People who use drugs and alcohol can develop a set of mental health symptoms that are collectively called psychosis. Drug-induced psychosis can also occur during withdrawal from substance abuse. Please keep reading to learn more about the risk factors, symptoms, and treatments for psychosis from drug use.
What is Drug-Induced Psychosis?
The term psychosis refers to a collection of symptoms that affect the mind and influence how a person thinks, feels, and behaves. Psychotic symptoms cause a person to lose touch with reality. The most common psychotic symptoms are delusions and hallucinations. During a psychotic episode, a person has trouble telling the difference between what is real and what is not. Psychosis is common in people with certain mental health disorders such as schizophrenia.
But psychosis can also occur in association with alcohol and drug use, both during substance use and during withdrawal from harmful substances. Psychosis that is brought on by alcohol or drugs is called substance-induced psychosis or drug-induced psychosis.
Types of Psychosis
Psychotic Disorders
Several mental health conditions called psychotic disorders have psychosis as the main symptom. Some of these mental illnesses cause short psychotic episodes while others cause long-term psychosis. Examples of mental health disorders that can cause psychosis include:
- Schizophrenia: A diagnosis of schizophrenia is made if a person has had psychotic symptoms for at least 6 months.
- Schizoaffective disorder: People with schizoaffective disorder have symptoms of schizophrenia and a mood disorder such as depression or mania.
- Delusional disorder: This is a psychiatric condition in which a person develops strong beliefs about things that are not true.
- Brief psychotic disorder: This is a mental health condition that is triggered by an emotionally stressful event such as the death of a loved one. The psychotic symptoms last less than one month.
- Other mental disorders: People with major depressive disorder and bipolar disorder can also have psychotic symptoms.
Short- and Long-Term Psychosis from Drug Use
As mentioned above, the use of alcohol and drugs can trigger psychotic symptoms. Risk factors for drug-induced psychosis include:
- An underlying predisposition to mental illness.
- Dual diagnosis of a substance use disorder and mental health condition.
- Use of certain types of drugs such as cannabis, stimulants (cocaine, methamphetamines), and hallucinogens (LSD).
- Use of multiple illicit drugs (polydrug abuse).
- Frequent, prolonged, or heavy use of illegal substances.
- Withdrawal from drugs or alcohol after prolonged or heavy substance use.
- Liver disease or kidney disease which can affect how quickly drugs are metabolized and eliminated from the body.
Side Effects of Prescription Medications
Many medications can cause psychosis as a side effect, including anticholinergics, antidepressants, anticonvulsants, antipsychotics, corticosteroids, amphetamines, muscle relaxants, antimalarials, antibiotics, antivirals, antifungals, opioid pain medications, and Parkinson’s medications.
What Drugs Can Cause Drug-Induced Psychosis?
Drugs that are commonly linked to drug-induced psychosis include:
- Cannabis
- Cocaine
- Methamphetamine
- MDMA
- LSD
- Psilocybin
- Phencyclidine (PCP)
- Alcohol
How Does Drug Use Cause Psychosis?
Research suggests that drug use can cause psychosis because of rapid changes in the levels of neurotransmitters (natural chemicals) in the brain such as dopamine, serotonin, and norepinephrine.
Cannabis-Induced Psychosis
The main psychoactive ingredient in cannabis, THC, attaches to CB1 cannabinoid receptors in the central nervous system and can cause adverse effects such as psychosis, anxiety, and cognitive impairment. Similarly, synthetic cannabinoids (Spice, K2) mimic the action of THC and cause psychotic side effects.
Stimulant-Induced Psychosis
Laboratory experiments have shown that administration of mephedrone, amphetamine, or MDMA to rats leads to a rapid and dramatic increase in extracellular dopamine levels by nearly 500% and serotonin levels by over 900%.
Psychotic symptoms (paranoid delusions and auditory hallucinations) are reported in about 30% to 85% of cocaine users. Researchers have found that cocaine blocks the reuptake (reabsorption) of serotonin and norepinephrine and is an antagonist at 5-HT3 receptors in the brain.
Studies show that about 15% of methamphetamine users develop a psychotic disorder, although some studies suggest higher prevalence rates of about 36%. Amphetamines increase synaptic concentrations of dopamine (the amount of dopamine present in the synapse or gap between brain cells). In addition, studies suggest amphetamines cause dopamine overflow which can lead to dysregulation of inhibitory neurotransmitters that are responsible for reducing brain activity. Psychotic symptoms may develop in amphetamine users due to damage to the brain cortex.
