if your son has a diagnosis of paranoid schizophrenia he is trying to fight very powerful "demons. " it is one of the most difficult psychiatric disorders there is and as you say it comes with other problems including severe anxiety. many individuals with this diagnosis do try to self-medicate with alcohol smoking and using street drugs. it is a painful situation as you well know. he requires the help of highly experienced mental health professionals because he has what is known as an illness that requires mica program intervention. this stands for "mentally ill chemically addicted. " i would think that he should be in individual counseling as well as receiving substance abuse counseling. usually there are local programs which have been developed for individuals who have a mica profile. when i worked in psychiatric hospitals we always had family programs in the evening where families of these patients would come together to offer each other support and suggestions on workable interventions. i would suggest that you inquire of social service agencies in your area to see what might be available for you your family and your son.
how can i help my stepson who has been diagnosed with paranoid schizophrenia and is smoking and drinking?