SUBSTANCE-ABUSE TREATMENT FOR PEOPLE WITH SCHIZOPHRENIA

Substance abuse by people with schizophrenia is a serious public healt h problem that is associated with poor treatment compliance, increased rates of relapse, and disruption of role functioning. There is widesp read agreement on the need to integrate psychiatric and substance abus e treatment for this dual disorder, but to date there are no specific treatments with solid empirical support. We first review the primary c onsequences of substance abuse by people with schizophrenia and then e xamine what is currently known about their treatment needs. We then de scribe the special problems faced by this population that interfere wi th their ability to reduce substance use, with or without treatment. T he remainder of the paper focuses on description of a new behavioral t reatment we have developed to compensate for the cognitive and motivat ional deficits that characterize the illness. We describe the developm ent process and present some process data that demonstrate that the in tervention is safe and acceptable for people with schizophrenia, and t hat we are able to train therapists to administer the procedures in a consistent and effective manner. Future studies will examine the effec tiveness of the intervention. (C) 1998 Elsevier Science Ltd.