Drug-Induced Psychosis

Many people associate psychosis with a range of medical health conditions including schizophrenia and bipolar disorder.

While these disorders do have the possibility to cause an episode of psychosis, a number of substances can also trigger a drug-induced psychosis involving similar symptoms. [1]

Drug-induced psychosis is primarily characterised by the sufferer experiencing a range of delusions and hallucinations, which can be a frightening and disorienting experience for both the individual and anyone around them.

If someone is in the midst of a drug-induced psychosis they may be described as being ‘out of touch with reality’ as they often see, hear, feel and believe things that are not actually occurring.

Taking too much of a particular substance, mixing a number of substances together or taking drugs while suffering from an underlying mental health condition are common reasons for experiencing a drug-induced psychosis.

What are the signs and symptoms of drug-induced psychosis?

While certain substances may be taken primarily to induce hallucinations, the experiences of someone suffering from a drug-induced psychosis are more severe and long-lasting.

These symptoms may be similar to those of more permanent mental health conditions such as schizophrenia and bipolar disorder and can be highly dangerous if left unmanaged.

Common types of psychotic delusions

Some people experience delusions during a drug-induced psychosis, during which they may hold a particular belief even when faced with evidence that their belief is incorrect:

Grandiose: People suffering from this delusion experience exaggerated beliefs about their own success, power or wealth. They may believe that they are extraordinarily wealthy, highly famous, a member of the royal family or even a religious idol. It is common for this delusion to be based on religious or supernatural themes, with some people believing that they are immortal and unable to die.
Erotomania: Someone experiencing erotomania will believe that another person is in love with them, even if they have never met. This delusion is usually focused on celebrities and people of high social standing, although it is possible for the sufferer to become fixated on someone who is not famous.
Persecution: One of the most common delusions is persecution, the belief that someone is attempting to conspire against the individual and plans to hurt or upset them or their loved ones. This often pertains to authority figures such as the police or the government, but individuals may also become fixated with their neighbours or other people that they see in their daily lives.
Jealousy: People suffering from this delusion may believe that their wife, husband or significant other is being unfaithful to them, even if there is no evidence that pertains to their belief. The partner may frequently be accused of cheating or of having cheated in the past, despite any proof to the contrary.
Somatic: Somatic delusion is the belief that part or all of the individual’s body is highly abnormal or not functioning correctly. Some people who experience this delusion may believe that they are infested with parasites or insects, that parts of their body are rotting or even that they are missing a limb. This delusion can persist even when assured by medical professionals that their body is completely healthy.

Common types of psychotic hallucinations

Drug-induced psychosis can cause sufferers to experience hallucinations in which they can smell, hear or feel things and sensations that are not actually occurring:

Visual hallucinations: The affected individual may see things that are not really there, such as shadows or physical figures. Their surroundings may seem distorted or warped in some way.
Auditory hallucinations: This type of hallucination involves hearing sounds or voices that do not exist. These voices may berate the individual or tell them to act out specific instructions. There may be more than one voice and they may interact with each other.
Tactile hallucinations: People experiencing tactile hallucinations may feel things on their skin, such as extreme itching or bugs crawling on them. They may touch their own body or skin and believe that it feels unusual or different from normal.
Olfactory hallucinations: Smelling an odour that is not really there is known as experiencing an olfactory hallucination, with some people believing that they can smell chemicals or smoke that other people are unable to sense.

Other symptoms of a drug-induced psychosis include:

Depression and anxiety
Paranoia
Frequent mood swings
Aggression
Fear and panic
Difficulty concentrated
Distorted and altered sense of space and time
Feeling disconnected from your own body or mind
Lack of balance and coordination
Difficulty making decisions
Poor judgement skills
Appearing out of touch with reality
Memory loss

Which substances are most likely to cause a drug-induced psychosis?

Many substances have the potential to cause drug-induced psychosis, even if they do not typically cause hallucinations or delusions as part of their expected side effects.

Even prescribed medications can induce psychosis in rare circumstances, particularly if they are taken by someone who does not have a legitimate prescription. [3]

Common substances that can cause a drug-induced psychosis include:

Cocaine
Magic mushrooms
Alcohol
Ketamine
Amphetamines
Phencyclidine (known as PCP or angel dust)
Methamphetamines
Ecstacy
Cannabis
LSD

As well as being a side effect of substance use drug-induced psychosis can also occur during withdrawal from specific substances, such as an individual suddenly stopping their consumption of alcohol after drinking a large amount on a regular basis for a long period of time.

How long does a drug-induced psychosis last?

As there are a number of factors involved in a drug-induced psychosis, there is no set amount of time in which this disorder will last for.

It can depend on the type of substance ingested, the amount of the substance that has been taken and whether the individual suffers from any underlying mental health conditions.

In the majority of cases, drug-induced psychosis will last for a maximum of 24 hours before the drug leaves your system.

If the individual has taken a large amount of the substance or continues to take the substance even while experiencing psychosis, it may last for a longer period of time.

A drug-induced psychosis often involves three key stages which are detailed below:

Prodrome phase: Before a psychotic episode begins, the individual may begin to display symptoms such as sleep disturbances and withdrawal from society. This can be an indication that a psychotic episode is about to begin.
Acute phase: This is the stage in which the individual will likely experience hallucinations and delusions, and may have trouble carrying out daily tasks and following their regular routines. These symptoms will usually last for a maximum of 24 hours but may last for a longer amount of time depending on a number of factors.
Recovery phase: Once the individual stops taking the substance that triggered the psychotic episode, their symptoms will usually begin to abate and they will enter the recovery phase. They will once again be able to carry out daily tasks and continue their regular activities.

Certain substances can trigger a longer episode of drug-induced psychosis which may last for a number of weeks including cocaine, amphetamines or PCP. Some studies indicate that a drug-induced psychosis caused by cannabis may have a permanent effect in some cases, although more research is needed to determine whether this statement is accurate. [3]

What should I do if I experience a drug-induced psychosis?

Experiencing a drug-induced psychosis can be extremely frightening, whether you are the affected individual or simply a concerned friend or family member.

As someone in this state of mind can be potentially dangerous both to themselves and others, it’s important to take the correct steps in order to avoid harm and help the individual move towards recovery.

If the individual has taken a specific substance that has directly triggered a drug-induced psychosis, they must immediately stop taking it. Many people combine substances such as ecstasy and alcohol, and in these cases, they must immediately stop taking both substances.

Continuing to ingest drugs or alcohol during a psychotic episode may worsen the symptoms or cause the episode to last for a longer period of time.

It is recommended that you should seek professional medical treatment for anyone experiencing a drug-induced psychosis, particularly if the individual feels as though they may harm themselves or someone else.

Call 999 immediately and request medical help.

In many cases, complete detoxification is required in order to cleanse the system of the substance. It is important that this process is completed under 24/7 medical supervision, as detoxification can result in dangerous side effects.

Certain medications may be prescribed in order to help the individual feel more comfortable during the process.

If the symptoms are severe, it may be necessary to admit the individual to a psychiatric hospital for evaluation and treatment.

This may include individual and group therapy along with a personalised aftercare plan in order to prevent relapse and lower the chances of experiencing another drug-induced psychosis.