The Link Between Drug Addiction and Under-diagnosed/misdiagnosed Schizophrenia

In a world where drug addiction is moderately common, it is quite typical to see an abuser struggling with their addiction almost anywhere they go. Whether they are simply walking down the street, in a restaurant, or even in a “family-friendly” environment, abusers of drugs are typically always in a constant struggle with their addiction. Statistics are continuing to increase, with “an estimated 23.9 million Americans aged 12 or older using an illicit drug or abusing psychotherapeutic medication in the past month, which is up from 8.3 % in 2002”. While it is extremely sad to see this, most people are completely unknowing that their addiction may come from an unaware or falsely diagnosed schizophrenia case. People suffering from drug addiction need to make sure they are getting proper treatments because their addiction may come from under-diagnosed or misdiagnosed schizophrenia.

It is important for people with addiction to get the proper treatment they need, as well as to educate themselves on schizophrenia and everything that comes with it. Schizophrenia is a long-term, often life long, mental disorder affecting the relation between thought, emotion, and behavior, leading to faulty perception, inappropriate and unusual actions and feelings, confusion from reality and personal relationships into fantasy and delusion, and a sense of mental fragmentation. It is often confused with bipolar diseases, personality disorders, and delusional disorders, but the symptoms slightly vary. With about half of schizophrenic patients having a history or current addiction of drugs (Winklbaur et al. 1), it is important for abusers to realize their addiction could have sparked from schizophrenia. The under-diagnosis and misdiagnosis of schizophrenia is quite common, and “approximately 30% of people with schizophrenia experiencing a severe lack of awareness of their diagnosis” (Anosognosia 1). Getting better is nearly impossible if the disease has been falsely diagnosed, and it is important for drug abusers to personally make sure they are not ignorant to the possibility they might be home to the vicious disease.

With there being five different types of schizophrenia, paranoid, catatonic, disorganized, undifferentiated, and residual, it might be more likely for the drug-like symptom types to be sparked by drug abuse. It is quite common for certain types of drugs to be like what patients feel when they are diagnosed with paranoid and catatonic schizophrenia. For example, LSD can cause hallucinations and paranoia, just like those types of schizophrenia. It is hard for a person to differentiate what is real and what is not when they are diagnosed with catatonic schizophrenia, and many psychedelic drugs give off those same symptoms. Drugs can make you feel the way certain types of schizophrenia do; therefore, the two diseases are commonly misdiagnosed. In a recent article called “Schizophrenia and Street Drugs”, it was stated that “a number of drugs used illicitly for recreational purposes do cause symptoms like those experienced in psychosis”. It is essential for drug abusers who have not yet been diagnosed with schizophrenia to become aware that their awful abuse symptoms could also be from schizophrenia.

Along with the five different types, each one is susceptible to having four different categories of symptoms. Depending on the category, some categories' effectiveness is much worse than others. These categories include, positive, negative, cognitive, and disorganization. The positive category, which includes the symptoms of hallucinations or hearing voices, delusions, and thought disorders or dysfunctional ways of thinking, is the category that correlates with the misuse of drugs. Although this is just one category out of four, this category can overtake a patient's entire disease if they submit to the abusing of drugs. The other three categories which hold symptoms like lack of motivation, trouble focusing, reduced expression of emotion, and lack of concentration are not nearly as serious as category one. While it would be difficult to complete certain tasks and focus on important things with the other three category symptoms, it would still be possible to live a close-to-normal everyday life. On the other hand, if category one took over, hallucinating and hearing voices every day would make it difficult to complete one's day to day tasks.

