What is Substance-Induced Psychosis? Causes, Symptoms, and Treatment

Drug and alcohol abuse often has serious or even life-threatening physical effects that can vary in intensity. Some individuals who abuse drugs or alcohol on a regular basis may be more likely to experience a disorder called substance-induced psychosis.

Substance-induced psychosis is a serious disorder that can have lasting effects that take weeks, months or even years to overcome. Experiencing symptoms of psychosis can be extremely scary and isolating, and people who suffer from substance-induced psychosis may be less likely to come forward for help out of fear of the consequences of illegal drug use or prescription drug abuse.

Although it can be scary to admit any sort of drug abuse, getting professional treatment for substance-induced psychosis and drug addiction is often necessary for a full recovery.

What is Substance-Induced Psychosis?

Substance-induced psychosis (also known as drug-induced psychosis) is a disorder that is characterized by the presence of hallucinations and/or delusions caused by alcohol or drug use.¹ The disorder is commonly seen in crisis centers or emergency rooms and symptoms can last for a short duration of time while a person is intoxicated or for several weeks during and after withdrawal.

Although the general side effects of many different drugs may include psychotic symptoms, substance-induced psychosis is different because the psychotic symptoms occur in addition to the normal effects of the drug use.

Symptoms of Substance-Induced Psychosis

A person suffering from substance-induced psychosis will often experience mood disturbances, sleep problems, low energy, lack of motivation, and anhedonia (an inability to experience pleasure).² Other distinct characteristics and symptoms of drug-induced psychosis include:

• Hallucinations – A person experiencing drug-induced psychosis may see, hear, or feel things that aren’t really there.
• Delusions – Someone suffering from delusions may believe strange or bizarre things like they are being followed, that they are a famous astronaut, or that they have special powers like mind-reading or telekinesis.
• Odd behaviors – Substance-induced psychosis can cause inappropriate or strange behaviors, such as extreme aggression or behaviors that are not age-appropriate.
• Cognitive and speech problems – Drug-induced psychosis can also cause cognitive problems like disorganized thinking and speaking. Someone suffering from this disorder may be unable to concentrate, think and speak clearly, or make clear judgments and decisions.

Although the more severe symptoms of drug-induced psychosis such as delusions, aggressive behavior, and hallucinations are the ones that are most publicized and covered in news stories, the less severe symptoms are still characteristic of the disorder and they can cause a variety of physical and mental problems.

Causes of Substance-Induced Psychosis

According to the Encyclopedia of Mental Disorders, substance-induced psychosis is directly caused by the effects of alcohol or drugs such as over-the-counter medications, prescription drugs, hypnotics, or illegal synthetic drugs like bath salts, which have dangerous chemical ingredients.²

As the name of the disorder implies, true substance-induced psychosis is caused by the abuse of certain drugs, including, but not limited to:

• Alcohol
• Amphetamines
• Cannabis
• Cocaine
• Hallucinogens
• Inhalants
• Opioids
• PCP (phencyclidine)
• Over-the-counter medications
• Prescription medications²

The rate at which substance-induced psychosis appears varies depending on the type of drug that is abused. In some instances, a drug may cause psychosis within minutes or hours of using it while other substances such as alcohol may only cause psychosis after prolonged, heavy use over the course of several weeks or months.

How to Identify Substance-Induced Psychosis

Differentiating between drug-induced psychosis and other psychotic disorders can sometimes be difficult, but a thorough and accurate history of substance use and abuse can help medical care providers correctly identify substance-induced psychosis and provide the necessary treatment.

To distinguish substance-induced psychosis from other disorders like drug withdrawal, dementia, delirium, or the effects of general substance abuse, medical providers may consider several factors such as:

• The time of onset
• The reasoning for substance use
• Patterns of substance use
• A family history of mental illness
• Problems with chronic relapse
• Response to prior substance abuse treatment
• Psychological evaluations²

The medical diagnostic criteria for substance-induced psychosis include: The person suffers from prominent delusions and/or hallucinations The psychotic symptoms developed during or within a month of the substance abuse or drug withdrawal The psychotic disturbance does not occur exclusively during delirium The disturbance is not caused by another psychiatric disorder

It is extremely important that substance-induced psychosis is identified and diagnosed correctly, as a differing psychiatric issue will not be resolved with a professional detox program and may continue even after detox or residential treatment for drug addiction and abuse is complete.

If you or a loved one is experiencing symptoms of psychosis following drug abuse, it’s important to seek medical attention at a hospital, detox facility, or crisis center so you can receive the proper diagnosis and treatment.

Is Substance-Induced Psychosis Permanent?

There is no absolute way to determine how long substance-induced psychosis may last, as it can last for hours, days, weeks, months, or even years. A person suffering from drug-induced psychosis may experience symptoms for varying amounts of time, depending on the type of drug being used, the size of the dosage, and how long the person has been using the drug.

Risk Factors for Substance-Induced Psychosis

People who have substance use disorders are also more likely to suffer from psychiatric disorders like depression, anxiety, schizophrenia, or substance-induced psychosis. A family history of mental illness may also increase a person’s likelihood of developing substance-induced psychosis.

One study also found the following factors to be the primary risk factors in the development of drug-induced psychosis:

• Polydrug use
• Cannabis (marijuana) use
• Previous psychiatric hospitalization
• Previous non-drug related hallucinations³

Although substance abuse is not the only accepted cause of psychosis, there is a strong correlation between the two.⁴ As a result, the best way to prevent substance-induced psychosis may be to abstain from drug and alcohol use completely.  

Medical Detox Treatment for Substance-Induced Psychosis

A person suffering from substance-induced psychosis will benefit from a calm, safe, and supportive environment with professional medical staff that can identify and treat co-occurring disorders alongside the substance abuse.

In addition to providing round-the-clock medical monitoring throughout the duration of the psychosis or withdrawal, a professional detox program can also support patients by addressing the underlying physical, psychological, and emotional causes of their substance abuse. This not only helps prepare clients for entry into a rehab program for continued addiction treatment, but it also gives clinical staff the opportunity to identify any other psychiatric conditions and provide appropriate treatment as needed.

Any type of psychosis, not just drug-induced psychosis, can be incredibly damaging and detrimental to a person’s health and well-being, making it very difficult to overcome any substance abuse disorder.

References:

1. https://www.merckmanuals.com/professional/psychiatric-disorders/schizophrenia-and-related-disorders/substance-medication%E2%80%93induced-psychotic-disorder
2. http://www.minddisorders.com/Py-Z/Substance-induced-psychotic-disorder.html
3. https://www.ncbi.nlm.nih.gov/pubmed/26359848
4. http://www.psychiatrictimes.com/schizophrenia/link-between-psychotic-disorders-and-substance-use