Individuals with severe mental illness bear an enormous burden due to smoking, alcohol and drug use. In a large, multi-ethnic sample we found substance use among individuals with severe psychotic disorder to be markedly higher than in population controls at a rate that far exceeds previous estimates based on assessments in individuals with mild mental illness 6. This association extends across substances (alcohol, smoking, and other drugs), across psychiatric diagnosis (bipolar disorder, schizoaffective disorder, and schizophrenia), across race and ethnicity (African American, Hispanic, Asian, and European American), across genders, and across age groups. This is the first large-scale study to robustly demonstrate these associations across subgroups. Although substance use among individuals with psychotic disorders has been documented 12,13,20,31, this study shows that there is a continuing pressing need to target smoking, alcohol, marijuana, and drug use among individuals with severe mental illness.