If patients use trigger drugs to make their hallucinations and delusions more susceptible to occur, category one, or the positive category, could take over their entire disease, leaving the other categories as a minor and distant memory. If a person with a drug addiction is constantly experiencing category one symptoms, it is likely that they have schizophrenia and should seriously consider going and getting the treatment they need. Whether or not they think it is just a coincidence and they are only having these symptoms because of the drugs they are using, the most common misdiagnosis of schizophrenia is drug abuse and addiction. “Schizophrenia is often mistaken for substance abuse because the disorders have similar symptoms. This can sometimes make it difficult to diagnose schizophrenia or co-occurring disorders” (Juergens 1). It is extremely important to be open and vulnerable to the fact that one’s addiction could have been sparked from schizophrenia.

As a fact, schizophrenia is mostly caused by genetics and is primarily hereditary. Drug abusers with a family history of schizophrenia need to be more precautious than those who do not. If one's sibling, parent, or grandparent have been infected with the brutal disease, it is exceptionally necessary for them to constantly be aware and in touch with their feelings, and to always be on the lookout for signs or symptoms of the disease. With there being as many as four out of five cases of schizophrenia being linked back to genetics, families whose DNA carries the schizophrenia gene must always be on the lookout for any signs or symptoms that might associate their disease, and especially need to avoid any drugs or alcohol that might mock their symptoms. If one is even suspicious, they might have contracted schizophrenia, they should seek help immediately and refrain from being oblivious towards the problem, in order to prevent a worse outcome. In October of 2017, a study was conducted using 31,524 pairs of identical twins all born between 1951 and 2000. Identical twins all inherit the same set of genes from their parents. It was found that almost every individual twin who was diagnosed with schizophrenia, the other twin sibling also carried the disease. The study concluded that “about 80% of schizophrenic patients got it from pure genetics” (McRae 1). If an abuser is unaware if their family has a history of schizophrenia, it is still important to get as much information as possible and continue to consider receiving an official diagnosis, despite the smaller chance of them having it.

With schizophrenia being only about 80% hereditary, it has been a constant battle to discover what could make up the rest. With theories of the causes being outside environmental factors, random mutated genes, childhood trauma or PTSD, and drug abuse, it is important to take all of these into consideration when trying to determine if a person could be diagnosed. There have been many studies, surveys, and articles researching this same statement, and five real categories that cause the disease have been discovered. The remaining 20% of schizophrenia causes are made up of five things, “structural changes in the brain, chemical changes in the brain, pregnancy or birth complications, childhood trauma, or previous drug use”. Continuously, drug abuse is a trigger of setting off one's schizophrenia symptoms. The use of prescribed and illegal drugs is able to set off certain symptoms, especially if one is not receiving treatment. In order to prevent setting off symptoms, abusers need to realize drugs are more dangerous if they are being used while they carry the disease.

Even if an abuser does not have a family history of schizophrenia, they should not rule out the chance of them having it now or later in life. People have a slightly better chance of developing schizophrenia later in life if they abuse drugs due to certain changes in the brain. A recent study was conducted in order to prove whether schizophrenia could develop in a person during their older age based on drug abuse. The study was said to prove that almost any type of drug abuse can increase the risk of eventually getting schizophrenia. The investigators used data from 3,133,968 individuals born between 1955-1999 nationwide. In all, they identified more than 200,000 cases of substance abuse and over 21,000 schizophrenia diagnoses. The authors of this study concluded that their results “illustrate a robust association between almost any type of substance abuse and an increased risk of developing schizophrenia later in life” (Newman 1). Although most feel as if they are safe from the disease if they have no family history, it is vital that people with addiction are not ignoring their symptoms and side effects and get a proper diagnosis in order to help themselves.

Unfortunately, the abuser’s addiction makes things much worse for their disease. One can only imagine living in paranoia and fear forever but adding that with psychedelic and hallucinogenic drugs creates an absolute monster. An article by Amy Carmosino states that, “Using drugs such as cocaine, amphetamines, and marijuana can also increase schizophrenic symptoms and worsen their severity. Also, people who have schizophrenia often abuse alcohol or drugs, and may experience particularly bad reactions to certain drugs”. Worsening schizophrenia symptoms could lead to extreme consequences like being hospitalized or doing unjustified and dangerous activities. For example, if one takes a hallucinogenic drug, becomes even more severely paranoid, and imagines one of their family members is out to get them (fearing someone or something always wants to hurt you is a common side effect of serious schizophrenia), the patient could ultimately severely hurt or even kill their family member because of their over-paranoia. Because it is proven that drug abuse worsens schizophrenia symptoms, abusers need to be careful and take their first steps into getting the help they seriously need.