Hallucinogen-Induced Psychosis
Hallucinogens or psychedelic drugs such as LSD, psilocybin (mushrooms), phencyclidine (PCP), and dimethyltryptamine (DMT) are known to cause psychosis in about 20% of users. These drugs affect brain levels of 5-HT. There are reports of long-term psychosis in hallucinogen users.
Alcohol-Related Psychosis
Alcohol-related hallucinations and paranoia are reported in chronic alcoholics who have a history of years of severe and heavy drinking. Potential causes for alcohol-induced psychotic disorders include thiamine deficiency (vitamin B1 deficiency) and neurotoxicity (damage to nerve cells from alcohol use).
Signs and Symptoms of Drug-Induced Psychosis
Psychosis causes changes in your thoughts, feelings, and behaviors. The main signs and symptoms of drug-induced psychosis are hearing or seeing things that aren’t there (hallucinations), believing things that aren’t true (delusions), and disordered thinking, speech, and behavior.
Sudden Changes in Behavior
Sudden behavior changes during an episode of psychosis from drug use can include:
- Problems remembering things or keeping track of conversations.
- Trouble maintaining personal hygiene.
- Difficulties keeping up with activities of daily living such as cooking, cleaning, and eating.
- Inappropriate behavior such as laughing inappropriately or being silly.
- Becoming angry or upset without provocation.
- Being inactive or lethargic.
- Losing interest in activities and withdrawing socially.
- Being unaware of surroundings.
Paranoia and Delusions
Delusions are false beliefs or misinterpretations of experiences or perceptions. For example, believing that:
- People are out to get you.
- Someone has special powers over you.
- Newspaper articles have hidden meanings.
- Someone is spying on you.
- Your partner has been unfaithful without any evidence for it.
- You have magical abilities.
Paranoia is an intense, irrational suspicion of others and a tendency to see threats everywhere.
Hallucinations
Hallucinations are false perceptions of sensory experiences, such as:
- Seeing things that aren’t there (visual hallucinations)
- Hearing things that aren’t there (auditory hallucinations)
- Smelling things that aren’t there (olfactory hallucinations)
- Feeling things that aren’t there (tactile hallucinations)
Disorganized Thinking and Speech
Jumbled or disorganized thoughts are common in people experiencing a psychotic episode. In addition, people with drug-induced psychosis can have fast or inconstant speech or jump from one topic to another mid-sentence.
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+18442884672 Changes in Emotions and Feelings
Drug-induced psychosis can cause strong emotions and feelings such as anger, aggression, agitation, confusion, or fear.
Risk of Schizophrenia Spectrum Disorders
Researchers have found that people who have visited the emergency department for substance-induced psychosis are at a 160% higher risk of developing a schizophrenia spectrum disorder (SSD) compared to the general population. Studies show that 3 years after an initial ER visit for psychosis from drug use, about 18% of people are diagnosed with a schizophrenia spectrum disorder.
Those with cannabis-induced psychotic disorder have the highest risk of developing a chronic schizophrenia spectrum disorder, followed by mixed substance related psychosis, methamphetamine use related psychosis, and alcohol-induced psychosis.
Treatment Options for Drug-Induced Psychosis
The main treatment for substance-induced psychosis is stopping use of the substance and recovering in a calm, quiet environment. Sometimes, medications such as anxiolytics (benzodiazepines) or antipsychotics are prescribed to relieve anxiety and calm the mind. At other times, quiet observation is all that is needed to let short-term psychosis from drug use run its course. Long-term psychosis from drug use may require treatment with psychotherapy.
Medical Interventions
Detoxification and Rehabilitation
Symptoms of a substance-induced psychotic disorder are usually short-lived and occur during active substance use or withdrawal from the substance. The psychotic symptoms disappear once the substance has cleared from the body. For example, alcohol-related psychosis usually goes away spontaneously after alcohol use is discontinued, but can reappear with repeated alcohol use. However, occasionally, psychotic symptoms can persist for several weeks.
Undergoing medically supervised detoxification in a drug addiction treatment facility can ensure safe withdrawal from alcohol and drugs. At such facilities, a medical team is on hand 24×7 to manage any severe withdrawal symptoms, including psychotic symptoms. Medical supervision is necessary to prevent self-harm during a psychotic episode.
Anti-Anxiety and Antipsychotic Medications
Antipsychotic medications or antianxiety medications such as benzodiazepines may be used to manage psychotic symptoms. These medications are particularly effective in people with psychosis from amphetamines or other dopamine-stimulating drugs.
