Dual Diagnosis of Schizophrenia and Drug Abuse

Dual Diagnosis of Schizophrenia & Drug Abuse

Abstract

There is a high prevalence of illicit drug abuse among the adult population: However, the comorbidity of substance abuse and mental illness is equally as high (Conway, 2007) Evidence suggests that those suffering from mental illnesses, such as schizophrenia, do not always seek out the appropriate assistance from the medical community and alternatively turn to illicit narcotics to self-medicate (Glantz, 2009). My main focus will then be on the obstacles of determining a dual diagnosis in schizophrenic patients. The patients with concurrent disorders are very difficult to treat because each disorder has a capability of exacerbating the other.

There is a high prevalence of illicit drug abuse among the adult population; However, the comorbidity of substance abuse and mental illness is equally as high (Conway, Monterey, & Compton, 2007). Evidence suggests that those suffering from mental illnesses, such as schizophrenia do not always seek out the appropriate assistance from the medical community and alternatively turn to illicit narcotics to self-medicate (Glantz, Anthony, Berglund, Degenhardt, Dieker, et al., 2009) Diagnosis has become increasingly difficult, especially when attempting to determine whether the long-term effects of prolonged drug abuse exacerbated a mental illness or the effects of the drugs caused the mental illness (Schneiner, Foose, Hasin, Heimberg, Liu, et al., 2010; Johnson, Cloninger, Roache, Bordnick, Ruiz, 2000). Either way the perpetuation of illicit drugs spirals mental disorders into higher levels of dysfunction, making it more difficult for healthcare professionals to treat (Glantz, et al., 2009; Braddizza, Maisto, Vincent, Staslewiez, Connor, Mercer, 2009). This paper will examine the obstacles of compromising a diagnosis of schizophrenia with substance abuse, consider the aspects of finding appropriate diagnosis, discuss the long-term effect of comorbidity of physician prescribed treatments and self-medication, and provide suggested treatment options for those that suffer from schizophrenia and substance abuse.

There are many obstacles in determining a dual diagnosis in schizophrenic patients. The doctors start out prescribing medications to alleviate symptoms of schizophrenia but in turn like any other medications there are negative side effects to these drugs. The most common symptoms of schizophrenia are the positive ones which are hallucinations, delusions, bizarre behavior, and paranoia, but it is the less noticeable negative symptoms that can delay treatment. A culmination of common schizophrenic symptoms combined with attributes of acceptable deficiencies with social interaction, inappropriate emotional expression and lack of motivation, or negative symptoms, often result in hospitalization (Schneiner, 2010). Upon the initial diagnosis and prescription of the appropriate pharmaceutical cocktail symptoms can remain out of control from anywhere from three weeks to months. There are two categories of medications used, the first being traditional antipsychotics which target the more obvious symptoms and the second being atypical antipsychotics which target the more subtle symptoms. Aside from some of the more common side effects of these drugs, include nausea and vomiting, weight gain, and sedation, patients may be unresponsive to certain pharmaceutical combinations or have more severe reactions (Tenhula, 2009). More than likely, patients will remain in a psychiatric facility until the side effects may where off or the doctor finds the medication combination that subsides the symptoms enough for the patients to reenter society.

Nevertheless, patients must face leaving a controlled environment with the realization that life-long medication is costly and they feel better, not necessarily realizing the medication is responsible and decide to stop being compliant (Glantz, 2009). Before long the symptoms reappear and whatever the case may be the patients may turn to illicit drugs such as alcohol, cannabis or stimulants such as cocaine to alter their state of mind to achieve the stability they had while under the care of the physician. Unfortunately, a more extensive problem arises when a patient cannot subside the symptoms without the assistance of the doctor, but fails to inform his or her physician of the illicit drug use. At his point a dual diagnosis must be concluded, but only if the patient surrenders the information or the physician is acute enough to distinguish the behaviors associated with schizophrenia from those exhibited by prolonged