Drug withdrawal occurs when the body, having adapted to the presence of a substance, reacts to its absence. Psychosis involves a distorted perception of reality, characterized by difficulties in distinguishing what is real from what is not.
Understanding Drug Withdrawal
Drug withdrawal is a physiological response that emerges when an individual significantly reduces or abruptly stops using a substance to which their body has become dependent. Consistent substance use leads the body to adapt, creating a new balance. When the substance is no longer available, the body struggles to regain equilibrium, leading to physical and psychological symptoms.
Withdrawal symptoms vary widely depending on the specific substance, the duration and intensity of its use, and individual biological factors such as metabolism, age, and genetics. Common non-psychotic withdrawal symptoms can include nausea, vomiting, muscle aches, tremors, anxiety, insomnia, irritability, and intense cravings for the substance.
How Withdrawal Can Lead to Psychosis
Withdrawal from certain substances can trigger psychosis due to their impact on brain chemistry, particularly neurotransmitter systems. Chronic substance use leads to compensatory changes in the brain. When the substance is removed, these adaptations result in an overactive or imbalanced nervous system, which can precipitate psychotic symptoms.
Alcohol withdrawal is a well-documented cause of psychosis, with Delirium Tremens (DTs) being a severe manifestation. DTs typically involves profound confusion, agitation, and hallucinations. Benzodiazepine withdrawal also carries a high risk of psychosis, similar to alcohol, because these drugs similarly act on GABA receptors, and their removal can lead to nervous system overactivity.
Stimulant withdrawal, from amphetamines and methamphetamine, can lead to psychosis. This is linked to altered dopamine levels in the brain, with symptoms emerging after cessation. While psychosis is less common in opioid withdrawal, it can occur in severe cases, sometimes involving paranoid delusions and hallucinations, especially with polysubstance use.
Identifying Withdrawal-Induced Psychosis
Psychosis during drug withdrawal manifests through symptoms indicating a break from reality. Hallucinations are common, involving unreal sensory perceptions, such as seeing, hearing, or feeling things that are not present. Visual hallucinations, like seeing “bugs crawling on the skin,” are particularly associated with severe alcohol and stimulant withdrawal. Auditory hallucinations, such as hearing voices, can also occur.
Delusions are false beliefs held despite evidence to the contrary. These can include paranoia, where an individual believes others are trying to harm them, or grandiose delusions. Disorganized thinking is also characteristic, leading to difficulty with logical thought, incoherent speech, or unusual behaviors.
These severe symptoms typically appear during the withdrawal period, often within hours to several days after the last substance use. Recognizing these symptoms as distinct from typical withdrawal discomfort is crucial, as they signal a more severe condition.
When to Seek Professional Help
Withdrawal-induced psychosis is a medical emergency requiring immediate professional intervention. Attempting to manage such symptoms without medical supervision is dangerous and can lead to complications, including seizures, cardiovascular issues, or harm to oneself or others. Contact emergency services, a doctor, or present at an emergency room immediately.
Medical professionals provide a safe, controlled environment for detoxification. This involves close monitoring of vital signs and medications to alleviate symptoms and stabilize the individual. Sedative medications, such as benzodiazepines, are used to reduce central nervous system hyperexcitability and prevent seizures, while antipsychotics may be employed for psychotic symptoms.
Beyond immediate stabilization, ongoing support and comprehensive treatment are important for long-term recovery. Medically supervised detoxification ensures safety during the acute phase and is the first step in a broader treatment plan addressing substance dependence. Self-management during withdrawal with psychotic features is not a safe option due to health risks.