Schizophrenia can be a touchy subject to some victims, and even if they are aware that they might have it, they could remain in a state of secrecy or denial. Some do not want people close to them to know about their disease, so coming to terms with it might become more difficult. A survey conducted in June of 2008 whose purpose was to see how people would react if they were diagnosed with schizophrenia reported that 46% of the people surveyed would not be comfortable telling their friends or family members that they contracted the disease (Fitzpatrick 11). Some users will under-diagnose themselves and continue to allow their minds to believe the only problem they have is drug abuse. Until an abuser comes to terms that they need professional help, they will only make their disease worse.

There are many paths abusers can take treatment wise. While people suffering from drug abuse may seem like they are going down a hopeless path, there are many ways to help. The first step that is an absolute necessity is to accept there is a chance the disease is there and to ask for help. Receiving a diagnosis is the only way to get valid treatment for the disease, so abusers must be open minded in accepting that they have the vicious disease and that they need serious treatment. After that, a clinically reviewed article by James Juergens states that “generally, detox—the process of removing drugs from the user’s system—is the first step in dual diagnosis treatment. Once the user’s body is free of the substance, a clinical team can better assess the patient’s schizophrenia symptoms and determine the best course of treatment”. It is extremely possible for one to become clean of their abuse, causing their category one symptoms to let up. It could decrease their risk of a bad reaction and overall increase their personal safety. Following that, a multitude of treatments can be provided once the best course of treatment is determined. Treatment is usually lifelong and often includes different combinations of medicines, psychotherapy, and specialty care services.

As drug addiction becomes more and more common among individuals, it is important to be educated on where a person’s addiction came from. Schizophrenia ultimately can spark the beginning of a life filled with the abuse of drugs, and it is necessary that abusers act for themselves and get the proper treatment they need. Drug abusers need to become educated about schizophrenia to prevent their disease from being under-diagnosed or misdiagnosed in order to get necessary treatment.

Works Cited

1. “Anosognosia.” NAMI, National Alliance on Mental Illness, 2015, www.nami.org/AboutMental-Illness/Common-with-Mental-Illness/Anosognosia.
2. Carmosino, Amy. “Schizophrenia and Substance Abuse.” Psych Central, Addiction Center, 17 Jan. 2020, psychcentral.com/lib/schizophrenia-and-substance-abuse/.
3. Fitzpatrick, Michael. “Schizophrenia: Public Attitudes, Personal Needs.” Survey. The National Alliance on Mental Illness. NAMI, 10 Jun. 2018, www.nami.org/getattachment/About-NAMI/Publications/Surveys/SchizeExecSummary.pdf.
4. Holland, Kimberly. “5 Schizophrenia Causes: Plus, How to Treat and Seek Help.” Healthline, Healthline Media, 21 Feb. 2020, www.healthline.com/health/schizophrenia-causes
5. Juergens, Jeffry. “Schizophrenia and Addiction.” Addiction Center, 17 Sept. 2020, www.addictioncenter.com/addiction/schizophrenia/
6. McRae, Mike. “Schizophrenia Is 80% Genetic, According to This Massive New Study on Twins.” ScienceAlert, Biological Psychiatry, 6 Oct. 2017, www.sciencealert.com/schizophrenia-is-80-genetic-according-to-this-massive-study-on-twins.
7. “Nationwide Trends.” National Institute on Drug Abuse, U.S. Department of Health and Human Services, Jan. 2014, www.drugabuse.gov/.