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1.12 - Approach to Substance Use Disorders in Schizophrenia Spectrum Disorders

from Part I - Treatment Strategies

Published online by Cambridge University Press:  19 October 2021

Michael Cummings
Affiliation:
University of California, Los Angeles
Stephen Stahl
Affiliation:
University of California, San Diego
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Summary

For many patients with schizophrenia, substance use predates the first psychotic episode. Patients suffering from their first psychotic break are more likely to be daily cannabis users and have a higher rate of tobacco use [1, 2]. Cannabis appears to exert a dose-dependent effect on the risk of developing a psychotic illness and illness onset is earlier [3]. Methamphetamine may increase the risk of schizophrenia on a par with cannabis [4]. Overall, 13–51% of patients entering treatment with their first psychotic episode have a co-occurring substance use disorder [5]. If substance use continues in parallel with a first-episode psychosis, patients fare more poorly in both the short and long terms.

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Publisher: Cambridge University Press
Print publication year: 2021

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