Psychosis from Drugs: How It Works & Treatment Options

Drug-induced psychosis is feeling disconnected from the world around you where you see and hear things that inevitably are not real.

The delusions or hallucinations that occur can be caused by a variety of substances, including medicines. Amphetamine substances, marijuana, and other hallucinogens are notorious for inducing psychotic symptoms.

For instance, drug-induced psychosis has been reported by 8 to 46 percent of amphetamine users, according to ScienceDirect.

Methamphetamine users can frequently experience psychosis in the form of feeling like bugs are crawling all over their skin, or the drug is coming out of their bodies, reports MDedge Family Medicine.

Marijuana, the most widely used illicit substance in the U.S., is often cited for its ability to induce symptoms of psychosis. Common symptoms from marijuana or cannabis-induced psychosis (CIP) are depression, anxiety, and hypomania.

Either way, drug-induced psychosis requires the specialized intervention of a professional treatment program that addresses the substance use and a mental health disorder.

Without treatment, this condition can levy undue distress and chaos in your life, harming relationships, employment prospects, and overall well-being.

WHAT IS DRUG-INDUCED PSYCHOSIS?

There is no known cause for what exactly causes drug-induced psychosis. The clinical term for this condition is substance/medication-induced psychotic disorder, which is caused by the use of or withdrawal from drugs like hallucinogens, according to WebMD.

Common symptoms of substance/medication-induced psychotic disorder can include:

• Hallucinations
• Confused or disordered thinking
• Delusions
• Disassociation

Other dangers tied to drug-induced psychosis include suicidal ideation (thinking about or planning suicide), violent, or aggressive behavior.

TRIGGERING DRUGS

A wide variety of substances and medications can trigger substance/medication-induced psychotic disorder. According to the Merck Manual, commonly abused substances that can spark this condition include:

• Alcohol
• Amphetamines
• Hallucinogens
• Phencyclidine (PCP)
• Cocaine
• Marijuana
• Opioids
• Sedative-hypnotic medications

The Merck Manual also says that the symptoms of psychosis tend to be brief and subside once a drug is cleared from the system. However, the psychosis that is set off by cocaine, amphetamines, or phencyclidine (PCP) can last for weeks.

Verywell Mindstates that the following medicines have been linked to this condition:

• Corticosteroid-induced psychotic disorder
• Anticholinergic-induced psychotic disorder
• Anticonvulsant-induced psychotic disorder
• Nonsteroidal anti-inflammatory medication-induced psychotic disorder
• Muscle relaxant-induced psychotic disorder
• Anesthetic-induced psychotic disorder
• Disulfiram-induced psychotic disorder
• Cardiovascular medication-induced psychotic disorder
• Analgesic-induced psychotic disorder
• Antihistamine-induced psychotic disorder
• Antihypertensive-induced psychotic disorder
• Antimicrobial medication-induced psychotic disorder
• Antiparkinsonian medication-induced psychotic disorder
• Chemotherapeutic agent-induced psychotic disorder
• Gastrointestinal medication-induced psychotic disorder
• Antidepressant medication-induced psychotic disorder

Certain over-the-counter (OTC) medicines have been linked to this condition as well, like pseudoephedrine and phenylephrine products.

HOW DRUG-INDUCED PSYCHOSIS IS DIAGNOSED

The Diagnostic and Statistical Manual of Mental Disorders, 5th Edition (DSM-5), which is considered the principal authority for psychiatric diagnoses, lists certain criteria that can indicate substance/medication-induced psychotic disorder.

According to the DSM-5, the criteria to determine whether someone has this condition are as follows:

• Presence of one or both of the following symptoms:

1. Delusions
2. Hallucinations

• There is evidence from the history, physical examination, or laboratory findings of both (1) and (2):

1. The symptoms in Criterion A developed during or soon after substance intoxication or withdrawal or after exposure to a medication.
2. The involved substance/medication is capable of producing the symptoms in Criterion A.

• The disturbance is not better explained by a psychotic disorder that is not substance or medication-induced. Such evidence of an independent psychotic disorder could include the following: The symptoms preceded the onset of substance/medication use; the symptoms persist for a substantial period of time (e.g., about one month) after the cessation of acute withdrawal or severe intoxication; or there is other evidence of an independent non-substance/medication-induced psychotic disorder (e.g., a history of recurrent non-substance/medication-related episodes)

• The disturbance does not occur exclusively during the course of delirium E. The disturbance causes clinically significant distress or impairment in social, occupational, or other areas of functioning

A patient must meet all of the above criteria before an official diagnosis for substance/medication-induced psychotic disorder is made.

HOW PROFESSIONAL TREATMENT CAN HELP YOU

For people with drug-induced psychosis, it is recommended that they enter into dual diagnosis treatment.

Dual diagnosis is a specialized treatment plan that addresses substance abuse and co-occurring mental health disorders, including those derived from psychosis.

According to the National Institute on Drug Abuse (NIDA), there is a significant correlation between substance use disorders and mental health conditions.

Along with psychotic symptoms, common mental health conditions that accompany substance abuse include:

• Depression
• Anxiety
• Attention-deficit hyperactivity disorder (ADHD)
• Borderline personality disorder
• Antisocial personality disorder
• Schizophrenia

Thus, a reputable dual diagnosis treatment program will provide clients with detoxification, substance abuse treatment, behavioral therapy, housing resources, medications for mental health disorders, and support group connections.

Sources

Frieden, J. (2019, January 18). Skin Manifestations May Signal Crystal Meth Use: Think 'meth mites' when patients are picking at their skin and think they have insects crawling on them. from https://www.mdedge.com/familymedicine/article/26173/dermatology/skin-manifestations-may-signal-crystal-meth-use-think-meth

Hartney, E. (2019, June 06). What You Need to Know About Substance-Induced Psychotic Disorder. from https://www.verywellmind.com/what-is-substance-medication-induced-psychotic-disorder-21938

Merck Manual. (n.d.). Substance/Medication–Induced Psychotic Disorder – Psychiatric Disorders. from https://www.merckmanuals.com/professional/psychiatric-disorders/schizophrenia-and-related-disorders/substance-medication–induced-psychotic-disorder

National Alliance on Mental Illness. (n.d.). NAMI. from https://www.nami.org/Learn-More/Mental-Health-Conditions/Related-Conditions/Dual-Diagnosis

National Institute on Drug Abuse. (n.d.). Part 1: The Connection Between Substance Use Disorders and Mental Illness. from https://www.drugabuse.gov/publications/research-reports/common-comorbidities-substance-use-disorders/part-1-connection-between-substance-use-disorders-mental-illness

ScienceDirect. (n.d.). Drug Induced Psychosis. from https://www.sciencedirect.com/topics/neuroscience/drug-induced-psychosis

WebMD. (n.d.). What are the symptoms of substance-induced psychotic disorder? from https://www.webmd.com/schizophrenia/qa/what-are-the-symptoms-of-substanceinduced-psychotic-disorder