Last Updated:

January 30th, 2026

Schizophrenia and addiction

What is schizophrenia?

Schizophrenia is a mental health condition that influences how a person interprets the world. It affects thinking, emotions and behaviour in ways that can disrupt daily functioning and create periods of significant distress. Schizophrenia does not mean a person has multiple personalities; instead, it describes a pattern of symptoms that can change how someone perceives reality and understands their own experiences.

In the UK, schizophrenia affects a smaller percentage of the population compared with conditions like anxiety or depression, yet its impact can be far-reaching. The condition usually begins in late adolescence or early adulthood, although the early signs can be subtle. Difficulties with concentration, reduced motivation and changes in emotional expression can be early indicators, while later stages may bring hallucinations, delusions or disorganised thinking.

Schizophrenia varies greatly between individuals. Some experience symptoms that stay relatively stable with treatment, while others face more unpredictable periods that require additional support. Because the condition influences multiple areas of functioning, a tailored approach is essential for helping the person stay grounded, connected and able to manage their symptoms.

woman suffering Schizophrenia

What are the signs of schizophrenia?

The signs of schizophrenia can emerge gradually, eventually creating a pattern that becomes difficult to overlook. These patterns influence how a person thinks, feels and relates to the world, building in ways that create confusion or emotional strain.

Common signs of schizophrenia include:

  • Hallucinations
  • Delusional beliefs that feel completely real to the person
  • Disorganised thinking
  • Reduced emotional expression
  • Difficulty with cognitive functions
  • A decline in the ability to complete daily tasks

If several of these signs have been present and are affecting a person’s ability to function, speaking with a professional can help clarify whether schizophrenia may be contributing to these experiences.

How can schizophrenia impact a person’s life?

Schizophrenia can make it hard to concentrate, remember information and learn new things. Because of this, many people struggle to keep up with school or work. Some describe trying to study but feeling like nothing stays in their mind, while others say even simple work tasks become difficult and lead to frequent mistakes. These challenges can lower confidence and make people feel inadequate. This lines up with real-world data showing that only about 10-30% of people with schizophrenia are employed at any given time.

Schizophrenia can also place a lot of strain on relationships. Difficulties with communication and social understanding can lead to misunderstandings or long silences during conversations. Many people report that they struggle to follow what others are saying or need things repeated several times. Family members or partners may misinterpret this as not listening, which can create frustration on both sides.

Schizophrenia affects physical health as well as mental health. Research shows it increases the risk of sleep problems and eating difficulties, which means many people experience irregular sleep patterns or changes in appetite. These issues can combine with lifestyle factors such as smoking, inactivity or unbalanced diets. As a result, people with schizophrenia have much higher rates of conditions like heart disease, diabetes and stroke. Their overall health can suffer significantly and studies show that life expectancy is 15-20 years shorter than average, mostly due to preventable medical illnesses.

One of the most concerning impacts is the relationship between schizophrenia and addiction, something explored in the next section.

Links between schizophrenia and addiction

While schizophrenia does not guarantee that an addiction will develop, certain symptoms, such as distressing hallucinations or unwanted thoughts, may contribute to reliance on substances or compulsive behaviours.

Below, we take a look at some of the most commonly associated addictions with schizophrenia:

  • Schizophrenia and alcohol addiction – Studies report that alcohol use disorder is the second most common comorbidity in schizophrenia, with around 20% lifetime prevalence. The study notes a bidirectional link in that AUD raises the odds of psychotic experiences by 1.6x and psychosis raises AUD risk by 1.5x.
  • Schizophrenia and drug addiction – Research found that around 27.5% of schizophrenia outpatients met the criteria for lifetime drug addiction (excluding alcohol), which is 3-6 times higher than the general population rate.
  • Schizophrenia and cannabis addiction – Studies have found that cannabis is the most common illicit drug used by people with schizophrenia. 43% of patients develop a cannabis use disorder vs around 6% for the general population.

woman has Schizophrenia issue

  • Schizophrenia and stimulant drug addiction – Recent research shows that schizophrenia and stimulant addiction share some of the same genetic and biological risk factors. For example, people with a higher genetic risk for schizophrenia are also more likely to develop cocaine addiction and studies on methamphetamine have found that some of the same genetic markers linked to meth-induced psychosis appear more often in people with schizophrenia.

This suggests that both conditions may involve similar dopamine-related and inflammatory processes in the brain, which can increase vulnerability to psychosis and stimulant addiction.

How are those with schizophrenia and addiction treated?

When schizophrenia and addiction appear together, treatment is most effective when both conditions are addressed through an integrated approach. Focusing on one without acknowledging the other leaves significant challenges in place, particularly when the addiction has developed in response to schizophrenic symptoms, like paranoia.

Therapies used in addiction treatment can be adapted to support someone living with schizophrenia. CBT, for example, helps explore intrusive thoughts and beliefs that feed both conditions, while DBT offers grounding strategies during intense emotional states. Some programmes introduce calming therapies, such as art or mindfulness-based approaches, which give the person safe ways to settle their nervous system without relying on harmful coping mechanisms.

Does addiction rehab differ for those with schizophrenia?

The general structure of rehab stays similar, yet certain adjustments create a sense of safety for someone living with schizophrenia. Detox can feel unsettling because physical and emotional changes happen quickly. A predictable routine and clear explanations of each stage help reduce confusion and fear during early withdrawal.

Therapy sessions consider how schizophrenia influences thinking patterns and daily functioning, with sessions exploring distressing beliefs or the impact of hallucinations on decision-making. As these links become clearer, the person gains a more grounded understanding of their symptoms and how they connect to addictive behaviour.

The next steps

If you’re living with schizophrenia and concerned about your relationship with substances or compulsive behaviours, you don’t need to work through this alone. Speaking with an addiction specialist can help you understand what support is available and how both conditions can be addressed in a way that feels manageable. Reaching out can create a clearer path forward and give you the reassurance that change is possible.

Frequently Asked Questions

Is schizophrenia genetic?
Genetics play a significant role in schizophrenia. A family history increases the likelihood but it does not guarantee the condition. Environmental pressures and life stress can also influence whether symptoms appear.
Can an addiction lead to schizophrenia?
Addiction does not directly cause schizophrenia but certain substances can trigger symptoms in people already vulnerable. Heavy use can also worsen existing symptoms and make early warning signs harder to recognise.
What is the difference between ‘paranoid schizophrenia’ and ‘catatonic schizophrenia’?
Paranoid schizophrenia involves distressing beliefs or heightened mistrust, while catatonic schizophrenia involves movement-based difficulties. These terms are now less common, with clinicians viewing schizophrenia as a spectrum rather than fixed subtypes.

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