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Co-Occurring Mental Health Disorder: Schizophrenia

By DeAnza Bonzelaar

Substance use disorder and mental health disorder go hand in hand. In this post, we will look at psychosis in general, schizophrenia in particular, and the substances that can cause both.

Psychosis is defined as a gross impairment of reality testing. Features of psychotic disorders include:

  1. Hallucinations–sensory perceptions in the absence of external stimuli
  2. Delusions–firmly held false beliefs, even when there is evidence of the contrary
  3. Thought disorder–disruption in form or organization of thinking, seen from speech
  4. Disorganized or abnormal motor behavior
  5. Negative symptoms–decreased emotional expression, decrease in self-motivated and purposeful movements, no pleasure, asocial

Schizophrenia is a mental disorder “characterized by disruptions in thought processes, perceptions, emotional responsiveness, and social interactions.”¹ To be diagnosed with schizophrenia, one most display two or more of the above five features of psychosis for at least a month.

Substances can cause psychosis and lead to schizophrenia. During intoxication, sedatives, stimulants and designer drugs, cannabis, hallucinogens, and opioids can cause psychosis. With discontinuation, alcohol, benzos, toxins, steroids, anesthetics, and anticonvulsants can cause psychosis.

If you are engaging with someone who has schizophrenia, keep these things in mind:

  1. Pay attention to the emotions of the person
  2. Discuss the way you see the delusion
  3. Express that you are concerned about the person
  4. Offer to pursue therapy together but be strategic
  5. Ask the person why they believe as they do and be open-minded
  6. Avoid getting frustrated and expressing that to the person
  7. Learn about Cognitive Distortions or Thinking Errors


  1. “Schizophrenia,” National Institute of Mental Health (U.S. Department of Health and Human Services, n.d.), accessed August 11, 2022,

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