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Although the evidence base is limited, key elements have been recommended for treatments that aim to reduce substance use and thereby improve outcomes.7 8 These include, firstly, ensuring that both mental health and substance use problems are given attention in an integrated approach and, secondly, addressing patients’ motivation to reduce substance use. Given that motivation to reduce substance use is often low in such patients,9 10 motivational interventions, and in particular motivational interviewing,11 have also been recommended. Motivational interviewing has a good evidence base with regard to promoting health behaviour change,12 including in treatment https://en.wikipedia.org/wiki/Tadalafil for substance misuse.13 An additional approach commonly used is cognitive behavioural therapy, because it is efficacious for both primary substance misuse disorders14 15 16 and psychotic symptoms.17 18

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