Drug-Induced Psychosis

What is Drug-Induced Psychosis?

Psychosis is a scary word.  For most people, it probably conjures images of unpredictable and out-of-control behavior caused by mental illness. While it’s true that psychosis is a symptom associated with various mental disorders, you may be surprised to know that it can be caused by drug use as well.  

The National Alliance on Mental Illness defines psychosis as an episode during which an individual experiences disruptions to their thoughts and perceptions, resulting in a severe break from reality.  Drug-induced psychosis, or substance-induced psychotic disorder, can be caused by hallucinogens, prescription medications, alcohol, marijuana, or other illicit drugs. It can be the result of heavy chronic drug use, too much of a single dose of certain drugs, or an adverse reaction to a mixture of drugs. Drug-induced psychosis is a serious condition that requires mental health treatment to make a full and lasting recovery and to prevent a recurrence. 

 What is Cannabis-Induced Psychosis?

While marijuana is considered by many to be a safe and even healthful substance, it can potentially trigger psychosis in healthy people or worsen psychotic symptoms in people with certain mental disorders. Recent studies show that daily cannabis use and the availability of high-potency marijuana (containing high levels of the psychoactive compound THC) are associated with an increased risk of having a psychotic episode. One study found that people who use pot daily are three times more likely to have a psychotic break as those who have never used marijuana; people who use high potency weed are twice as likely; and people who use high-potency weed daily are four times more likely to experience psychosis than those who have never used marjiuana. 

Cannabis-induced psychosis, or psychosis triggered by marijuana, is a rare but possible symptom of cannabis consumption. While the effects of cannabis intoxication (paranoia, grandiosity, perceptual alterations, and impaired cognition) wear off within a couple of hours after ingestion, symptoms of cannabis-induced psychosis can persist for a week, a month, or even a year. These symptoms may include paranoia, delusions, hallucinations, and disorganized thinking. 

 Types of Drug-Induced Psychosis

While people with mental health disorders are more likely to have symptoms of psychosis triggered by drug use, it is possible in those without prior mental health issues as well. Drug-induced psychosis typically comes on suddenly. In most cases, it is acute, with symptoms lasting only until the drug wears off. Sometimes, particularly after prolonged use, the symptoms will last far longer than the intoxicating effects of the substance. Although each person is different, and there’s no way to determine which substances will result in a psychotic break in an individual, certain drugs are more likely than others to trigger drug-induced psychosis overall. Those include: 

• Methamphetamines
• Cannabis
• Cocaine
• Amphetamines
• Alcohol
• Psychedelic drugs
• Ecstasy
• Ketamine 

For some people, the psychosis is brought on by taking their prescription medications as instructed by their doctor. Prescription medications that potentially cause psychosis include certain:

• Anticonvulsants
• Cardiovascular medications
• Corticosteroids
• Chemotherapy agents
• Antiparkinson medications

 Drug-Induced Psychosis Symptoms and Diagnosis

Drug-induced psychosis is characterized by delusions and hallucinations brought on by substance use. Delusions refer to unshakeable beliefs that are contrary to reality, despite clear evidence to contradict those beliefs. Hallucinations refer to the perception of things that are not there. 

Examples of delusions:

• Grandiose – the belief that the individual wields great power or talent
• Erotomanic – the belief that someone is in love with them, often someone famous
• Persecutory – the belief that someone is watching them or planning to harm them

Examples of hallucinations:

• Hearing voices
• Seeing things (such as shadows or people)
• Feeling sensations (such as bugs crawling on the skin)
• Smelling odors that no one else smells or can confirm

For a diagnosis of substance- or medication-induced psychosis as defined by the Diagnostic and Statistical Manual of Mental Disorders (DSM-5), the following must be true: 

• The symptoms developed during or soon after substance use or withdrawal
• The substance is capable of producing the symptoms
• The symptoms include delusions and/or hallucinations
• The psychosis is not better explained by a psychotic disorder that is not drug-induced
• The psychotic symptoms do not occur exclusively during the course of a delirium
• The symptoms cause significant stress and impaired functioning

The above criteria are very important for the diagnosis of drug-induced psychosis because they help to distinguish it from other possible psychotic disorders. 

 Co-Occuring Disorders

People who have both substance abuse disorders and mental health disorders are diagnosed with co-occuring disorders, or dual diagnosis. Either disorder can develop first. Often, people with mental health disorders such as depression and anxiety turn to drugs, alcohol, or other substances to cope with their symptoms. Other people who have substance abuse issues develop depression, anxiety, or other mental health disorders as a result of their substance use. 

The symptoms of drug-induced psychosis mimic the symptoms of psychosis associated with severe mental health disorders such as schizophrenia and schizoaffective disorder. To make it more complicated, it is possible for someone with schizophrenia to experience drug-induced psychosis before they show signs of schizophrenia. 

Dual diagnosis treatment refers to the simultaneous treatment of the mental health disorder and the substance abuse disorder. Dual diagnosis treatment helps people with co-occuring disorders learn to manage their symptoms and optimize their mental health. 

 Drug-Induced Psychosis Treatment

The treatment programs at Alvarado Parkway Institute can help patients recover from drug-induced psychosis. Treatment plans are customized to the precise needs of each patient, but typically, each will include some combination of the following:

• Medically supervised detoxification aids in the safe elimination of the substance from the body. Medical staff monitor patient safety during withdrawal and help to prevent more severe symptoms of psychosis from developing. 

• Inpatient drug rehabilitation helps patients with chemical dependency get sober, identify triggers, and learn relapse-prevention strategies. 

• Psychotherapy aims to help patients learn to communicate effectively, to strengthen relationships, and to manage symptoms related to co-occuring disorders. This may include:
  • Individual therapy
  • Group therapy
  • Cognitive behavioral therapy
  • Dialectic behavioral therapy

• Medications reduce symptoms and help regulate emotions in people with co-occuring disorders. These may include: 
  • Antipsychotic medications
  • Antidepressants
  • Anti-anxiety medications

Treatment for drug-induced psychosis at Alvarado Parkway goes beyond the psychosis itself to incorporate treatment of the substance abuse that caused it and as well as any underlying mental health conditions. At Alvarado Parkway, our goal is to help every patient achieve optimal mental health so they can go on to live rich and meaningful lives. 

CTA: For more information on drug-induced psychosis treatment at Alvarado Parkway Institute, please call us at (619) 667-6125.