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OF mental health care and mentally ill

SUBSTANCE MISUSE IN PEOPLE WITH PSYCHIATRIC

Having described the possible impact of some commonly misused drugs on mental health, it may be useful to approach the situation from the perspective of substance misuse in people with diagnosed psychiatric disorders.
Studies show that up to 50% of people with schizophrenia have either a drug or alcohol problem. Both conditions feature the impairment
of social functioning, cognitive ability, emotional state and relationships; so it is understandable that, when combined, the impact of both conditions compounds any initial symptoms or features. Substance misuse may worsen existing psychotic
features of schizophrenia, such as hallucinations, delusions and lack of insight, or the same individual may experience these features as a direct consequence of their substance misuse. The resulting experience will depend on the type and strength of the drug used.
Cocaine, cannabis and alcohol have been noted to exacerbate existing psychotic symptoms and to affect treatment of the condition. Service users report things differently. They report using non-prescribed drugs to alleviate boredom, help to socialise, relieve anxiety and depression, help with sleep or to cope with the side effects of prescribed medication.

The effects of non-prescribed drugs tend to be short lived, and the service user then has to cope with any experience of withdrawal and activity associated with getting and paying for the drugs. Mental health service users are then engaged in illegal activity and vulnerable to arrest and involvement with the criminal justice system.
Substance misuse is recognised to be detrimental to the long-term outcome and prognosis of schizophrenia. Working effectively with this group of people presents challenges to service delivery and attitudes to substance misuse. There is often discrepancy between what the service and the service user see as a priority in terms of which of the service user’s needs should be addressed first. Only by understanding the service user’s experience of their life can staff engage and begin the process of intervention .

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