Mind trap: 4 million Russians with mental disorders become addicted to alcohol

According to surveys, 42% of patients with schizophrenic spectrum disorders use surfactants. Among people with depressive disorders, at least a quarter of them. In bipolar disorder, alcohol dependence develops in 30% of cases. This combination can change the course of the disease and complicate diagnosis. In addition, this “union” correlates with a more severe course of the disease and worse treatment outcomes.

In 2025, 83 thousand Russians were first diagnosed with alcohol dependence or alcohol psychosis, and in 2024, 377.9 thousand people with mental disorders associated with drug use were under the supervision of the narcological service.

As the psychiatrist, narcologist, researcher of the department of therapy of inpatients with addictive disorders of the FGBI "NMIC of Psychiatry and Neurology named after V.M. Bekhterev" of the Ministry of Health of Russia, associate professor of the department of psychiatry, narcology and psychotherapy with courses of IDPE of the Bashkir State Medical University of the Ministry of Health of Russia Elvin Akhmetov, no person in his right mind wants to become dependent on surfactants.

“In people with depression, addiction develops as a result of trying to silence experiences. At some stage, it can really contribute to the normalization of the state - increase activity, give energy. With the debut of schizophrenia, the passion for surfactants develops due to the fact that the symptoms of the disease begin to frighten him. Therefore, he uses something to, for example, muffle voices, the expert explains.

Surfactants can be used as an attempt to cope with anxiety, reduced mood or insomnia on their own. However, the main problem is that over time, the addiction further aggravates the condition and increases mental symptoms.

“The whole attack is on the neurobiological system: psychoactive substances affect the same parts of the brain, the work of which is already disrupted due to the underlying disease, so surfactants will only aggravate it,” says Dr. Akhmetova. Addiction can develop tomorrow and in a few years – it all depends on the initial basic settings and the strength of biological resources. A lot of people control themselves, they go to work, they have a family, but at some point it can all disappear. In recent years, a patient of a new formation has appeared - with a higher education, a good job, occupying high positions, a family who relieves stress with the help of surfactants.

People with alcohol addiction experience a stronger sense of loneliness and are more likely to feel lonely, even if they are not alone.

How do you know if someone close to you is addicted? “This can be understood by changing behavior,” says psychiatrist, psychotherapist Nadezhda Stepunina. A person has euphoria, then unmotivated aggression. He is increasingly late for work, his motivation is reduced and there is an inadequate reaction to remarks. Alcohol dependence is easier to detect - by the smell of overcooking”.

Experts emphasize that it is important to pay attention to the frequency of taking surfactants (every day, every weekend). However, psychoactive substances can be used asymptomatically. “Sometimes a person cannot sleep without them or cannot work, and this is not always apparent. But there is a change in mood, plus the family budget suffers, it is not cheap, says Dr. Akhmetova.

If alcohol appears in the life of a family member, relatives should remember that it can quickly turn into uncontrolled consumption. We have a law on psychiatric care, but there is no law on drug treatment. Therefore, a person who abuses alcohol does not violate anything, but in practice families are destroyed.

What is the modern approach to the treatment of patients with mental disorders and addictions? First of all, says Elvin Akhmetova, it is important to convince a person almost by force to go to the doctor because he believes that there are no problems.

Doctors note that it is important to simultaneously work with both mental disorder and addiction, and choose the right medication. Modern antipsychotic drugs can affect not only psychotic symptoms, but also other manifestations of the disease. Their goal is to help the patient achieve an overall state of stability. This is especially true in the presence of both diagnoses, when therapy must address both mental disorder and addiction without exacerbating either condition. And neuroleptics of the new generation act not only on symptoms and affective disorders, but also reduce the pathological attraction to surfactants, reducing the risk of breakdowns.

“No one requires a patient to stop using surfactants in the first month or two. But it is important to explain that the use of surfactants will increase the symptoms of the underlying disease. In addition, there is a model of psychotherapy aimed at shifting addiction to a more acceptable one, such as cooking, says Akhmetova.

Hope Stepunin adds that the behavior of loved ones plays a huge role in therapy - as soon as the addict understands that no one will follow his lead, will not call him an IV on the house, his behavior will change. With this combined problem, it is important not to isolate a person, but, if possible, to maintain his connection with his usual life - through work, study, volunteering, communication. "Social inclusion in some cases becomes an important part of treatment," Stepunina says.

Properly selected treatment creates a basis for further rehabilitation, which helps a person to return and preserve skills important for life in society, experts say.