Psychosis is a severe mental state where an individual experiences a significant disconnect from reality. This condition involves disruptions in thoughts and perceptions, making it challenging to distinguish between what is real and what is not. Drug-induced psychosis, specifically, represents a temporary form of this state directly triggered by the physiological effects of substance use or withdrawal.
Defining Drug-Induced Psychosis
These symptoms typically include delusions, which are false beliefs held firmly despite evidence to the contrary, and hallucinations, which are sensory experiences occurring without an external stimulus. Disorganized thinking and speech, along with unusual behaviors, also characterize a psychotic episode.
Drug-induced psychosis, also known as substance-induced psychotic disorder, is distinguished by its direct causation by a psychoactive substance or its withdrawal. Unlike other forms of psychosis, such as those associated with schizophrenia, drug-induced episodes are often acute and temporary.
Substances Linked to Psychosis
Various substances can disrupt brain chemistry and induce psychotic episodes. Stimulants, such as amphetamines, methamphetamine, and cocaine, can lead to intense paranoia, persecutory delusions, and vivid hallucinations, including tactile sensations like feeling insects crawling on or under the skin. The psychotic effects of stimulants are often linked to their ability to increase dopamine levels in the brain.
Hallucinogens and dissociatives also induce psychotic states. Substances like LSD, psilocybin (magic mushrooms), PCP, ketamine, and MDMA can cause profound distortions of perception, an altered sense of time and space, and vivid hallucinations. The mechanism often involves interactions with serotonin receptors in the brain, leading to an imbalance in neuronal activity. Cannabinoids, particularly high-potency cannabis with high tetrahydrocannabinol (THC) content, also trigger paranoia, delusions, heightened sensory perceptions, and fear, possibly by increasing dopamine and affecting other neurotransmitter systems like GABA and glutamate.
Psychosis can also emerge during withdrawal from certain depressants, including alcohol and benzodiazepines. Alcohol withdrawal, for example, can result in auditory hallucinations and delirium. Some prescription and over-the-counter medications, such as certain pain relievers, Parkinson’s disease medications, heart medications, corticosteroids, antibiotics, and antihistamines, can trigger psychotic symptoms in susceptible individuals.
Identifying the Symptoms
During a drug-induced psychotic episode, individuals experience a range of symptoms. Hallucinations, where a person perceives things not actually present, can manifest as auditory experiences, such as hearing voices or sounds; visual disturbances, like seeing objects or figures that others cannot; or even tactile sensations, such as feeling things on the skin. Olfactory hallucinations, involving smells, can also occur.
Delusions, characterized by false beliefs resistant to logic or evidence, are also a core symptom. Common types include persecutory delusions, where the individual believes others are trying to harm or conspire against them, and grandiose delusions, involving an exaggerated sense of self-importance or power. Disorganized thinking often leads to incoherent or jumbled speech, making it difficult for others to follow their train of thought. Individuals may also exhibit extreme agitation, paranoia, and an inability to engage with reality. Behavioral changes, mood swings, and impaired judgment are also observed.
Treatment and Outlook
Experiencing drug-induced psychosis is a medical emergency that requires immediate professional attention. Acute stabilization is the primary goal, often involving a safe and monitored environment to ensure the individual’s safety and to allow the substance to clear from their system. Medical interventions may include the short-term administration of antipsychotic medications to manage severe psychotic symptoms like agitation, hallucinations, and delusions.
The most important step in recovery involves discontinuing the causative substance, as symptoms typically resolve once the drug is eliminated from the body. The prognosis for drug-induced psychosis is generally favorable, with symptoms often subsiding within hours to weeks after cessation of the substance. However, for some substances like amphetamines, PCP, and cocaine, symptoms may persist for several weeks. While many individuals recover fully, a drug-induced psychotic episode can sometimes unmask or accelerate the onset of an underlying chronic mental health condition, such as schizophrenia or bipolar disorder. This risk is particularly elevated in individuals with a genetic predisposition or those with early-onset or prolonged substance use.