Psychosis or psychotic disorders are a category of mental health conditions characterized by severe impairment in a person’s decision-making abilities. Psychotic disorders make it difficult for a person to think clearly and make sound decisions, respond, communicate effectively, and act correctly. These effects are usually because psychosis is often accompanied by visual and auditory hallucinations. There are several different causes of psychosis, but one commonly associated cause of psychosis is drug abuse. 1
Drug induced psychosis (also known as substance abuse psychosis or toxic psychosis) refers to a mental illness condition in which a person suffers hallucinations and delusions either as a result of drug/substance abuse or due to withdrawal from prescription medications or substances of abuse (such as alcohol or illicit drugs). 2
Drug abuse is a common problem in many societies globally, and unfortunately, substance abuse psychosis is one of the prevalent effects of drug abuse. In fact, according to the Diagnostic and Statistical Manual (DSM-5), up to 25% of people who have undergone treatment for psychosis have a history of substance abuse disorder. 2
Drugs and substance abuse have been linked with many adverse effects, including several mental and physical side effects. Drug dependence problems usually cause these adverse effects due to prolonged drug use and abuse. They may also occur upon withdrawal from the drug of abuse. One pervasive drug induced mental health disorder is psychosis.
Drug abuse and psychosis have been severally linked together; in fact, results from various research have shown that individuals who abuse or misuse drugs and other substances of abuse are very likely to experience drug induced psychosis. The question is, what exactly is drug induced psychosis and what drugs cause psychosis?
The brain is a complex organ that controls and coordinates all other body functions. It does this by sending and responding to “signals,” some of which are impulse-generated while others are of a much more chemical sort (neurotransmitters). Psychosis from drugs occurs due to drugs interfering with the release of brain neurotransmitters like serotonin and dopamine. Psychosis from drugs also occurs as a result of drug dependence. 3
Drug dependence occurs due to prolonged abuse of drugs. As a result of constant exposure to certain drugs with central activity, the brain structure and configuration gradually change, leading to altered brain function. The brain also begins to heavily depend on the presence of these drugs for it to function correctly. When drug supply is restricted or outrightly cut off (as in drug withdrawal changes), it may trigger severe withdrawal side effects, one of which is psychosis from drugs (drug withdrawal psychosis). 3
In addition to this, there are also several psychoactive substances, such as LSD and ketamine, which may cause hallucinations and psychosis when abused or misused. 3
Drugs induce several types of psychosis. Any of these types may manifest in cases of psychosis induced by drugs, and some of them include schizoaffective disorder, delusional disorder, and even schizophrenia.
Drug induced schizophrenia refers to the occurrence or presence of schizophrenic episodes brought on by substance abuse. Drug induced schizophrenia symptoms may include sensory impairment issues such as visual and auditory hallucinations and delusions.
Although there are confirmed links between drug abuse cases and schizophrenic episodes, the term “drug-induced schizophrenia” is incorrect. This is because, according to research, drug abuse does not cause schizophrenia. 4 However, drug abuse may trigger schizophrenia in people who are predisposed to having schizophrenic episodes but, up until then, have not experienced schizophrenia. 4
Another essential thing to note is that although psychosis and schizophrenia are often used together, they are quite different. Psychosis may occur as a symptom of schizophrenia; however, a person may have psychosis (that may be characterized by drug induced hallucinations) without having schizophrenia. 5
Drug induced psychosis symptoms range from mild to severe, and their “duration and severity” may depend on the drug responsible. For example, symptoms of psychosis induced by drugs like cocaine or amphetamines usually persist longer than psychosis symptoms of some other drugs that induce psychosis. Generally, however, drugs that induce psychosis tend to elicit the same or similar effects. Drug induced psychosis symptoms include the following: 6
Drugs that induce psychosis are of several different types. They include:
Stimulants are drugs that elevate body activity levels by speeding up the transmission of signals between the brain and the body. Essentially, these drugs cause increased alertness, confidence, and high energy and activity levels. Some stimulants that have been known to cause psychosis include the following: 7
Cannabis (also known as weed or marijuana) is a collective name for three plants: Cannabis ruderalis, Cannabis indica, and Cannabis sativa. These plants contain several psychoactive substances which are responsible for their psychosis-causing effect. 8Depressants
Depressants, or central depressants, are a class of drugs that reduce brain and CNS activity by reducing neurotransmission levels. 9
Although some members of this drug class have beneficial therapeutic effects, they have high addiction-causing effects, so their withdrawal after prolonged use may lead to drug induced psychosis. Examples include:
Hallucinogens and dissociatives are a drug class that causes substantial distortion of perception and reality in users. Hallucinogens can be classified as either classic (such as LSD) or dissociative, and they occur naturally in some mushrooms and plants. There are also synthetic (artificial) hallucinogens. People who abuse hallucinogens experience emotional imbalances as well as hallucinations. 10
Examples of hallucinogens and dissociatives include:
The type of drug implicated in drug induced psychosis and the duration of use may also play a significant role in determining how long the effects of psychosis persist. Usually, the symptoms of drug induced psychosis last for about a month after drug withdrawal and cessation of use. However, there are cases where drug induced psychosis effects extend for up to six months or even beyond. The type of drug implicated in drug induced psychosis and the duration of use may also play a significant role in determining how long the effects of psychosis persist. 11
Drug induced psychosis treatment varies depending on several factors such as patient health conditions and the substance of abuse. Irrespective of the “fine details,” however, treatment usually follows the following pattern:
Detox (detoxification) involves a gradual reduction of drug concentration levels in the body. Drug withdrawal in detoxification must be gradual (and not abrupt) to limit the occurrence and severity of accompanying withdrawal side effects.
Drug induced psychosis treatment is usually done in two different forms: inpatient treatment and outpatient treatment.
In-patient treatment involves patients opting for full-time, focused treatment in a treatment facility, and it is usually recommended for people with severe cases of psychosis. In in-patient treatment, medical professionals constantly supervise the patient’s condition to ensure safe and optimal recovery results.
On the other hand, outpatient treatment is a sort of “part-time” arrangement where patients can go about their regular daily routines and only visit their treatment center on appointment days. Some people prefer the outpatient treatment option because of the increased freedom. However, it must be said that relapse is a huge possibility because the patient will be constantly exposed to distractions and temptations.
Medications such as benzodiazepines are also used in drug induced psychosis treatment to treat or manage withdrawal symptoms and effect mood stabilization in patients.
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