Substance-Induced Psychosis

A number of mental health conditions like depression and post-traumatic stress disorder can contribute to the development of addictions or alcoholism (Read Dual Diagnosis: When Addiction and Mental Health Collide and Post Traumatic Stress Disorder: When the Past Affects the Present).  However, sometimes substance use or abuse can also be the cause of mental health issues.  One unfortunate yet well-known example occurs when suicide is attempted after an individual’s inhibitions have been lowered by substance use (Read Suicide and Substance Abuse: Know the Risks).  Another, less common possible outcome of substance abuse is the psychiatric condition known as substance-induced psychosis.

What is substance-induced psychosis?

Someone who is having psychotic symptoms has lost touch with reality.  They may be delusional (have an inaccurate understanding of people and events) and/or they may have false sensory experiences (e.g., auditory or visual hallucinations).  Strange behaviors or paranoia may be the end result. In substance-induced psychosis, the psychotic symptoms must be more than what would normally be associated with using the substance; should not be attributable to a different psychotic disorder (e.g., the person has no history of psychosis); and the person is not cognizant of the fact that their behavior and beliefs are related to substance use.

What substances can cause someone to enter a psychotic state?

Someone may become psychotic either while intoxicated by or during withdrawal from a variety of substances including alcohol, sedatives, cocaine, marijuana, hallucinogens, opiates, and amphetamines to name a few.

How long does it last?

In some cases, the state will end once the substance has been metabolized (Read Back to Sobriety: How Long Different Substances Stay in Your System).  However, symptoms can last for weeks or even months if the result of certain substances (e.g., cocaine, amphetamines, phencyclidine).

How is it treated?

Depending on the severity of symptoms and the length of time that they have persisted, a physician may treat substance-induced psychosis with an atypical anti-psychotic medication such as clozapine and quetiapine. If the symptoms subside quickly, treatment may not be necessary.

What should I do if I am with someone who I believe has substance-induced psychosis?

If you determine that someone is hallucinating after ingesting a substance, first do your best to figure out what substance caused the problem.  If the person’s hallucinations are non-threatening (e.g., they do not have plans to harm themselves or others) and they are willing to stay with you in a safe environment, contact an out-patient psychiatrist and ask whether the symptoms will dissipate on their own or if you need to make an appointment.  If the person is becoming violent or planning to leave, you may need to take them to an emergency room or contact the police.

Is there anything I can do to prevent someone from getting it?

Drug-induced psychosis can occur from use of illegal drugs, but it can also happen with prescription medications for the treatment of a medical condition such as Parkinson’s.  If you or a loved one is being treated for an illness, you should ask your doctor whether the medications you/they are taking have been implicated in drug-induced psychosis.  The best way to help someone who is abusing or addicted to a drug to avoid the phenomenon is to schedule an intervention and get the person into a drug treatment facility.