Abuse of alcohol or other substances by schizophrenic patients seriously undermines effective treatment. To document the extent of substance abuse among schizophrenic patients hospitalized in one Veterans Administration Hospital, medical records of 100 patients were reviewed. The results revealed that 54 patients had recent substance abuse, with alcohol (N=47) and marijuana (N=25) being the most commonly abused substances. A significant relationship was found between age and substance choice with substances other than alcohol more often abused by patients younger than 40. Treatment for the abuse followed a dual-disease model, designed both to alter the substance abuse behavior and to comply with treatment for schizophrenia. Inpatient programming during acute psychiatric hospitalization was used to identify substance abuse and to engage the patient and family in the treatment process. Further treatment, after discharge from the hospital, was provided by residential recovery programs and outpatient followup. Supportive therapy, both group and individual, family and patient self-help groups, and medication management were used to maintain recovery. (ABB)