Substance-induced psychosis, also referred to as drug-induced psychosis or psychosis from drugs, is a serious mental health condition that can arise from the use or misuse of certain substances. This condition can cause profound disturbances in perception, thought processes, and behavior, often resembling other psychiatric disorders.
According to recent data, approximately 25% of individuals with substance use disorders experience some form of psychotic symptoms during their lifetime, highlighting the significant prevalence of this condition. Recognizing and addressing drug-induced psychosis promptly is critical for recovery and long-term well-being.
What Is Drug-Induced Psychosis?
Drug-induced psychosis occurs when the use of certain substances triggers a temporary or prolonged episode of psychosis. Psychosis is characterized by symptoms such as hallucinations, delusions, and disorganized thinking. Unlike psychosis stemming from chronic mental health disorders like schizophrenia, substance-induced psychosis is directly linked to the effects of drugs or alcohol on the brain.
The onset of drug-induced psychosis can vary depending on the substance involved, the amount consumed, and individual factors such as genetic predisposition and mental health history. Some individuals may experience psychosis during intoxication, while others may develop symptoms during withdrawal.
Signs and Symptoms of Drug-Induced Psychosis
Recognizing the signs of drug-induced psychosis is crucial for seeking appropriate treatment. Common symptoms include:
- Alcohol hallucinations: Seeing, hearing, or feeling things that are not present, such as hearing voices or seeing nonexistent objects.
- Delusions: Strongly held false beliefs, often involving paranoia or grandiosity. For example, believing one is being followed or has extraordinary abilities.
- Disorganized Thinking: Difficulty organizing thoughts or expressing them coherently, often leading to fragmented or illogical speech.
- Agitation and Aggression: Heightened irritability and potential for violent behavior. This may include reacting to perceived threats or becoming defensive without cause.
- Confusion: Difficulty understanding reality or making sense of surroundings. This can manifest as trouble identifying where they are or what they are doing.
- Mood Disturbances: Rapid mood swings, anxiety, or depression that seem disproportionate or sudden.
These symptoms can range from mild to severe, depending on the substance involved, the dose, frequency of use, and the individual’s overall health and genetic predisposition. Recognizing these signs early can facilitate timely intervention and prevent further complications.
How Does Substance Use Cause Psychosis?
The mechanisms behind substance-induced psychosis vary by drug, but they often involve alterations in brain chemistry and function. Substances can:
Disrupt Neurotransmitters
Many drugs affect dopamine, serotonin, or glutamate levels, which are crucial for mood, perception, and thought processes. For example, stimulants like cocaine and methamphetamine flood the brain with dopamine, causing an intense rush but also overstimulating the brain’s reward system. Over time, this can lead to altered brain pathways that increase the likelihood of psychosis. Similarly, hallucinogens can disrupt serotonin pathways, leading to distorted sensory perceptions and hallucinations.
Trigger Brain Inflammation
Chronic drug use may cause inflammation in the brain, particularly in areas responsible for decision-making and emotional regulation. This inflammation can result from repeated oxidative stress or immune system responses triggered by toxins in substances. Prolonged inflammation may exacerbate symptoms like delusions and disorganized thinking.
Exacerbate Underlying Vulnerabilities
Individuals with a predisposition to mental health disorders—whether due to genetic factors, early-life trauma, or chronic stress—are more likely to develop psychosis when exposed to certain substances. For instance, cannabis use in individuals with a family history of schizophrenia has been shown to increase the risk of psychotic episodes significantly. Additionally, ongoing substance use can heighten the severity and frequency of these episodes, complicating recovery efforts.
Which Drugs Can Cause Substance-Induced Psychosis?
Several types of drugs are known to induce psychosis. The following categories outline the substances most commonly associated with this condition:
Stimulants like amphetamines, methamphetamine, and cocaine can trigger psychosis, especially with high doses or prolonged use. These drugs boost levels of neurotransmitters like dopamine and serotonin, leading to symptoms like paranoia, hallucinations, and delusions. Meth, in particular, can cause “meth psychosis” that might last for days or even weeks. While the effects can be temporary, repeated use can lead to lasting mental health issues.
