Recreational and prescription drugs can cause someone to develop symptoms of psychosis that look like a psychiatric disorder, such as schizophrenia or bipolar disorder. A drug or substance-induced psychotic disorder is diagnosed following the occurrence of psychotic symptoms that were caused by a psychoactive substance. These symptoms may appear while a person is under the influence of these drugs or during drug withdrawal.

In the case of psychosis, a person loses touch with reality and can experience disturbing hallucinations and delusions. They may struggle to decipher whether the hallucinations and delusions are real or not, and they may suffer from distressing confusion as a result. The onset of these symptoms will vary from person to person and can come on quickly or gradually.

The symptoms of drug-induced psychosis do not pose a significant physical danger to users, though associated behaviors can. The two clearest symptoms of drug-induced psychosis are hallucinations and delusions, but in reaction to these, individuals may engage in unpredictable and dangerous behaviors. Specific dangers associated with drug-induced psychosis include:

  • Aggression
  • Violent behavior
  • Suicidal thoughts
  • Delusions
  • Hallucinations
  • Hospitalization

The risks associated with drug-induced psychosis make it important to closely monitor the symptoms of someone who is having this experience. Keep the individual in a calm and safe environment. If this is not possible, emergency medical care or hospitalization may be necessary to ensure everyone’s safety.

Substances That Can Cause Psychosis

Many drugs produce mind-altering effects in users, but not all are likely to lead to symptoms of psychosis. Certain recreational drugs, as well as prescription medications, are known to cause drug-induced psychosis. Among them are:

  • Alcohol
  • Cannabis
  • Phencyclidine
  • Inhalants
  • Sedatives
  • Hypnotics
  • Amphetamine
  • Methamphetamine
  • Cocaine
  • Psychedelic drugs
  • Anesthetics
  • Analgesics
  • Anticholinergics
  • Anticonvulsants
  • Antihistamines
  • Cardiovascular medications
  • Antimicrobials
  • Chemotherapy drugs
  • Parkinson’s medications
  • Corticosteroids
  • Gastrointestinal medicines
  • Muscle relaxants
  • Nonsteroidal anti-inflammatory medications
  • Antidepressants
  • Disulfiram

The severity of psychosis experienced as a result of using any of the above substances will vary depending on one’s mental and physical health, the substance being used, and personal history with substance misuse. Methamphetamine, cannabis, amphetamine, cocaine, alcohol, psychedelic drugs, and club drugs are most known for their tendencies to cause drug-induced psychosis.

Symptoms of psychosis can appear after a period of heavy use or even after just one use. In most situations, symptoms will dissipate when drug use has stopped. In some situations, such as with methamphetamine, cannabis, or cocaine use, symptoms can persist for weeks or months, or they may reappear during times of stress.

Primary Symptoms of Drug-Induced Psychosis

Again, hallucinations and delusions are the two primary symptoms of drug-induced psychosis. Hallucinations can be auditory, visual, tactile, or olfactory. Delusions may be grandiose, somatic, erotomanic, or centered around persecution and jealousy.

To be diagnosed as a drug-induced psychosis, the delusions and hallucinations must be greater than what the typical effects of the drug are. Some level of hallucinations or delusions may be expected from certain drugs or during withdrawal, so they would not classify as psychosis.

Additional symptoms of drug-induced psychosis include:

  • Lethargy
  • Confused speech
  • Thoughts that don’t make sense
  • Lack of emotion
  • Difficulty expressing oneself
  • Erratic or antisocial behavior

The Diagnostic and Statistical Manual of Mental Disorders, Fifth Edition (DSM-V) outlines criteria for diagnosing drug-induced psychosis. Five criteria must be met for such a diagnosis to be made. Ultimately, these five criteria are the clearest symptoms of drug-induced psychosis.

