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There are some existing cases where the substance abuse problem seems to be the less causative difficulty in treatment, and the recovering person's mental illness symptoms, such as hallucinations, paranoia, and/or suicidal or homicidal ideation are prevalent. It is not yet known if in such cases it is the severe disturbances in such person's brain functioning that causes the person to abuse substances, or if the addiction began prior to the mental illness.
It is known, however, that both substance abuse and other mental illnesses do have a genetic component and that those struggling with severe and/or chronic mental illness and homelessness are the most common population to struggle with substance abuse issues. There are most likely multiple causative relationships for this reality.
If you or a loved one is showing symptoms of both severe mental illness and/or substance abuse, it is highly recommended that you visit the website for the National Association for the Mentally Ill (NAMI) where limitless resources and advocacy/educational materials and programming can be found. Help is available for both those struggling with such severe symptoms and their families.