Schizophrenia & Cocaine Use

Cocaine is widely abused in various forms. It is potent, euphoric, and powerfully addictive. 

In recent decades, cocaine use has also become strongly associated with the mental health disorder schizophrenia for a number of reasons.

Cocaine Use Disorder & Schizophrenia

There is a misconception that cocaine use is a cause of schizophrenia. However, this is not true.

While the cause of schizophrenia is not fully understood, health care experts understand it to be something you are either born with the potential to develop, or not. 

This potential, which may involve issues with the neurotransmitters dopamine and glutamate, is then triggered by specific environmental factors, including:

• pregnancy and birth complications
• childhood trauma
• changing environments
• social isolation
• urban settings
• substance abuse

While cocaine use does not cause schizophrenia, it can contribute to its development among those born with particular genetic predispositions. 

Self-Medication

In addition, there is a high prevalence of comorbid substance abuse among those with mental disorders. 

Many seek out substances like alcohol, opioids, or cocaine in an attempt to self-medicate, using drugs to help cope with the discomfort, confusion, and distress that schizophrenia and other serious mental illnesses can cause.

Symptoms Of Schizophrenia

Symptoms of schizophrenia typically start in the early to mid-20s for men, and in the late 20s for women. These include both positive and negative symptoms.

Positive Symptoms

Positive symptoms are those that involve changes in behavior or thinking, including:

• delusions, or coming to believe things that are not based in reality
• hallucinations, or hearing/seeing things that are not real
• disorganized thinking and speech, or being unable to properly communicate
• disorganized or abnormal movements and postures

Negative Symptoms

Negative symptoms are those associated with a reduction in activity or participation in daily life. These symptoms may include:

• reduced motivation to work, study, or meet other responsibilities
• lack of outward emotion
• no eye contact
• inability to feel pleasure
• lack of self-care or personal hygiene
• irritability and depression

Symptoms Of Cocaine Use Disorder

Cocaine use can cause a number of symptoms which are strikingly similar to schizophrenia. While an individual is high, symptoms of cocaine use may include:

• elevated mood and energy level
• sensitivity to sight, touch, or sound
• restlessness
• paranoia
• dilated pupils
• increased body temperature, blood pressure, and heart rate
• loss of appetite
• reduced inhibition
• unpredictable movement

After the high wears off, the effects of cocaine comedowns or crashes often include:

• exhaustion
• depression
• anxiety
• difficulty sleeping or excessive sleep
• neglect of self-care, including dehydration, malnourishment, and poor hygiene
• withdrawal and secrecy
• mood swings
• paranoia
• lack of initiative, motivation, or interest in normal activities
• psychosis

Cocaine-Induced Psychosis

​Psychotic symptoms are some of the most severe side effects associated with cocaine substance use disorder. 

Stimulant drug use, including cocaine, methamphetamine, and amphetamine, greatly increases dopamine activity for a short period in the brain, resulting in a euphoric high. 

But because cocaine provides such a short-lived rush, it is sometimes used repeatedly and binged for days at a time. As this use continues, however, the body downregulates dopamine receptors until cocaine loses its effect, leaving individuals with a severe dopamine deficiency. 

This deficiency can then trigger psychosis, with individuals crashing into a psychotic episode with symptoms that may include: 

• paranoia
• anxiety
• delusions
• anger
• hallucinations
• delirium
• suicidal or homicidal impulses
• disorganized thinking 

Cocaine-Induced Psychosis & Schizophrenia

Unfortunately, those with a psychiatric disorder like schizophrenia may encounter activation of stimulant psychosis at much lower doses than would cause psychosis in members of the general population. 

And with continued drug abuse, they may become increasingly sensitized to stimulant drugs and have an increased risk of hospitalization and serious harm as a result.

Dual Diagnosis Treatment Options

While cocaine addiction may not cause schizophrenia, it can impact the treatment of schizophrenic patients. 

Those with schizophrenia and an addiction to cocaine may be less likely to seek treatment, which likely requires an integrated and comprehensive dual diagnosis treatment program to address schizophrenic symptoms and addiction.

Inpatient Treatment For Both Conditions

Clinicians can best provide dual diagnosis care in an inpatient setting, where both the drug addiction and mental illness can be addressed simultaneously. 

Schizophrenia is likely first treated with antipsychotic medications. Treatment providers attempt to find the best combination of drugs to manage symptoms at the lowest possible dose. Further treatments involve varied forms of therapy, social skills training, and vocational rehabilitation.

Substance abuse treatment for cocaine addiction begins with medical detox, followed by motivational or behavioral therapy like contingency management.

If you or a loved one struggles with addiction and one or more comorbidities, including schizophrenia, professional treatment can help. To learn more, please contact us today.