Substance-Induced Psychosis

In mental health, it is relatively common for patients to suffer from both a condition like depression or bipolar disorder and addiction.  When this occurs, it is referred to as dual diagnosis.  However, substance use in and of itself can imitate and sometimes even directly cause other mental health issues. This article addresses a condition known as substance-induced psychosis.

Understanding Substance-Induced Psychosis

As the name suggests, this condition occurs when substance use produces a psychotic state in a patient. Psychosis is characterized by the person being out of touch with reality; delusions (incorrect perceptions of events, people, and other things in their world) and unusual sensory experiences (like hearing voices or seeing things) are common.  Perhaps because these are often unsettling for the person who is experiencing them, patients with substance-induced psychosis may be paranoid or behave in strange ways. 

Some substances – like hallucinogens, for example – are known to produce similar results simply from use.  However, a diagnosis of substance-induced psychosis requires severity of symptoms over and above that which would typically be attributable to the use of the drug. Additionally, the doctor must determine that these symptoms are not really caused by a different underlying psychiatric condition (e.g., the patient’s medical records do not indicate that psychosis has been a problem in the past).  If the person is able to articulate that he or she is behaving strangely because of drug use, a diagnosis of substance-induced psychosis is unlikely.

Causes of Substance-Induced Psychosis

Symptoms of this condition can begin during intoxication or withdrawal.  Among the substances that can cause this problem are hallucinogens, amphetamines, cocaine, opiates, alcohol, marijuana, and sedatives among others.

Duration of Symptoms

How long a person suffers from substance-induced psychosis depends on a number of different factors.  For example, some users may return to reality after their bodies have processed the drug.  Drugs like cocaine and PCP can lead to prolonged psychotic states that last for days, weeks, or, in some situations, months.

Medical Treatment of Substance-Induced Psychosis

If it is known the drug was consumed recently, and if the drug is not usually associated with a lengthy presentation of symptoms, a physician may stabilize the patient and monitor them until the period after the drug would normally be metabolized.  If symptoms have not resolved by this time, or if the person first seeks medical attention after the symptoms have persisted for a long period, treatment with pharmacological options such as quetiapine and clozapine (atypical anti-psychotic medications) may be the next best option.

How to Help a Person With Substance-Induced Psychosis

Keep in mind that few people with substance-induced psychosis have insight into the fact that they have a problem; if they do, they may not actually have it and may still simply be experiencing the normal effects of recent drug use.  Therefore, it is often up to loved ones to recognize and get help for the problem.  If you cannot persuade the person to go to a psychiatrist’s appointment with you, ask the physician or a social worker for advice specific to your situation.

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