Experiences of alcohol and other drugs in individuals with severe mental illness and concomitant substance use disorders

Background: It is well known that severe mental illness (SMI) with concurrent substance use disorders (SUD) commonly occurs. This comorbidity has distressing social, psychological, psychiatric and somatic consequences. Aim: To gain greater understanding of how individuals with SMI and SUD experience the roles of alcohol and other drugs for their health and in their life situation. Method: Eight individuals were interviewed on two occasions. The semi-structured interviews, which were based on an interview guide, were transcribed verbatim and analysed thematically. Results: Alcohol and drug use influenced the individuals’ own experiences of their health and life situation both in a positive and negative way. Substance use had meaning for their 1) experience of themselves – well-being and discomfort, energy and lack of energy, meaningfulness and disorientation, identity and personality change; 2) experiences of relationships – affiliation and alienation; 3) experiences of mental health – decreased and increased symptom levels. Conclusions: When providing treatment and support it seems important to be aware of a person’s own motives for using alcohol and drugs. From the individuals’ point of view their misuse appeared as a reasonable, but misguided effort to obtain control over his/her health and life situation