Nearly a quarter of people with schizophrenia have had alcohol use disorder at some point in their lives. If you’re in need of help, treatment options are available right now.
Alcohol use disorder (AUD) is the most common co-occurring disorder in people with schizophrenia.
Schizophrenia by itself is a mental health condition primarily characterized by hallucinations, delusions, disorganization, and cognitive impairment.
When alcohol use is added to these symptoms, it can significantly affect the course of your experience with schizophrenia and interfere with treatment.
A 2018 review of 123 studies found that 24.3% of people with schizophrenia have had AUD at some point in their lives.
Overall, people living with schizophrenia typically drink alcohol to temporarily feel better.
They may drink alcohol to seek relief from feelings of hopelessness or to help relieve symptoms they may experience.
While the exact mechanisms contributing to increased substance use in people with schizophrenia are unknown, there are likely several contributing factors.
It’s believed that genetics, environmental factors, and dysfunction in the brain’s reward system may all play a role.
In addition, people with schizophrenia are at
Researchers in one genome-wide
For instance, abnormalities in the brain’s reward system (commonly seen in both schizophrenia and substance use disorder) may lead adolescents who may experience psychosis to use alcohol at greater rates than other teens.
The alcohol use itself may trigger the onset of schizophrenia or lead to continued substance use.
According to a 2019 research review, one study found that out of 404 participants,
The use of alcohol often leads to severe effects for people with schizophrenia, but many find it difficult to quit drinking. However, support is available to start and maintain recovery.
Among people with schizophrenia, AUD is
- not following treatment (e.g., not taking medication)
- chronic physical problems
- housing instability
- aggression or violence
If you’re considering self-harm or suicide, you’re not alone
You can access free support right away with these resources:
- The National Suicide Prevention Lifeline. Call the Lifeline at 800-273-8255 for English or 888-628-9454 for Spanish, 24 hours a day, 7 days a week.
- The Crisis Text Line. Text HOME to the Crisis Text Line at 741741.
- The Trevor Project. LGBTQIA+ and under 25 years old? Call 866-488-7386, text “START” to 678678, or chat online 24/7.
- Veterans Crisis Line. Call 800-273-8255, text 838255, or chat online 24/7.
- Deaf Crisis Line. Call 321-800-3323, text “HAND” to 839863, or visit their website.
- Befrienders Worldwide. This international crisis helpline network can help you find a local helpline.
Symptoms of psychosis can arise from acute alcohol intoxication, alcohol withdrawal, or long-term alcohol use.
In alcohol hallucinosis, symptoms of psychosis are directly related to alcohol use. They resolve when alcohol consumption stops.
It’s similar to schizophrenia in that it involves hallucinations, paranoia, and fear, but it’s considered a separate and relatively rare condition.
In contrast, alcohol can also trigger first-episode psychosis if there are increased chances of developing schizophrenia.
A medication regimen that addresses both psychosis and AUD is the typical treatment for these conditions. Other types of therapies may be used as well.
Specific treatment depends on whether the psychosis was temporarily induced by alcohol or if you have a primary psychotic disorder with AUD.
Treatment for alcohol-induced psychosis
If you seek emergency care for alcohol-induced psychosis, healthcare professionals will need to first determine whether the psychosis is temporary or if alcohol use triggered the onset of schizophrenia.
Treatment for alcohol-induced psychosis requires a supportive environment, sometimes with short-term antipsychotic treatment. Abstaining from alcohol following treatment
Researchers from a
However, 25% of psychosis cases persist, they report, resulting in a diagnosis of schizophrenia spectrum disorder.
Treatment for schizophrenia and AUD
If you have schizophrenia and co-occurring AUD, treatment typically includes long-term antipsychotic medication use, psychosocial interventions, and medication for alcohol dependence. It’s very important that both conditions are treated simultaneously.
When it comes to schizophrenia medication, the newer class of antipsychotic drugs — called “atypical” or “second-generation” antipsychotics — appear to work better for alcohol dependence than the older “first-generation” drugs.
Results show that a larger proportion of people treated with clozapine achieved remission from AUD, compared with those taking another antipsychotic drug. Participants taking clozapine also had lower relapse rates a year later.
Psychosocial interventions for schizophrenia and AUD
Psychosocial interventions address a person’s social and cultural environment, and target any problematic psychological and behavioral patterns.
Two well-studied interventions for people with schizophrenia and AUD include contingency management and assertive community treatment (ACT).
Contingency management is a type of behavioral therapy in which a person is rewarded or incentivized for positive behavior. It’s been shown to be effective for people with schizophrenia and AUD.
This type of therapy involves agreed-upon, immediate, tangible rewards for positive behaviors, such as abstinence from alcohol.
Assertive community treatment (ACT)
Assertive community treatment (ACT) is the most widely tested model of community care for people with severe mental health conditions. ACT has been shown to help people with co-occurring schizophrenia and AUD.
The goal is to help people with severe mental health conditions continue to live in their community of choice.
This intervention involves a treatment team, typically a psychiatrist, social workers, nurses, occupational therapists, and peer support. There is a low participant-to-staff ratio.
Clients are assisted with physical and mental health care and substance use treatment. They also receive support with housing, daily living activities, employment, and financial management.
Visits are provided at the client’s home or another place of their choosing.
Alcohol use disorder (AUD) is commonly seen in people with schizophrenia. If you or someone you love has schizophrenia and AUD, know you’re not alone and support is available.
Consider speaking with a healthcare professional to discuss treatment options. There are many effective interventions that can help you on your journey to wellness.