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1.12 - Approach to Substance Use Disorders in Schizophrenia Spectrum Disorders

from Part I - Treatment Strategies

Published online by Cambridge University Press:  19 October 2021

Edited by
Michael Cummings  and
Stephen Stahl
Michael Cummings
Affiliation:
University of California, Los Angeles
Stephen Stahl
Affiliation:
University of California, San Diego
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Summary

For many patients with schizophrenia, substance use predates the first psychotic episode. Patients suffering from their first psychotic break are more likely to be daily cannabis users and have a higher rate of tobacco use [1, 2]. Cannabis appears to exert a dose-dependent effect on the risk of developing a psychotic illness and illness onset is earlier [3]. Methamphetamine may increase the risk of schizophrenia on a par with cannabis [4]. Overall, 13–51% of patients entering treatment with their first psychotic episode have a co-occurring substance use disorder [5]. If substance use continues in parallel with a first-episode psychosis, patients fare more poorly in both the short and long terms.

Type
Chapter
Information
Management of Complex Treatment-resistant Psychotic Disorders , pp. 86 - 97
Publisher: Cambridge University Press
Print publication year: 2021

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References

Myles, N., Newall, H. D., Curtis, J., et al. (2012). Tobacco use before, at, and after first-episode psychosis: a systematic meta-analysis. J Clin Psychiatry, 73, 468–475.CrossRefGoogle ScholarPubMed
Myles, H., Myles, N., Large, M. (2016). Cannabis use in first episode psychosis: meta-analysis of prevalence, and the time course of initiation and continued use. Aust N Z J Psychiatry, 50, 208–219.CrossRefGoogle ScholarPubMed
Hasan, A., von Keller, R., Friemel, C. M., et al. (2019). Cannabis use and psychosis: a review of reviews. Eur Arch Psychiatry Clin Neurosci, 270(4), 403–412.CrossRefGoogle ScholarPubMed
Callaghan, R. C., Cunningham, J. K., Allebeck, P., et al. (2012). Methamphetamine use and schizophrenia: a population-based cohort study in California. Am J Psychiatry, 169, 389–396.Google Scholar
Substance Abuse and Mental Health Services Administration. (2019). First-episode psychosis and co-occurring substance use disorders. Rockville, MD: National Mental Health and Substance Use Policy Laboratory. Publication no. PEP19-PL-Guide-3.Google Scholar
Swartz, M. S., Wagner, H. R., Swanson, J. W., et al. (2006). Substance use in persons with schizophrenia: baseline prevalence and correlates from the NIMH CATIE study. J Nerv Ment Dis, 194, 164–172.CrossRefGoogle ScholarPubMed
Kerfoot, K. E., Rosenheck, R. A., Petrakis, I. L., et al. (2011). Substance use and schizophrenia: adverse correlates in the CATIE study sample. Schizophr Res, 132, 177–182.Google Scholar
Fazel, S., Långström, N., Hjern, A., et al. (2009). Schizophrenia, substance abuse, and violent crime. JAMA, 301, 2016–2023.CrossRefGoogle ScholarPubMed
Lamsma, J., Cahn, W., Fazel, S. (2019). Use of illicit substances and violent behaviour in psychotic disorders: two nationwide case-control studies and meta-analyses. Psychol Med, 50(12), 2028–2033.CrossRefGoogle ScholarPubMed
Jaffee, W. B., Trucco, E., Levy, S., et al. (2007). Is this urine really negative? A systematic review of tampering methods in urine drug screening and testing. J Subst Abuse Treat, 33, 33–42.CrossRefGoogle ScholarPubMed
DiClemente, C. C., Nidecker, M., Bellack, A. S. (2008). Motivation and the stages of change among individuals with severe mental illness and substance abuse disorders. J Subst Abuse Treat, 34, 25–35.CrossRefGoogle ScholarPubMed
Ziedonis, D. M., Smelson, D., Rosenthal, R. N., et al. (2005). Improving the care of individuals with schizophrenia and substance use disorders: consensus recommendations. J Psychiatr Pract, 11, 315.CrossRefGoogle ScholarPubMed
McDonell, M. G., Srebnik, D., Angelo, F., et al. (2013). Randomized controlled trial of contingency management for stimulant use in community mental health patients with serious mental illness. Am J Psychiatry, 170, 94–101.Google Scholar
