SUBSTANCE USE LEADS TO SCHIZOPHRENIA
Experts, noting that substance use is always accompanied by a psychiatric disorder, stated that substance use—particularly in the presence of a genetic predisposition—can lead to schizophrenia and psychotic episodes.
Emphasizing that substances that lead to addiction increase dopamine levels in the brain, the experts said, “Elevated dopamine levels in the brain cause many other psychiatric disorders; in particular, schizophrenia—or what we call psychosis—is associated with elevated dopamine levels in the brain.”
Assistant Professor Dr. Onur Noyan, a psychiatrist at Üsküdar University NPİSTANBUL Hospital, noted that substance use rarely occurs in isolation and highlighted that it is almost always accompanied by a co-occurring psychiatric disorder.
Assistant Professor Dr. Onur Noyan said, “Substance use is very frequently seen alongside other psychiatric disorders. In 60% of people who use substances, an anxiety disorder is present; in 45% of cases, depression is present; and in 40% of cases, a psychotic disorder—or what we call schizophrenia—accompanies substance use.”
THE CHICKEN-AND-EGG QUESTION
Noting that the question “Do psychiatric disorders lead to substance use, or does substance use lead to psychiatric disorders?” resembles the chicken-and-egg dilemma, Assistant Professor Dr. Onur Noyan said the following:
“There is, of course, a very serious chicken-and-egg relationship at play here. Sometimes an underlying psychiatric disorder can lead to substance use. Other times, substance use can cause additional psychiatric disorders. And sometimes, two different disorders appear simultaneously, independent of one another, due to biological and genetic predispositions. At times, psychiatric disorders emerge in an individual without him realizing it. Since anxiety disorders, anxiety-related conditions, or depression may develop without the person noticing, he may turn to substance use as a way to cope with these emotions or thoughts.”
SUBSTANCE USE INCREASES DOPAMINE
Noting that this applies to all types of addiction but is particularly significant in substance use, Assistant Professor Dr. Onur Noyan stated, “This is because the substances we refer to as drugs increase dopamine in the brain. Elevated dopamine levels in the brain contribute to many other psychiatric disorders; in particular, schizophrenia—or what we call psychosis—is linked to elevated dopamine levels in the brain. Recent studies have shown that half of schizophrenia patients were exposed to and used substances during their adolescence,” he said.
A SINGLE DOSE CAN TRIGGER AN EPISODE
Assistant Professor Dr. Onur Noyan noted that if a person has a genetic predisposition to a psychiatric disorder, even a single use of a substance can accelerate the onset of that disorder, “In fact, it acts as a trigger; if the individual has a genetic predisposition to schizophrenia, even a single dose of the substance could cause that person to suddenly experience a psychotic episode or a schizophrenia episode,” he warned.
Noting that a family history of the disease in any relative is, of course, very important, Assistant Professor Dr. Onur Noyan stated, “If there is a history of schizophrenia among a person’s first-degree relatives, that person’s risk of developing schizophrenia is already several times higher than the general population’s. “Drugs can trigger this, but beyond that, we have a biological genetic code—even if none of our family members have it—if there is a genetic predisposition to schizophrenia, marijuana can trigger it and cause the condition to emerge suddenly,” he said.
ADDICTION AND PSYCHIATRIC DISEASES MUST BE TREATED SIMULTANEOUSLY
Emphasizing that one of the biggest problems in our country is the inability to treat substance addiction and other co-occurring psychiatric disorders simultaneously at state-run AMATEM centers, Assistant Professor Dr. Onur Noyan said, “If schizophrenia is the primary condition in a patient—even if there is concurrent substance use—they are treated as an inpatient in the general psychiatry ward. In this situation, the patient is deprived of addiction treatment. In our country, we need integrated units where both conditions can be treated simultaneously. The greatest feature of our hospital is that both conditions can be treated at the same time,” he said.