom or to feel part of a group.
  • Encourage them to use some of the harm-reduction tips and workbooks available.