McPherson, S., Orr, M., Lederhos, C., et al. (2018). Decreases in smoking during treatment for methamphetamine-use disorders: preliminary evidence. Behav Pharmacol, 29, 370–374.Google Scholar
Green, A. I., Tohen, M. F., Hamer, R. M., et al. (2004). First episode schizophrenia-related psychosis and substance use disorders: acute response to olanzapine and haloperidol. Schizophr Res, 66, 125–135.Google Scholar
Bennett, M. E., Bradshaw, K. R., Catalano, L. T. (2017). Treatment of substance use disorders in schizophrenia. Am J Drug Alcohol Abuse, 43, 377–390.CrossRefGoogle ScholarPubMed
Buchanan, R. W., Kreyenbuhl, J., Kelly, D. L., et al. (2012). The 2009 schizophrenia PORT psychopharmacological treatment recommendations and summary statements. FOCUS, 10, 194–216.Google Scholar
Martins, S. S., Gorelick, D. A. (2011). Conditional substance abuse and dependence by diagnosis of mood or anxiety disorder or schizophrenia in the U.S. population. Drug Alcohol Depend, 119, 28–36.CrossRefGoogle ScholarPubMed
Wildgust, H. J., Beary, M. (2010). Are there modifiable risk factors which will reduce the excess mortality in schizophrenia? J Psychopharmacol, 24, 37–50.CrossRefGoogle ScholarPubMed
Cather, C., Pachas, G. N., Cieslak, K. M., et al. (2017). Achieving smoking cessation in individuals with schizophrenia: special considerations. CNS Drugs, 31, 471–481.Google Scholar
Kalkhoran, S., Glantz, S. A. (2016). E-cigarettes and smoking cessation in real-world and clinical settings: a systematic review and meta-analysis. Lancet Respir Med, 4, 116–128.CrossRefGoogle ScholarPubMed
Tsuda, Y., Saruwatari, J., Yasui-Furukori, N. (2014). Meta-analysis: the effects of smoking on the disposition of two commonly used antipsychotic agents, olanzapine and clozapine. BMJ Open, 4, e004216.CrossRefGoogle ScholarPubMed
Meyer, J. M. (2001). Individual changes in clozapine levels after smoking cessation: results and a predictive model. J Clin Psychopharmacol, 21, 569–574.Google Scholar
Robertson, A. G., Easter, M. M., Lin, H., et al. (2018). Medication-assisted treatment for alcohol-dependent adults with serious mental illness and criminal justice involvement: effects on treatment utilization and outcomes. Am J Psychiatry, 175, 665–673.CrossRefGoogle ScholarPubMed
Robertson, A. G., Easter, M. M., Lin, H. J., et al. (2018). Associations between pharmacotherapy for opioid dependence and clinical and criminal justice outcomes among adults with co-occurring serious mental illness. J Subst Abuse Treat, 86, 17–25.CrossRefGoogle ScholarPubMed
Spencer, C., Castle, D., Michie, P. T. (2002). Motivations that maintain substance use among individuals with psychotic disorders. Schizophr Bull, 28, 233–247.CrossRefGoogle ScholarPubMed
Toftdahl, N. G., Nordentoft, M., Hjorthoj, C. (2016). The effect of changes in cannabis exposure on psychotic symptoms in patients with comorbid cannabis use disorder. J Dual Diagn, 12, 129–136.CrossRefGoogle ScholarPubMed
Green, A. I., Burgess, E. S., Dawson, R., et al. (2003). Alcohol and cannabis use in schizophrenia: effects of clozapine vs. risperidone. Schizophr Res, 60, 81–85.CrossRefGoogle ScholarPubMed
Chan, B., Freeman, M., Kondo, K., et al. (2019). Pharmacotherapy for methamphetamine/amphetamine use disorder – a systematic review and meta-analysis. Addiction, 114, 2122–2136.CrossRefGoogle ScholarPubMed
Chan, B., Kondo, K., Freeman, M., et al. (2019). Pharmacotherapy for cocaine use disorder – a systematic review and meta-analysis. J Gen Intern Med, 34, 2858–2873.CrossRefGoogle ScholarPubMed
Sena, S. F., Kazimi, S., Wu, A. H. (2002). False-positive phencyclidine immunoassay results caused by venlafaxine and O-desmethylvenlafaxine. Clin Chem, 48, 676–677.CrossRefGoogle ScholarPubMed
Heit, H. A., Gourlay, D. L. (2004). Urine drug testing in pain medicine. J Pain Symptom Manage, 27, 260–267.CrossRefGoogle ScholarPubMed
Moeller, K. E., Lee, K. C., Kissack, J. C. (2008). Urine drug screening: practical guide for clinicians. Mayo Clin Proc, 83(1), 66–76.Google Scholar
Nasky, K. M., Cowan, G. L., Knittel, D. R. (2009). False-positive urine screening for benzodiazepines: an association with sertraline? A two-year retrospective chart analysis. Psychiatry (Edgmont), 6, 36.Google ScholarPubMed