For psychosis related to other drugs of abuse such as phencyclidine (PCP), management may consist of monitoring the person in a calm, quiet environment, without the need for medications.
If the drug of abuse is unknown, healthcare providers typically avoid benzodiazepines and instead use a low-potency first-generation antipsychotic for its calming effects.
Long-Term Treatments for Psychosis from Drug Use
Frequent or prolonged use of drugs or alcohol can result in long-term psychosis, which can be difficult to distinguish from psychiatric disorders such as schizophrenia. Healthcare providers generally say that the distinguishing feature is that, unlike schizophrenia, drug or alcohol-related psychosis remits with abstinence.
Psychotherapy (Cognitive Behavioral Therapy CBT)
Evidence-based treatments for long-term management of substance use disorders include psychotherapy (talk therapy) modalities such as cognitive behavioral therapy (CBT). CBT involves working with a licensed therapist or counselor to learn to identify negative patterns of thinking and behavior and replace them with healthier ones. The goal is to learn coping mechanisms to avoid triggers and cravings for drug and alcohol use. Ultimately, abstinence from drugs and alcohol is the best way to avoid complications such as drug-induced psychosis.
Supportive Therapy for Dual Diagnosis
As mentioned, the risk of drug or alcohol-induced psychosis is higher in people with a co-occurring mental health condition. Also, experiencing psychosis from drug use is a risk factor for developing psychiatric disorders like schizophrenia. If you or a loved one has a dual diagnosis of substance use and mental health conditions, it is very important to seek care at a specialized rehabilitation facility that offers dual diagnosis and treatment. Treating both conditions at the same time is vital to overcoming substance abuse and managing the mental health symptoms.
Ongoing Support with Aftercare Programs
The best addiction treatment facilities offer aftercare programs to graduates of inpatient and outpatient rehab for drug or alcohol abuse. These aftercare programs are designed to help you sustain sobriety and stay on the path to recovery. They can include things like sober living, job training, financial planning, ongoing therapy, 12-step programs, and more.
- Educational groups teach you about substance abuse and its consequences, including psychosis caused by drug use.
- Skills development groups help you learn and apply skills needed to remain abstinent.
- Cognitive behavioral therapy in group format helps to reduce addictive behaviors and avoid triggers.
- Support groups help you in gain confidence, self-reflect, practice honest communication, feel less isolated, and be accountable for your commitment to change.
Key Takeaways: Drug Induced Psychosis Can Be Managed Safely
Psychosis from drug use is a serious mental health complication in people with substance use disorders. It involves the development of psychiatric symptoms like hallucinations, delusions, and disordered thinking and behaviors. It’s important to seek help if you or a loved one is struggling with short- or long-term psychosis from drug use. Effective treatments are available to manage the symptoms and help you feel more like yourself again.
Call Discover Recovery Treatment Center today to find out how our programs can help you in your recovery from substance abuse. Our team of experienced healthcare professionals is trained to manage the complications of drug and alcohol withdrawal, including drug-induced psychosis.
Frequently Asked Questions (FAQs)
What are the main symptoms of psychosis?
The main symptoms of psychosis from drug use are hallucinations, delusions, and disordered thinking.
Which drugs are most likely to cause psychosis?
Cannabis, stimulants (cocaine, amphetamines), hallucinogens (LSD, mushrooms), and alcohol are most likely to cause substance-induced psychosis.
Is drug-induced psychosis permanent?
Drug-induced psychosis is not permanent in most cases. The psychotic episode typically resolves once the drug clears from the system. However, sometimes psychotic symptoms can persist for several weeks. Also, people who experience psychosis from drug use are at an increased risk of developing a psychotic disorder such as schizophrenia, which is associated with chronic (long-term) psychotic symptoms.
What happens in the brain during drug-induced psychosis?
The brain experiences rapid and significant changes in the levels of natural chemicals called neurotransmitters during drug-induced psychosis.
Can a single use of a drug trigger psychosis?
Yes, a single use of a drug can trigger psychosis. However, psychosis from drug use is more common in people with heavy, frequent, or prolonged drug use.
Can mixing different drugs increase the risk of psychosis?
Yes, mixing different drugs (polydrug abuse) can increase the risk of psychosis related to drug use.
Is drug-induced psychosis the same as a ‘bad trip’ from hallucinogens?
The term “bad trip” from hallucinogens such as LSD is often used to describe a psychotic episode. This can occur the first time you use a drug or after using it several times.
