First-Episode Psychosis and Substance Abuse in Young Adults


first-episode psychosis

First-Episode Psychosis and Substance Abuse in Young Adults

Tuesday, September 12th, 2023

The journey from adolescence to adulthood presents multiple challenges, growth opportunities and pivotal decisions. Amid these complexities, the emergence of mental health disorders such as first-episode psychosis can significantly impact a young adult’s life. As illustrated in a new SAMHSA report, this issue further intensifies when coupled with a co-occurring substance use disorder.

What Is Psychosis?

Psychosis is a mental state that causes intense and frightening delusions or hallucinations. During a psychotic episode, it can be challenging to tell what is real and what isn’t.

Symptoms usually emerge between the ages of 16 and 30 and can link to various disorders, including:

  • Schizophrenia
  • Schizoaffective disorder
  • Schizophreniform disorder
  • Brief psychotic disorder
  • Delusional disorder

Moreover, other disorders such as major depression or bipolar disorder might present psychosis as a secondary, yet severe, symptom.

Psychosis can be an overwhelming experience for young adults and their families. The impact of these symptoms can ripple through various facets of life, causing disruptions in education, relationships and overall well-being.

The Connection Between Substance Abuse and Psychosis

Drug use has shown a concerning correlation with first-episode psychosis, especially among young adults.

  • 60 to 80% of young adults with first-episode psychosis have reported using cannabis.
  • 88% have used alcohol.
  • 70% report tobacco use.

Alcohol and cannabis misuse can cause reduced social functioning and quality of life, and they also have direct repercussions on the onset and prognosis of psychosis. Persistent cannabis use after first-episode psychosis can aggravate symptoms, leading to frequent relapses even among people who consistently take antipsychotic medication.

Among young people aged 18 to 25 in the United States, approximately 15.1% have a substance use disorder, and up to 51% of young people who have first-episode psychosis have a co-occurring substance use disorder when starting psychosis treatment.

The Complex Interplay and the Road to Recovery

Recovering from co-occurring first-episode psychosis and substance abuse can be uniquely challenging. The presence of these conditions often results in:

  • Recurring psychotic episodes
  • Higher dropout rates from treatment
  • Heightened severity of psychotic and depressive symptoms
  • Increased risk of homelessness and medical issues

However, it’s essential to underscore that recovery is achievable. Numerous studies suggest that when young adults stop taking drugs after a psychotic episode, they tend to experience significant improvements in their mental health symptoms. Moreover, the long-term outcomes generally parallel those who had never engaged in substance use.

A Call to Vigilance and Action

The intersection of first-episode psychosis and substance misuse calls for a comprehensive, informed and compassionate evaluation and treatment approach. At R&A Therapeutic Partners, we support young adults and their families as they navigate these complexities. With timely intervention, understanding and a tailored care plan, we can help guide you to recovery and a fulfilling life.

If your family faces challenges related to first-episode psychosis and substance use, don’t hesitate to reach out to us today. Together, we can chart a path to better mental well-being.

At R&A Therapeutic Partners Raymond Estefania and Ana Moreno specialize in substance use and mental health disorder evaluations, treatment, intervention and therapeutic/educational consulting for clients throughout the greater South Florida area, as well as nationally and internationally. For more resources and information please visit Therapeutic-Partners.com or on Facebook.

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