Substance Induced Psychosis
What is it?
Psychosis is a mental health condition that temporarily alters an individual’s perception of reality, differing from the perspectives of those around them. Drug-induced psychosis occurs when a person experiences episodes of psychosis, such as delusions or hallucinations, as a direct result of substance misuse. Delusions refer to irrational beliefs that persist despite contradicting evidence, while hallucinations involve vivid sensory experiences of things that are not real, such as seeing, hearing, or feeling sensations that do not exist.
Causes
Substance misuse can either worsen existing mental illnesses like bipolar disorder or Schizophrenia, both of which are characterised by psychotic symptoms, or trigger their onset in individuals predisposed to such conditions. Drug-induced psychosis often stems from excessive consumption of a particular substance, leading to heightened toxicity levels that induce paranoia and a psychotic episode. It can also occur due to adverse reactions caused by mixing different substances or withdrawing from a drug, whether it was prescribed or not.
Some common causes associated with drug-induced psychosis:
- Stimulant Drugs : Stimulant drugs such as amphetamines (e.g., methamphetamine), cocaine, and certain prescription medications (e.g. ADHD medications) can cause psychosis. The excessive release of dopamine, a neurotransmitter associated with reward and pleasure, can disrupt the brain’s normal functioning and contribute to psychotic symptoms.
- Hallucinogens : Hallucinogenic substances like LSD, psilocybin (magic mushrooms), and mescaline can induce psychosis. These substances affect serotonin receptors in the brain, leading to altered perception, thought patterns, and sometimes psychosis.
- Cannabis : While cannabis is generally considered a relatively mild psychoactive substance, it can trigger psychosis in susceptible individuals, especially those with a predisposition to mental health conditions such as schizophrenia. The specific mechanisms underlying cannabis-induced psychosis are not fully understood but are thought to involve the interaction between THC (tetrahydrocannabinol) and brain receptors.
- Alcohol and Sedatives : Chronic and excessive alcohol consumption, as well as the abuse of sedative medications (e.g., benzodiazepines), can lead to psychotic symptoms. Alcohol and sedatives can depress the central nervous system, disrupt neurotransmitter balance, and interfere with cognitive processes, potentially triggering psychosis.
- Withdrawal or Rebound Effects : Abrupt discontinuation or rapid reduction of certain substances, such as benzodiazepines or certain antidepressants, can result in withdrawal or rebound effects that may include psychotic symptoms.
Symptoms
Symptoms of drug-induced psychosis usually develop gradually, with the drug’s toxicity becoming increasingly dangerous as the individual becomes more dependent on it, both in terms of frequency and dosage. These symptoms may include :
- Paranoia
- Hallucination
- Delusion
- Antisocial Behaviour
- Panic Attacks
- Confusion
Drug-induced psychosis is typically temporary and resolves once the effects of the substances wear off or are eliminated from the body. However, in some cases, individuals with a predisposition to mental illness may experience a more prolonged or recurrent psychotic disorder.
Treatment
The treatment for substance-induced psychosis, which refers to psychotic symptoms triggered by substance use, typically involves addressing both the underlying substance use disorder and the acute psychotic symptoms. Here are some common approaches to treating substance-induced psychosis :
- Medical Evaluation and Stabilization : If someone is experiencing substance-induced psychosis, it is crucial to seek immediate medical attention. A thorough evaluation is necessary to assess the person’s physical health, the substances involved, and the severity of psychosis. Medical stabilisation may be required to ensure safety and manage any medical complications.
- Substance Withdrawal and Detoxification : If the psychosis is directly related to substance use, detoxification may be necessary to safely remove the substance from the person’s system. Medical supervision and support can help manage withdrawal symptoms and minimise discomfort.
- Medications : In some cases, medications may be prescribed to alleviate acute psychotic symptoms or to address underlying mental health conditions. Antipsychotic medications can help reduce hallucinations, delusions, and disorganised thinking. The choice of medication and dosage depends on the individual’s specific symptoms and needs.
- Psychotherapy and Counseling : Once the acute symptoms are stabilised, psychotherapy and counselling play a crucial role in the treatment process. Therapeutic interventions, such as Cognitive-Behavioral Therapy (CBT), can help individuals understand the relationship between substance use and psychosis, develop coping strategies, and address underlying emotional and psychological issues.
- Dual Diagnosis Treatment : If there is an underlying mental health condition contributing to both substance use and psychosis, integrated treatment for co-occurring disorders is necessary. This involves addressing both the substance use disorder and the mental health condition simultaneously through a coordinated treatment approach.
- Relapse Prevention and Aftercare : After the acute phase of treatment, ongoing support and aftercare are essential to prevent relapse and promote long-term recovery. This may involve participating in support groups, engaging in continued therapy, developing healthy coping skills, and making necessary lifestyle changes to maintain sobriety and overall well-being.
It’s important to note that treatment for substance-induced psychosis may vary based on the specific substances involved, the severity of psychosis, and individual factors. Seeking professional help from healthcare providers, addiction specialists, and mental health professionals is crucial for accurate assessment, diagnosis, and personalised treatment planning.
