Drug psychosis is a form of psychosis triggered by various mind-altering substances. The specific form of psychosis is distinguished according to its cause, for example, alcohol, LSD or cocaine, with specific symptoms. Therapy consists of abstinence from the triggering substance and symptom-dependent treatment.
What is drug-induced psychosis?
Drug-induced psychosis is one of the severe mental disorders in which a temporary or permanent loss of reality occurs. It is important to distinguish it from symptoms that are triggered by and still during drug use and the nonorganic psychotic disorder, the causes of which remain unexplored to this day. There are six forms of drug psychosis: schizophrenia form, predominantly delusional, predominantly hallucinatory, predominantly polymorphic, and predominantly affective. In the schizophrenic form, mainly auditory hallucinations occur, and rarely the patient suffers from visual hallucinations. The delusional form, as the name suggests, is characterized by delusions; in hallucinatory psychosis, the patient experiences visual, auditory, or olfactory, phenomena affecting the sense of smell, and gustatory, phenomena affecting the sense of taste. Affective psychoses involve the state of mind and result in mania or depression. Polymorphic psychoses are multiform and may affect all domains combined.
Causes
The causes of drug-induced psychosis are psychoactive substances such as alcohol and cocaine. These can trigger already established psychosis, revive psychosis that has subsided, or cause new psychosis. However, other forms of drugs can also trigger psychosis.
Symptoms, complaints, and signs
In the worst case scenario, drug-induced psychosis can lead to the death of the affected person. This case usually occurs only when the affected person has taken an overdose of a particular drug. The complaints and symptoms always have a negative effect on the patient’s health and can cause permanent damage. First and foremost, patients with drug-induced psychosis suffer from severe hallucinations and, consequently, delusions. As a result, it is not uncommon to experience severe social difficulties and further, injuries. Likewise, patients suffer from personality disorders so that they can hurt someone else or put them in danger. If a high amount of drugs has been consumed, [[disorders of consciousness]] may also occur, which can lead to a loss of consciousness. In some cases, this causes the affected person to fall into a coma. Sleep disturbances and anxiety disorders continue to occur, so that most affected persons appear irritable or aggressive. Many patients see white mice or spiders or hear voices in their head that do not exist. It can also lead to suicidal thoughts or, in the worst case, suicide. Possibly, drug-induced psychosis also reduces the patient’s life expectancy.
Diagnosis and course
Psychosis is indicated by the symptoms that occur, but must be clearly diagnosed by the attending physician and differentiated from similar disorders. These include psychotic states not triggered by chemical substances, mental retardation and neuroses, personality disorders such as borderline syndrome. Once the psychotic state is confirmed, the exact cause must be found in order to subsequently target treatment accordingly. The main causes of drug psychosis are alcohol and cocaine. In alcohol psychosis, the affected person suffers from delusional perceptions of spiders or white mice and voices in his head, violent agitation, anxiety, sleep disorders, and Korsakow syndrome, a severe memory disorder that also affects the brain. Delusional states, such as delusional belief that a partner is unfaithful, are also possible. Cocaine psychosis is characterized by paranoid states, auditory, visual, and sensory perceptual disturbances, and the belief that insects are under the skin. Drug-induced psychosis may resolve quickly or persist for a longer period of time, so the chances of recovery are unpredictable.
Complications
Drug psychosis can be triggered by severe substance abuse. It is not only hard drugs such as heroin, cocaine, opium that cause psychosis, but also lighter drugs such as designer drugs, hashish, LSD, in extreme cases even psychoactive mushrooms, alcohol and tobacco.If drug psychosis is suspected, a doctor must be consulted. If not treated, there is a risk of danger to others and oneself. The specialists for drug problems are psychiatrists. If necessary, they initiate drug treatments, hospitalization and classic drug therapies. Different drug psychoses include schizophrenic, hallucinatory, polymorphic, delusional, and affective forms, which can be diagnosed with testing methods. Often, individuals suffering from drug psychosis are inconsistent and pretend to be healthy. They then need to be convinced by professionals or family members to seek treatment. If acute danger to self or others has already occurred or is likely to occur, the Mental Health Act, or PsychKG for short, can be applied, which is regulated differently in each federal state. On the basis of this, judges and, in emergencies, doctors decide on admission and coercive measures. Drug psychoses either occur once, recur or are even irreversible. If drug psychoses later break out again, a doctor or clinic should be consulted immediately. Patients should not discontinue medication or drug treatment early to avoid relapses into psychosis or drug addiction.
