What is a substance/drug-induced mental disorder?
Substance/drug-induced psychosis, also known as toxic psychosis, alcohol-induced psychosis, and drug-induced psychosis, is the diagnostic name for a specific mental health condition in which an individual has hallucinations, delusions, or two symptoms within one month of drug use. Or quit prescription drugs, illegal drugs and/or alcohol.
According to the Diagnostic and Statistical Manual (DSM-5), it is reported that 7% to 25% of patients receiving treatment for their first episode of psychosis suffer from substance/drug-induced psychosis.
If you or your loved one is experiencing symptoms of substance/drug-induced mental disorders, please know that there are many treatment options and resources to support you.
Symptoms of substance/drug-induced mental disorders include delusions, hallucinations, or both. People experiencing these symptoms may or may not understand whether their delusions and/or hallucinations are real.
Delusions are not based on realistic thoughts and beliefs.
Types of delusions include:
- Persecutory: think other people, including organizations, want to get you or are monitoring you
- Hongda: Believe that you are outstanding, special, talented, and better than others
- Reference: Believe that personal and environmental signals have the hidden meaning of communicating with you
- Erotica: Despite the evidence to the contrary, still believe that someone or more love you
- Nihilism: the belief that disaster will happen
- Body: Believe that there is a problem with your body
For example, a delusion of persecution may be “My previous company is monitoring my every move and trying to catch me.” An example of a delusion of eroticism may be “Tom Hanks is madly in love with me.”
If you have hallucinations, you are experiencing something from one or more senses, not based on reality.
If a person suffers from substance/drug-induced psychosis and their hallucinations are caused by drugs and/or alcohol, this symptom is not included in their diagnostic criteria.
Types of hallucinations include:
- Hearing: hearing sounds or sounds that do not really exist
- Vision: seeing things that don’t exist
- Smell: smell the smell that others can’t smell
- Touch: When no one or nothing is on you, it feels like you have been touched
- Taste: taste when there is nothing in your mouth
For example, in the presence of auditory hallucinations, a person may hear a voice telling them to run away or be followed. Through visual hallucinations, a person may see someone following them, but it does not actually exist.
How long does it last?
The individual’s medical history, time of ingestion of a particular substance, and amount of intake all influence how long the substance/drug-induced psychotic symptoms may last.
Although symptoms may decrease and stop shortly after a substance is discharged from the body, other substances may cause symptoms that last for several weeks.
- People taking certain painkillers may experience substance/drug-induced psychotic symptoms, which may take up to a week to resolve.
- People taking amphetamines (such as methamphetamine) may experience symptoms that last for several weeks. It is important to note that the use of amphetamine in some patients is also associated with schizophrenia (more persistent psychotic symptoms).
- In a study of individuals with marijuana or stimulant use disorder, 46% of individuals diagnosed with substance-induced psychosis later developed schizophrenia. Those who suffer from cannabis use disorder are more prone to long-term symptoms. About half of the others in the study only experienced symptoms for a short period of time.
To diagnose a mental disorder caused by a substance/drug, the symptoms must have a significant impact on your quality of life.
Although it is difficult to distinguish substance/drug-induced mental disorders from schizophrenia spectrum and other mental disorders, there are some key factors that require attention.
Psychosis caused by substances/drugs:
- Symptoms start within one month of using or withdrawing drugs, alcohol, or both.
- Failure to notice symptoms related to psychosis before substance use or withdrawal.
- Symptoms usually last less than a month.
- Symptoms usually decrease after stopping the medication.
- Individuals usually do not experience disturbances in speech or behavior, or reduced emotional expression, which are common symptoms of schizophrenia and other mental illnesses.
Attack when poisoning
The symptoms of substance/drug-induced mental disorders can appear almost immediately after ingesting certain substances.
When diagnosing an individual, the treating physician or mental health professional will determine whether the symptoms started while the substance is still present in the individual’s system. This condition is called a poisoning episode.
Onset during withdrawal
Symptoms of substance/drug-induced mental disorders may also appear during withdrawal.
Your clinician will monitor how long your symptoms last to ensure that other mental health disorders do not need to be ruled out.
If symptoms persist for more than a month and the substance has cleared your body, they may collect more information to determine whether other mental health disorders (such as substance-induced mood disorders) are more suitable for your symptom experience.
While the substance use disorder is diagnosed, there is a high incidence of concurrent mental health disorders. Although the substance itself does not directly cause the mental disorder caused by the substance/drug, some substances may cause people at greater risk of mental illness.
In a longitudinal study of individuals with substance-induced mental disorders due to cannabis, opiates, stimulants, or multiple drugs, risk factors include:
- As a male
- Under 30
- Have an underlying mental health condition
These people are not only at risk of substance-induced mental disorders, but also more likely to develop schizophrenia in the next few years.
A variety of psychoactive substances can cause substance-induced mental disorders, including:
Drugs that may cause mental disorders caused by substances/drugs include:
- Antiepileptic drugs
- Muscle relaxants
The treatment of substance/drug-induced mental disorders will vary according to the specific patient and its unique needs. In many cases, it may be sufficient to stop the triggering substance and closely monitor the patient in a safe environment. However, different substances, such as alcohol, may require more intensive treatment.
Although removing substances from the personal system (acute) is critical, it is equally important to treat any underlying mental health conditions (long-term). In some cases, combining acute care and long-term care may prevent individuals from experiencing substance/drug-induced psychosis in the future.
Medications can be used to help relieve the symptoms of substance/drug-induced psychosis and stabilize the individual’s mood. Medications that may be used include:
In the long run, it is important to treat any underlying mental health conditions to reduce the chance of experiencing substance/drug-induced psychosis again.
Treatment options may include:
Precautions for mental disorders caused by alcohol
Compared with other substances and drugs, abstinence may require more monitoring. In severe, potentially fatal situations, individuals may experience delirium tremens (DTs), alcohol-induced psychotic symptoms, and physical failure.
Treatment options and care may include:
- Inspection and monitoring at discharge
- Stabilize vital signs, supplement electrolytes and vitamins, and detect liver disease
- If needed, use antipsychotics or benzodiazepines for sedation
- Suicide assessment and monitoring
Once withdrawal is complete and the patient is stable, it may be very helpful to start hospitalization or outpatient treatment. In addition to psychotherapy, support groups may also be helpful.
If you or your loved one is experiencing substance/drug-induced psychosis, it is important to prioritize self-care.
In addition to seeking professional care, you can also:
- Start practicing mindfulness to help reduce stress
- Do breathing exercises to root yourself
- Look for signs of caregiver fatigue and take time to relieve yourself
- Connect with trusted relatives and learn about your experience
- Read useful articles about substance/drug-induced psychosis
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Although experiencing psychiatric symptoms can be very scary, remember that they may be directly related to substances or medications that can be resolved. If you or your loved one show any symptoms of psychosis, be sure to contact a medical professional so that you can get proper care.