© 2003 The Royal College of Psychiatrists
Correspondence |
Problem substance use and schizophrenia
Tolworth Hospital, Red Lion Road, Surbiton KT6 7QU, UK
McCreadie et al (2002) report on the problem use of drugs and alcohol by people with schizophrenia. This is an excellent study as the pattern of use by patients is compared with controls from the general population, although the findings — that problem use is greater among patients — are unsurprising. It is impressive that the study included tobacco use, often disregarded as a ‘problem’ drug despite the obvious financial implications for patients surviving on state benefits. Previous studies quoted in the paper indicate that patients with schizophrenia often have been smoking for many years prior to the onset of the illness.
We are very interested to know whether the data collected for the study show that particular groups of patients appear to be more at risk from problem substance use, in order to focus efforts on helping them. Our experience is that admission to a psychiatric ward leads to increased tobacco use, and patients who have given up smoking recommence and continue smoking post-discharge, despite anti-smoking strategies. Also, we would like to know whether the study shows, or the authors know of, cultures that may be at lesser risk for developing problem use, accepting that numbers of ethnic minorities in the study sample may be small.
REFERENCES
- McCreadie, R. on behalf of the Scottish Comorbidity Study Group
(2002) Use of drugs, alcohol and tobacco by people with
schizophrenia: case—control study. British Journal of
Psychiatry, 181,
321-325.
[Abstract/Free Full Text]
Author's reply
Department of Clinical Research, Crichton Royal Hospital, Dumfries DG1 4TG, UK
Bates & Rutherford raise some interesting points. I am impressed by their experience that admission to a psychiatric ward leads to increased tobacco use; this is certainly worthy of more-detailed study.
Smoking habits of people with schizophrenia probably do differ in different cultures. Colleagues in south India, where I have carried out much research, have found that people with schizophrenia probably smoke less than the general population. This is largely for economic reasons. Most are unemployed or in part-time employment. There are no state benefits, and therefore patients cannot afford to buy cigarettes.
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