  1. Psychotic symptoms cannot be better explained by a pre-existing psychotic disorder, such as schizophrenia or bipolar disorder.
  2. Medical tests have been conducted and confirm that psychotic symptoms presented during substance use or within one month of withdrawing from the substance.
  3. Delusions and/or hallucinations are present.
  4. Psychotic symptoms are consistent and do not occur only during states of delirium.
  5. Psychotic symptoms are having a significant impact on the individual’s ability to function in daily life and causing great distress.

All of the above criteria must be met for a formal diagnosis of drug-induced psychosis to be made. While this can be a scary diagnosis to receive, once it is made, proper treatment can begin.

Treatment Options and Outcomes

The first step to providing proper treatment for drug-induced psychosis is to recognize if the psychosis was caused by drug use. This is done by determining if symptoms were present before the drug use took place. Once it is clear that an individual’s psychotic symptoms are drug-related rather than caused by a mental health disorder, the proper treatment can be given. All treatment begins with the individual ceasing drug use. As long as they continue to use drugs, the drug-induced psychosis is likely to persist.

If symptoms persist after drug use has stopped, and the individual does not appear to be in a safe condition, it may be necessary to seek emergency medical care by calling 911 or going to the nearest emergency room. Due to the risks of violence and suicidal ideation, it is important to ensure that the individual is not a threat to themselves or anyone else around them. If necessary, doctors can prescribe antipsychotic medications to alleviate severe symptoms. The individual may need to be admitted to an inpatient treatment program to receive medically assisted detox and/or psychiatric treatment.

Following recovery from an episode of drug-induced psychosis, individuals may be referred to outpatient treatment programs. Through a combination of medication, individual therapy, and group therapy, the individual will be given the opportunities to explore their history of drug use, identify triggers for use, and develop skills to live a healthy, substance-free life.

Drug-Induced Psychosis and Mental Health

Recent studies have investigated the connection between drug-induced psychosis and mental health disorders like schizophrenia. Researchers looked into the number of people who had been diagnosed with drug-induced psychosis and went on to develop schizophrenia or bipolar disorder within the following years. The highest rate of conversion to schizophrenia was seen in people who had experienced cannabis-induced psychosis.

During a 20-year period, 26 percent of people who had experienced drug-induced psychosis developed schizophrenia. They were 77 times more likely to develop schizophrenia than people in the study who never experienced drug-induced psychosis.

Additionally, more than half of the people who converted to schizophrenia did so within three years of their episode of drug-induced psychosis. Due to these findings, researchers strongly suggest following up with people who have experienced drug-induced psychosis for at least two years after the incident.

Experiencing drug-induced psychosis does not guarantee you will experience long-term adverse effects to your mental health. It appears, however, to put you at greater risk of developing complications. If you have had drug-induced psychosis, be aware of the potential mental health issues, and take the steps necessary to ensure your mental and physical health.

Are You at Risk for Drug-Induced Psychosis?

Anyone who experiments with recreational drugs or is prescribed certain medications may be at a greater risk of experiencing drug-induced psychosis. Personal factors, such as family history of mental illness and your own history of drug use, can certainly affect your likelihood of developing drug-induced psychosis. In general, people who abuse alcohol and other substances are more likely to experience psychotic symptoms when using drugs and withdrawing from them.

Evidence also indicates, however, that psychotic symptoms can present after just a single use of certain drugs. Symptoms are likely to disappear once the effects of the drug have worn off or once you have made it through the withdrawal process. In some cases, however, symptoms can reappear up to years later. The best way to reduce your risk of experiencing drug-induced psychosis is to refrain from experimenting with recreational drugs and use prescription medications only under the supervision of your doctor.

If you do find yourself in a situation where you, or someone you know, are experiencing drug-induced psychosis, the best thing to do is to stay calm. Managing anxieties and fears that often result from disturbing hallucinations and delusions will help to keep the psychosis under control and reduce the likelihood of aggressive and violent behaviors.

Do not hesitate to seek medical attention. Medical professionals are experienced in helping people manage psychotic episodes and make full recoveries.

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