An Intervention for Substance Abuse in Schizophrenia

Abstract

Substance abuse in schizophrenia is a significant management problem for both clients and treatment agencies, impacting on psychotic symptoms, medication adherence, and participation in training and employment. However, there is little published work on the treatment of drug abuse in this population. This paper describes a cognitive-behavioural intervention for alcohol and cannabis abuse which integrates substance abuse treatment with other aspects of psychosis management.

Contrasting Views and Experiences of Health Professionals on the Management of Comorbid Substance Misuse and Mental Disorders

“…There is now substantial evidence that substance abuse in people with psychiatric disorders leads to poorer functional and symptomatic outcomes, and to higher treatment costs [6][7][8]. Substance use in psychosis can lead to housing instability, poorer self-care, concurrent medical disorders, antisocial relationships and disrupted motivation [6]. Substance use in psychosis can lead to housing instability, poorer self-care, concurrent medical disorders, antisocial relationships and disrupted motivation [6].…”

“…Substance abuse may lead to anxiety and depression and these are also exacerbated by intoxication by or withdrawal from several substances [11][12][13] and in some cases, substantial recovery can be obtained after a period of abstinence from substance use [12]. Despite the importance of the issue, the treatment of comorbid substance misuse and mental health problems has attracted very little research [6,7,17]. The association between substance misuse and mental health disorders is therefore an important and complex one.…”

“…The association between substance misuse and mental health disorders is therefore an important and complex one. Changes in substance use can impact on psychiatric symptoms or interact with psychotropic medication, and changes in symptomatic status sometimes trigger abrupt changes in substance use [6][7][8]. Despite the importance of the issue, the treatment of comorbid substance misuse and mental health problems has attracted very little research [6,7,17].…”

Troubles mentaux graves et abus de substances : composantes efficaces de progammes de traitements intégrés à l’intention des personnes présentant une comorbidité

“…Dif fé rents pro gram mes de trai te ments in té grés ont été dé ve lop pés au cours des der niè res an nées afin de ré pon dre aux be soins des per sonnes pré sen tant une co mor bi dité (Brady et al, 1996;Carey, 1996;Drake et al, 1991;Kavanagh, 1995;Minkoff, 1989;Osher et Kofoed, 1989;Rosenthal et al, 1992;Ziedonis et Fisher, 1996). Plu sieurs de ces program mes par ta gent une même phi lo so phie et leur in ter ven tion comprend les mê mes com po san tes fon da men ta les.…”

Substance misuse among clients with severe and enduring mental illness: Service utilisation and implications for clinical management

“…Young men living in poor, urban areas have been identified as being at particularly high risk of having these dual problems (Mueser et al, 1992). Several studies have reported particularly high rates of psychosocial difficulties among this group which have in-cluded family discord, financial difficulties, housing instability, homelessness, poor selfcare and legal entanglements (Drake & Wallach, 1989;O'Leary, 1997;Kavanagh, 1995). Several studies have reported particularly high rates of psychosocial difficulties among this group which have in-cluded family discord, financial difficulties, housing instability, homelessness, poor selfcare and legal entanglements (Drake & Wallach, 1989;O'Leary, 1997;Kavanagh, 1995).…”