Reisfield, G. M., Goldberger, B. A., Bertholf, R. L. (2009). “False-positive” and “false-negative” test results in clinical urine drug testing. Bioanalysis, 1, 937–952.CrossRefGoogle ScholarPubMed
Mikel, C., Pesce, A. J., Rosenthal, M., et al. (2012). Therapeutic monitoring of benzodiazepines in the management of pain: current limitations of point of care immunoassays suggest testing by mass spectrometry to assure accuracy and improve patient safety. Clin Chim Acta, 413, 1199–1202.CrossRefGoogle ScholarPubMed
Saitman, A., Park, H-D., Fitzgerald, R. L. (2014). False-positive interferences of common urine drug screen immunoassays: a review. J Anal Toxicol, 38, 387–396.CrossRefGoogle ScholarPubMed
Bohn, M., Babor, T., Kranzler, H. (1991). Validity of the Drug Abuse Screening Test (DAST-10) in inpatient substance abusers. Problems of Drug Dependence, 119, 233–235.Google Scholar
Heatherton, T. F., Kozlowski, L. T., Frecker, R. C., et al. (1991). The Fagerström test for nicotine dependence: a revision of the Fagerstrom Tolerance Questionnaire. Br J Addict, 86, 1119–1127.CrossRefGoogle ScholarPubMed
Saunders, J. B., Aasland, O. G., Babor, T. F., et al. (1993). Development of the Alcohol Use Disorders Identification Test (AUDIT): WHO collaborative project on early detection of persons with harmful alcohol consumption – II. Addiction, 88, 791–804.CrossRefGoogle ScholarPubMed
Bush, K., Kivlahan, D. R., McDonell, M. B., et al. (1998). The AUDIT alcohol consumption questions (AUDIT-C): an effective brief screening test for problem drinking. Arch Intern Med, 158, 1789–1795.CrossRefGoogle ScholarPubMed
Knight, J. R., Shrier, L. A., Bravender, T. D., et al. (1999). A new brief screen for adolescent substance abuse. Arch Pediatr Adolesc Med, 153, 591–596.CrossRefGoogle ScholarPubMed
Maisto, S. A., Carey, M. P., Carey, K. B., et al. (2000). Use of the AUDIT and the DAST-10 to identify alcohol and drug use disorders among adults with a severe and persistent mental illness. Psychol Assess, 12, 186–192.CrossRefGoogle ScholarPubMed
Knight, J. R., Sherritt, L., Shrier, L. A., et al. (2002). Validity of the CRAFFT substance abuse screening test among adolescent clinic patients. Arch Pediatr Adolesc Med, 156, 607–614.CrossRefGoogle ScholarPubMed
Bradley, K. A., DeBenedetti, A. F., Volk, R. J., et al. (2007). AUDIT-C as a brief screen for alcohol misuse in primary care. Alcohol Clin Exp Res, 31, 1208–1217.CrossRefGoogle ScholarPubMed
Pearsall, R., Smith, D. J., Geddes, J. R. (2019). Pharmacological and behavioural interventions to promote smoking cessation in adults with schizophrenia and bipolar disorders: a systematic review and meta-analysis of randomised trials. BMJ Open, 9, e027389.CrossRefGoogle ScholarPubMed
Tsoi, D. T-Y., Porwal, M., Webster, A. C. (2010). Efficacy and safety of bupropion for smoking cessation and reduction in schizophrenia: systematic review and meta-analysis. Br J Psychiatry, 196, 346–353.CrossRefGoogle ScholarPubMed
Evins, A. E., Cather, C., Pratt, S. A., et al. (2014). Maintenance treatment with varenicline for smoking cessation in patients with schizophrenia and bipolar disorder: a randomized clinical trial. JAMA, 311, 145–154.CrossRefGoogle ScholarPubMed
Ralevski, E., O’Brien, E., Jane, J. S., et al. (2011). Treatment with acamprosate in patients with schizophrenia spectrum disorders and comorbid alcohol dependence. J Dual Diagn, 7, 64–73.CrossRefGoogle ScholarPubMed
Paz, R. D., Tardito, S., Atzori, M., et al. (2008). Glutamatergic dysfunction in schizophrenia: from basic neuroscience to clinical psychopharmacology. Eur Neuropsychopharmacol, 18, 773–786.Google Scholar
Forest Pharmaceuticals, I. (2004). Highlights of prescribing information for acamprosate sodium. New York.Google Scholar
Petrakis, I. L., Nich, C., Ralevski, E. (2006). Psychotic spectrum disorders and alcohol abuse: a review of pharmacotherapeutic strategies and a report on the effectiveness of naltrexone and disulfiram. Schizophr Bull, 32, 644–654.CrossRefGoogle Scholar

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