Date of Award


Document Type

Open Access Thesis

Degree Name

MS in Physician Assistant Studies (PA)


Physician Assistant Studies

First Advisor

Kurt DeVine, MD


Introduction: This research was conducted on the topic of dual diagnosis (DD) patients with co-occurring schizophrenia (SZ) and substance use disorder (SUD). The research question posed for this topic: among patients with a DD of SZ and SUD what current treatments offer optimal outcomes?

Methods: The research for this paper was predominantly a literature review. Forty-five sources were utilized in its construction. The majority of sources were peer-reviewed studies obtained from an online service via the Lindell Library at Augsburg University. Three textbooks were utilized. One expert interview was conducted.

Results: Three key findings within the research identified first, SUD rates were shown to be higher among patients with SZ than the general population (47-70% vs. 6%). The second finding suggests that Long-acting injectable (LAI) medications have shown promise in offering optimal outcomes due to fewer opportunities for missed doses. Third, according to a U.S. prison study and two leading mental health organizations, 26.1% and 3% of inmates had documented SUDs or SZ diagnosis respectively compared to 6% and 0.25-0.64% in the general population.

Discussion: In this essay I will discuss the issue of this patient population disproportionately overlapping with the CJS and the demand for policy change and societal accountability. More resources will need to be dedicated to this patient population in order to move towards optimal outcomes. Patients with SZ and SUD have complex needs and require an interdisciplinarian mental health team to achieve the best outcomes.


SC 11.PAS.2021.McNamara.D