Substance abuse is a common concern of the family and friends of people with
schizophrenia. Since some people who abuse drugs may show symptoms
similar to those of schizophrenia, people with schizophrenia may
be mistaken for people "high on drugs." While most researchers
do not believe that substance abuse causes schizophrenia, people
who have schizophrenia often abuse alcohol and/or drugs, and may
have particularly bad reactions to certain drugs. Substance abuse
can reduce the effectiveness of treatment for schizophrenia. Stimulants
(such as amphetamines or cocaine) may cause major problems for
patients with schizophrenia, as may PCP or marijuana. In fact,
some people experience a worsening of their schizophrenic symptoms
when they are taking such drugs. Substance abuse also reduces
the likelihood that patients will follow the treatment plans recommended
by their doctors. Schizophrenia and Nicotine The most common form
of substance use disorder in people with schizophrenia is nicotine
dependence due to smoking. While the prevalence of smoking in
the U.S. population is about 25 to 30 percent, the prevalence
among people with schizophrenia is approximately three times as
high. Research has shown that the relationship between smoking
and schizophrenia is complex. Although people with schizophrenia
may smoke to self medicate their symptoms, smoking has been found
to interfere with the response to antipsychotic drugs. Several
studies have found that schizophrenia patients who smoke need
higher doses of antipsychotic medication. Quitting smoking may
be especially difficult for people with schizophrenia, because
the symptoms of nicotine withdrawal may cause a temporary worsening
of schizophrenia symptoms. However, smoking cessation strategies
that include nicotine replacement methods may be effective. Doctors
should carefully monitor medication dosage and response when patients
with schizophrenia either start or stop smoking. BACK
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Schizophrenia often affects a person's ability to "think straight."
Thoughts may come and go rapidly; the person may not be able to concentrate
on one thought for very long and may be easily distracted, unable to focus attention.
People with schizophrenia may not be able to sort out what is relevant and
what is not relevant to a situation. The person may be unable to connect thoughts
into logical sequences, with thoughts becoming disorganized and fragmented.
This lack of logical continuity of thought, termed "thought disorder,"
can make conversation very difficult and may contribute to social isolation.
If people cannot make sense of what an individual is saying, they are likely
to become uncomfortable and tend to leave that person alone.
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