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

Abstract

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

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

Method: Qualitative interviews with 14 patients with psychosis who misuse drugs.

Results: 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.

Conclusions: 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.

Keywords:

• Psychosis
• drug misuse
• qualitative research

Acknowledgements

This work was funded under the Department of Health's Drug Misuse Research Initiative (Grant no.: 1217194). The views expressed in this publication are those of the authors and not necessarily those of the sponsors. The authors are grateful to the funders for supporting this work. We are also indebted to the staff in the mental health services who made this work possible, and to the patients who gave their time to be interviewed and whose often frank and candid comments provided valuable insight into their lives.

Declaration of interest: The authors report no conflicts of interest. The authors alone are responsible for the content and writing of the paper.