Drug-induced Psychosis

Psychosis is defined in the dictionary as a mental disorder characterised by symptoms such as hallucinations or delusions.

A person suffering from psychosis will most often interpret reality differently from those around them and will not change their beliefs despite being shown evidence that what they believe is not real.

Delusions may cause a person to believe that they are being mistreated when they are not, or that they have a serious medical condition when they don’t.

Hallucinations may cause a person to see things that are not there or hear voices when no one is speaking.

Hallucinations can also cause a person to imagine that something is touching them or crawling on their skin. In most cases, it is only temporary.

Drug-induced psychosis, commonly known as stimulant psychosis, is an episode of psychosis that has been triggered by the use of drugs or alcohol.

It can occur as a reaction to a mixture of several drugs, overdosing or if the person already has underlying mental health issues. It is also common during a withdrawal from drugs or alcohol.

What are the causes and symptoms of drug-induced psychosis?

Any drug that alters the chemicals in your brain can cause drug-induced psychosis, including prescription medications.

It is also important to note that a person suffering from drug-induced psychosis is not necessarily dependent on drugs, as even one use of certain drugs might alter a person’s brain chemicals to the point of triggering a psychotic reaction.

This is commonly referred to as a “bad trip”.

However, the majority of people presenting with psychosis also suffer from substance abuse (1) and long-term build-up of toxins of certain drugs can also trigger a psychotic reaction.

Some of the most common substances that are associated with drug-induced psychosis are:

  • Alcohol

Alcohol is well known to cause confusion and delusions when a person is intoxicated. Most often, the psychosis disappears as the person sobers up, however, prolonged, and excessive use of alcohol can cause alcohol-induced psychosis.

  • Cocaine

A study of cocaine users found that over 50% of users had suffered from some sort of drug-induced psychosis and showed that chronic users were more likely to suffer from drug-induced psychosis (2). Symptoms may take some days or weeks to disappear after using the drug.

  • Methamphetamines

Drug-induced psychosis is common among methamphetamine users, with prolonged use being linked to paranoid delusions often coupled with violent behaviour, as well as auditory hallucinations (3).

  • Cannabis

Approximately 50% of psychosis cases involve the use of cannabis, and studies have shown that those who use cannabis in their later teenage years are more likely to develop schizophrenia (4).

  • Ecstasy

Ecstasy is linked to episodes of psychosis and severe paranoia. Studies have also shown that even a single dose of ecstasy can cause persistent psychosis (5).

  • Lysergic acid diethylamide (LSD)

Serotonin levels infrequent users of LSD is similar to the serotonin levels of those with schizophrenia. Frequent LSD use has been linked to schizophrenia and is also known to speed up symptoms and bring on the disorder much quicker (6).

  • Phencyclidine (PCP)

PCP is linked to violent behaviour, anxiety, delusions, and hallucinations. Many people who present with PCP-induced psychosis are often initially diagnosed with schizophrenia as the hallucinations can be quite severe (7).

Common symptoms include:

  • Hallucinations
  • Delusions
  • Talking to or responding to voices that are not there
  • Acting strangely or dangerously and claiming that the voices told them to
  • Paranoia
  • Fear
  • Catatonia

How is drug-related psychosis different from other forms of psychosis?

Drug-related psychosis happens suddenly and is often much more intense than other forms of psychosis with more severe cases of hallucinations and delusions.

It is also directly related to a substance. If a person has recently taken drugs, has an addiction to drugs, or is currently withdrawing from drugs – then it is drug-induced psychosis.

How long does drug-induced psychosis last?

Drug-induced psychosis is typically a temporary symptom of a more serious condition such as addiction. It usually only lasts a short time and often resolves after the substance which caused the reaction has been eliminated from the body – usually less than a day.

Heavy drug users may experience longer-lasting symptoms as it will take longer for the drugs to leave their system.

Some drugs such as cocaine often lead to longer-lasting symptoms with some reports of cocaine-induced psychosis lasting several weeks. However, long-lasting symptoms of drug-induced psychosis are often a sign that there is an underlying mental health issue such as schizophrenia.

Treatment of drug-induced psychosis

Treatment for drug-induced psychosis varies from person to person depending on the individual’s circumstances and level of dependency on the drug. The first thing that needs to be done in any case is to stop taking the drug which caused the reaction.

This may involve a stay in a residential rehabilitation facility if the psychosis was brought on by a dependency to certain substances.

However, in many cases, it may be enough to closely monitor the person in a safe environment as they come out of their psychotic episode.

Your healthcare provider will determine whether your drug-induced psychosis was the result of a one-time “bad trip”, a substance addiction, or the result of an underlying condition such as depression, schizophrenia, or bipolar disorder and will suggest a necessary treatment.

If your drug-induced psychosis was brought on by a co-occurring condition, you will be offered a range of treatments depending on your needs.

These might include:

  • Rehabilitation

This could be within a residential treatment facility or done at home with frequent visits to an outpatient clinic to monitor your progress.

  • Prescription medication

If your healthcare provider has determined a substance use disorder, you may require certain medications to counteract any withdrawal symptoms you might experience.

  • Therapy

There is a range of therapies that could help someone overcome an addiction. These include one-to-one counselling, family counselling, cognitive behavioural therapy (CBT) or peer support groups such as 12 step programs.

Regardless of the reason for your drug-induced psychosis, being open and honest with your healthcare provider is the best way to make sure you receive the correct treatment and get on the road to recovery.

Your GP will have seen cases like yours before and will know the correct advice to give to you to help you overcome your addiction.

References

  1. https://www.ncbi.nlm.nih.gov/books/NBK459134/
  2. https://pubmed.ncbi.nlm.nih.gov/1752853/
  3. https://www.ncbi.nlm.nih.gov/pmc/articles/PMC5027896/
  4. https://www.ncbi.nlm.nih.gov/pmc/articles/PMC3927252/
  5. https://www.ncbi.nlm.nih.gov/pmc/articles/PMC3304680/
  6. https://www.ncbi.nlm.nih.gov/pmc/articles/PMC3024828/
  7. https://pubmed.ncbi.nlm.nih.gov/6395556/