A qualitative study of illicit and non-prescribed drug use amongst people with psychotic disorders

The reasons for drug use amongst people with psychosis are poorly understood.

To investigate patterns of drug use and self-reported reasons for drug use amongst people with psychosis.

Qualitative interviews with 14 patients with psychosis who misuse drugs.

Most participants felt drug use was implicated in the development or exacerbation of psychosis. Most changed their pattern of drug use post-onset, reported transient motivation to abstain from drug use but became discerning drug users. Despite awareness of the negative physical and mental health consequences of drug use participants reported that drugs were used for social reasons, to achieve pleasurable intoxication, to relieve dysphoria or the side effects of anti-psychotic medication and to enhance or modify mood. Self-medication in response to psychotic symptoms was not reported.

Participants described reasons for drug use that were consistent with those previously reported, but we found no strong evidence that patients self-medicated in response to their psychotic symptoms. Transient motivation to abstain from drug use may provide opportunities for intervention but psychiatric professionals need to assess each patient's motivations for use to intervene effectively.