Alcohol and benzodiazepines can also cause psychosis, particularly during withdrawal. When someone stops drinking heavily or quits benzodiazepines, the brain overcompensates, leading to confusion, hallucinations, and anxiety. Alcohol withdrawal can even cause delirium tremens (DTs), a severe form of psychosis. While symptoms usually resolve within days to weeks, the withdrawal from benzodiazepines can take longer.
While marijuana is typically considered mild, high-potency strains with lots of THC can cause psychosis, especially in people with underlying mental health issues. It can lead to paranoia, hallucinations, and delusions, but these effects usually fade after a few hours or days. However, regular use, especially of strong strains, might increase the risk of lasting mental health problems.
Drugs like LSD, peyote, mushrooms, PCP, ketamine, and ecstasy can cause intense hallucinations, paranoia, and dissociation. While the effects often wear off as the drug clears from the body, repeated use or underlying mental health issues can cause longer-lasting psychological problems. For example, PCP and ketamine can lead to aggression, memory loss, and even lasting psychosis.
MDMA, or ecstasy, can induce psychosis, especially with high doses. The drug increases serotonin, dopamine, and norepinephrine in the brain, which can cause hallucinations and paranoia. Though the effects usually wear off quickly, frequent use can lead to long-term psychological problems, such as anxiety and depression.
Inhalants like solvents and nitrous oxide can also cause psychosis. These substances depress the central nervous system and can lead to hallucinations, confusion, and dissociation. The effects are typically short-lived, but long-term use can result in cognitive problems and persistent mental health issues.
How Long Does Psychosis Last?
The duration of drug-induced psychosis can vary widely depending on the substance and the individual. In many cases, acute episodes of psychosis resolve within hours to days as the drug leaves the system. However, if the person has used the substance repeatedly or has an underlying mental health condition, the psychosis may persist for weeks or even longer. For example, psychosis caused by stimulant drugs like methamphetamine may last longer due to the drug’s powerful effects on the brain.
In rare cases, chronic use of certain substances can lead to lasting psychotic disorders. Drugs like methamphetamine, cannabis, and hallucinogens have been associated with long-term psychosis in some individuals. Early and effective intervention can significantly reduce the duration and severity of psychotic symptoms, helping to prevent long-term mental health issues.
Treatment for Drug-Induced Psychosis
Effective treatment for drug-induced psychosis typically involves a combination of medical, psychiatric, and therapeutic interventions.
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Once detox is completed, antipsychotic medications are often prescribed to manage acute symptoms like hallucinations, delusions, and paranoia. Medications such as haloperidol or olanzapine help stabilize mood and behavior, allowing the person to engage in therapy and other treatment strategies. They are often used during the initial stages of recovery, but may also be part of a longer-term treatment plan if there’s an underlying mental health disorder.
Many individuals with substance-induced psychosis also have co-occurring mental health conditions like depression or schizophrenia. Effective treatment addresses both substance use and mental health disorders at the same time through dual diagnosis treatment. This approach prevents relapse and promotes long-term recovery by treating the root causes of both issues.
Therapy and counseling play a key role in recovery. Cognitive behavioral therapy (CBT) helps individuals change negative thought patterns linked to substance use and psychosis. Group therapy offers peer support, while family therapy involves loved ones in the healing process, helping create a strong support network. These therapies address both emotional and behavioral aspects of recovery.
Long-term rehabilitation provides continued care and support after detox. Rehab programs focus on maintaining sobriety and addressing underlying causes of substance use. These programs offer a mix of individual and group therapies, as well as tools to help individuals reintegrate into daily life without relapse.
In addition to treatment, healthy lifestyle changes are important for long-term recovery. Regular exercise, a balanced diet, and effective stress management can improve physical and mental health, reduce the risk of relapse, and help maintain emotional stability. Adopting these habits supports overall well-being and contributes to a successful recovery journey.
Laguna Shores Recovery Can Help Break the Cycle of Drug Abuse
Breaking the cycle of drug abuse and psychosis requires professional care and a supportive environment. At Laguna Shores Recovery, we offer evidence-based treatment programs tailored to individual needs, addressing both substance use and mental health issues. With a holistic approach to recovery, individuals can achieve long-lasting sobriety and mental stability.
If you or a loved one is struggling with substance-induced psychosis, don’t wait to seek help. Contact us to begin the journey toward healing and a brighter future.
Matthew Beck B.A, M.A, LMFT 
