What Is Drug-Induced Psychosis?

A psychosis or psychotic episode greatly affects the way a person thinks, feels, and behaves. A person experiencing psychosis may lose touch with reality and struggle to separate what is real from what is unreal.

There are various types of psychosis and causes. A person with drug-induced psychosis experiences symptoms triggered by substance use.

Keep reading to learn more about substance-induced psychosis and what you can do to help those with the condition.

What are psychotic disorders?

Psychotic disorders are a large group of mental health conditions that share similar signs and symptoms. These conditions could last for hours, days, or months — or even years. Symptoms can range from mild to very distressing.

Psychotic disorders usually involve some combination of hallucinations and delusions:

• Hallucinations are when you see, hear, or feel things that are not really there. Some people could even smell or taste things that are not present.

• Delusions are beliefs about something that is not true. They may cause people to be very suspicious or paranoid of others.

Some types of psychotic disorders include:

• Schizophrenia: A long-term disorder lasting more than 6 months where a person may experience hallucinations, delusions, disorganized thinking and behavior, and a lack of emotional expression or motivation.

• Schizophreniform disorder: A condition like schizophrenia that lasts more than 1 month but less than 6 months.

• Schizoaffective disorder: A condition where a person experiences schizophrenia and a mood disorder, like depression or bipolar disorder.

• Delusional disorder: This condition occurs when a person has powerful delusions but no other psychotic symptoms.

• Brief psychotic episode: Psychotic symptoms that last less than a month and are usually caused by experiencing a trauma.

Other mental health conditions can also lead to psychotic symptoms. A person with severe depression or bipolar disorder could experience psychosis.

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What is a substance-induced psychosis?

A substance-induced psychosis is a type of psychosis created by use of alcohol or other drugs. Psychotic symptoms may appear while you are intoxicated or while you are withdrawing from the substance. 

A substance-induced psychosis could emerge quickly, fade, and never return. It could go away and come back. Or, it could trigger a long-term psychotic disorder like schizophrenia.

Substance-induced psychosis may also be referred to as:

• Drug-induced psychosis

• Medication-induced psychosis 

• Substance-induced psychotic disorder 

Can substances create a long-term psychosis?

Experts have long identified the connection between substance use and psychotic disorder. As many as 51% of people with a new psychotic disorder also have a substance use disorder. Alcohol, cannabis (marijuana), and tobacco are frequently used among this group.

It’s possible these substances created the psychosis. It’s also possible the disorder was going to develop whether or not a person used substances. At this point, the exact nature of the relationship is unknown, and it may vary from person to person.

What are the symptoms of psychosis?

Overall, the symptoms of psychosis will disconnect someone’s thoughts from reality. It will be more challenging to know what’s real and what is not.

People may show different signs of psychosis. Some common symptoms of psychosis are:

• Delusions

• Hallucinations

• Disorganized or jumbled thoughts

• Intense feelings of confusion, fear, or agitation

• Loss of interest in activities

During a psychotic episode, someone’s behaviors could change dramatically. Some behavioral symptoms of psychosis include:

• Struggling to maintain conversations

• Trouble remembering things

• Lack of self-care and hygiene

• Being silly or laughing for no reason

• Becoming angry for no reason

• A loss of energy or activity

• Becoming disconnected from your environment

For substance-induced psychosis, the most common problems are hallucinations, extreme confusion, and memory troubles. But you remain at risk for any psychotic symptom. 

What are the signs of drug-induced psychosis in others?

Depending on their substance use, the signs of drug-induced psychosis could appear all at once. Or, the symptoms could come and go. They could affect all aspects of life or only certain parts. 

If you are concerned about a loved one having a substance-induced psychosis, look for signs like:

• Drop in grades or poor job performance

• Suspicion or paranoia of others, even close friends and family

• Isolating and spending more time alone

• Having intense, strange, or odd ideas

• Appearing like they lack emotions

• Speech that is confusing or very unclear

Some people with psychotic disorders may have a higher risk of violence and aggression. But certainly not everyone with a psychotic disorder will become violent. 

If you have any concerns that a person may become violent toward themselves or others, call 9-1-1 right away. Explain the situation and the drugs used. Professional assistance can help keep everyone safe.

What causes drug-induced psychosis?

As the name suggests, a drug-induced psychosis is caused by using alcohol or certain drugs. The substances can disrupt the normal functioning in the body and the brain to create these unwanted symptoms.

The substances most often connected to substance-induced psychosis are:

• Cannabis (marijuana)

• Amphetamine and methamphetamine

• Cocaine

• Alcohol

At times, separating the wanted effects of the drugs from psychosis can be challenging. For example, drugs like LSD, psilocybin, and ketamine are intended to create hallucinations. So, you may experience psychotic symptoms while under the influence. But you wouldn’t technically have a substance-induced psychotic disorder, unless these symptoms persist after the “high” is over. 

Not all people who use these drugs will experience psychosis. Studies have found that:

• Up to 10% of people who use cannabis will experience psychotic symptoms

• Of people addicted to cocaine, 90% have paranoid delusions and 96% have hallucinations.

• Nearly 15% of people using amphetamine and more than 11% of people using methamphetamine note psychotic symptoms. 

Which medications can cause psychosis?

With substance-induced psychosis, over-the-counter and prescription medications can create symptoms as well. Some medications that may trigger psychosis in people include:

• Pain relievers, like opioids and some NSAIDs (ibuprofen)

• Medications for Parkinson’s disease

• Heart medications, like beta-blockers and ACE inhibitors

• Corticosteroids

• Antibiotics

• Antihistamines

Most people will not experience the unwanted symptoms of psychosis connected when using these medications, but some will. If you start feeling symptoms of psychosis in yourself or notice symptoms in a loved one, talk to a healthcare provider. Review any medications, especially ones started recently.

In many cases, stopping the medication will end the psychotic symptoms. Be sure to speak to your doctor for advice on ways to safely end your use.

How long can drug-induced psychosis last?

In many cases, the psychotic symptoms you experience will only last while the substance is in your system. After intoxication and withdrawal, you will return to your normal functioning. All hallucinations, delusions, and other symptoms will fade.

In other situations, though, your symptoms could persist. A study that mostly looked at people using methamphetamine in China found:

• 60% of people saw their psychotic symptoms resolve in less than a month.

• 30% saw their symptoms end between 1 and 6 months.

• 10% experienced symptoms for more than 6 months.

When you restart use of the drug, there is a high risk of symptoms returning. The best way to ensure symptoms leave for good is to not use substances.

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Written by:

Eric Patterson, LPC

Eric Patterson, LPC, has been a professional counselor in school and outpatient settings for over 15 years. Patterson has been cited as a mental health expert in publications such as Today.com, Good Housekeeping, and InStyle.

Reviewed by:

Emily Guarnotta, PsyD

Emily Guarnotta, PsyD, is a licensed clinical psychologist and certified perinatal mental health professional with over 10 years of clinical experience.

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