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Abstract
Background: It is well known that severe mental illness (SMI) with concurrent substance use disorders (SUD) commonly occurs. This comorbidity has distressing social, psychological, psychiatric and somatic consequences.
Aim: To gain greater understanding of how individuals with SMI and SUD experience the roles of alcohol and other drugs for their health and life situation.
Method: Eight individuals were interviewed on two occasions. The semi-structured interviews, which were based on an interview guide, were transcribed verbatim and analysed thematically.
Results: Alcohol and drug use influenced the individuals' own experiences of their health and life situation both in a positive and negative way. Substance use had meaning for their: ‘experience of themselves’ – well-being and discomfort, energy and lack of energy, meaningfulness and disorientation, identity and personality change; ‘experiences of relationships’ – affiliation and alienation; ‘experiences of mental health’ – decreased and increased symptom levels.
Conclusions: When providing treatment and support it seems important to be aware of a person's own motives for using alcohol and drugs. From the individuals' point of view, their misuse appeared as a reasonable, but misguided, effort to obtain control over his/her health and life situation.
Acknowledgements
We wish to thank David Brunt who revised the language and translated the quotations.
The study was supported by The Vårdal Institute, The Swedish Institute for Health Sciences; The Faculty of Medicine, Department of Clinical Sciences – psychiatry; The Swedish Research Council (K 2007-61X-1579-04-03) and The Fund for Alcohol Research of the Swedish Retailing Monopoly (SRA).