Problem substance use and schizophrenia.

McCreadie McCreadie et al et al (2002) report on the prob-(2002) report on the problem use of drugs and alcohol by people lem use of drugs and alcohol by people with with schizophrenia. This is an excellent study schizophrenia. This is an excellent study as as the pattern of use by patients is compared the pattern of use by patients is compared with controls from the general popu with controls from the general population, lation, although the findings – that problem although the findings – that problem use is use is greater among patients – are unsurprising. greater among patients – are unsurprising. It is impressive that the study included to-It is impressive that the study included tobacco use, often disregarded as a 'problem' bacco use, often disregarded as a 'problem' drug despite the obvious financial impli-drug despite the obvious financial implications for patients surviving on state bene-cations for patients surviving on state benefits. Previous studies quoted in the paper fits. Previous studies quoted in the paper indicate that patients with schizophrenia indicate that patients with schizophrenia often have been smoking for many years often have been smoking for many years prior to the onset of the illness. prior to the onset of the illness. We are very interested to know whether We are very interested to know whether the data collected for the study show that the data collected for the study show that particular groups of patients appear to be particular groups of patients appear to be more at risk from problem substance use, more at risk from problem substance use, in order to focus efforts on helping them. in order to focus efforts on helping them. Our experience is that admission to a psy-Our experience is that admission to a psychiatric ward leads to increased tobacco chiatric ward leads to increased tobacco use, and patients who have given up use, and patients who have given up smoking recommence and continue smok-smoking recommence and continue smoking posting post-discharge, despite anti-smoking discharge, despite anti-smoking strategies. Also, we would like to know strategies. Also, we would like to know whether the study shows, or the authors whether the study shows, or the authors know of, cultures know of, cultures that may be at lesser risk that may be at lesser risk for developing problem use, accepting that for developing problem use, accepting that numbers of ethnic minorities in the study …