Do current talk therapies help people with schizophrenia who also use substances?

Imagine trying to manage the symptoms of schizophrenia while also struggling with substance use. It's a devastating combination that affects a huge number of people—nearly half of those with schizophrenia also have a substance use disorder. The big question is: do the talk therapies and support programs we currently offer actually help? A major review of 35 clinical trials, involving over 4,100 people, has given us a sobering answer. The analysis found that current psychological and psychosocial interventions have only a very small effect on reducing overall symptoms. More strikingly, they found no difference at all between therapy and control groups when it came to reducing the use of substances like alcohol, cannabis, or stimulants. It's important to note that the tiny benefit seen for symptoms was mainly driven by studies focused on nicotine use. The researchers have low confidence in the symptom reduction finding, meaning we can't be very sure of it. For the substance use result, they have moderate confidence. The bottom line is clear: the current standard of care is falling short for people facing this dual challenge, highlighting a critical gap that demands new solutions.