"It’s always surprising when I encounter a patient who doesn’t smoke or hasn’t used drugs"

ST. LOUIS (KMOX) – In the largest ever study of substance use among the severely mentally ill population, researchers at Washington University School of Medicine in St. Louis and the University of Southern California, found that rates of smoking, drinking and drug use are significantly higher among those with psychotic disorders.

That fact is particularly concerning, according to Sarah M. Hartz, MD, PhD, lead Washington University researcher.

“These patients tend to pass away much younger, with estimates ranging from 12 to 25 years earlier than individuals in the general population,” explained Hartz. “The causes of death are not drug overdoes, they’re not suicide — the kinds of things you might suspect in the severely ill population. They’re from heart disease, cancer, things that are preventable.”

The study analyzed smoking, drinking and drug use in nearly 20,000 people. That included 9,142 psychiatric patients diagnosed with schizophrenia, bipolar disorder or schizoaffective disorder — an illness characterized by hallucinations and delusions, and mood disorders such as depression.

The investigators also assessed nicotine use, heavy drinking, heavy marijuana use and recreational drug use in more than 10,000 healthy people without mental illness.

The researchers found that 30 percent of those with severe psychiatric illness engaged in binge drinking. In comparison, the rate of binge drinking in the general population is 8 percent.

Among those with mental illness, more than 75 percent were regular smokers. This compares with 33 percent of those in the control group who smoked regularly. There were similar findings with heavy marijuana use: 50 percent of people with psychotic disorders used marijuana regularly, versus 18 percent in the general population. Half of those with mental illness also used other illicit drugs, while the rate of recreational drug use in the general population is 12 percent.

“There have been study’s recently about the rates of mild mental illness and those have found [smoking] rates at about twice as high, so this is another factor of two more,” said Hartz.

“I take care of a lot of patients with severe mental illness, many of whom are sick enough that they are on disability,” she added. “And it’s always surprising when I encounter a patient who doesn’t smoke or hasn’t used drugs or had alcohol problems.”

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