When should you see a doctor?
Anyone who notices personality changes or other symptoms of psychosis in themselves or others should consult a doctor or psychotherapist immediately. Medical or psychological advice is advisable at the first signs of a change in demeanor. Medical advice is recommended at the latest when the sufferer endangers himself or others. In general, drug psychosis should be diagnosed and treated as soon as possible. In particular, high-risk groups such as drug addicts or people with previous mental illnesses should pay attention to physical and mental changes. Anyone who suspects signs of drug psychosis in a third party should seek professional help immediately. Warning signs that require immediate hospitalization include hallucinations, neuroses, self-injurious behavior, and paranoid states. If one or more of these symptoms are noticed, admission to a psychiatric facility may also be necessary. If there has already been danger to self or others, a judge must be called in, who can order appropriate measures. Accompanying this, the family members of the affected person should be informed about the condition of the affected person.
Treatment and therapy
Treatment for drug psychosis consists initially of abstinence. The affected person should abstain not only from the triggering substance, but from all substances that are harmful to the body, in order to allow the organs and brain a period of regeneration. This can help, but success is not guaranteed. Drug-induced psychosis is then treated in the same way as other forms of psychosis, with medication, psychotherapy, occupational therapy and sociotherapy. The most important medications include antipsychotic and sedative neuroleptics or, depending on the symptoms present, antidepressants. These are especially important in affective disorders to avoid escalating depressive phases and severe manias. New phases of the disease are tried to be avoided with a lithium therapy. The complementary psychotherapeutic measures should only be carried out in stable patients in order to avoid labilization of the patients. Provided that the psychotic states are not acute, the therapeutic intervention can also be carried out in psychiatric clinics, where talk therapy, neurological treatment and the processing of interpersonal and social difficulties are possible at the same time. As a rule, inpatient therapy is carried out as psychoserehabilitation. Sociotherapeutic interventions include measures to maintain employment or employment in a sheltered workplace, assisted living services, and regular supervision by a social worker. Occupational therapy is primarily aimed at restoring the patient’s ability to work and enabling him or her to re-establish a daily structure. The performance of a stress test is mandatory.
Outlook and prognosis
The prognosis of drug psychosis depends on several factors. The intensity and duration of drug use are determinants of lasting recovery.If the patient uses the drugs infrequently or once, the symptoms of psychosis often disappear in parallel with the effect of the drug. Subsequently, freedom from symptoms sets in, which is permanent. If drug use is regular, there is a good chance of recovery with both drug and psychotherapeutic treatment. The prognosis improves as soon as drug use is discontinued. Psychotherapy is then used to treat the remaining symptoms of psychosis. If there is an existing drug addiction, the prognosis is unfavorable. The addiction is treated as a priority. Often, the body must be detoxified. In some cases, the patient needs a substitute drug, as drug withdrawal poses too great a health risk. On an individual basis, it must be determined whether a cure for drug psychosis is possible in these patients. The prognosis also worsens as soon as another mental or organic illness is present. In particular, personality, anxiety, or affective disorders, as well as brain damage, are considered difficult to treat in conjunction with drug psychosis. The goal of treatment may be to achieve the greatest possible stability when a cure seems hopeless. Many patients must undergo long-term therapy to improve well-being.
Prevention
To avoid the occurrence of drug psychosis, there is only one preventive measure: abstaining from mind-altering substances or drinking alcohol in non-harmful, considered normal, measures. In particular, patients who belong to a special psychosis risk group due to mental instability should refrain from taking these substances.
Here’s what you can do yourself
An acute onset of exogenous psychosis should be countered by immediate withdrawal of the substance in question. If the perceptual disturbances or delusions were induced by alcohol, then under no circumstances continue to add alcohol. The same applies to cannabis, MDMA or cocaine. Any intensification of the respective dose also intensifies the symptoms. This also and especially applies to the following days and when the psychotic experience has subsided. If possible, the affected person should be calmed down or escorted to a quiet place; under no circumstances should he or she be left alone. Drug abuse is often accompanied by dehydration, so it is important to provide water or tea – but never sugary or stimulating drinks such as coffee or energy drinks. If valerian tincture or tablets are available, then these should be resorted to. Following a psychotic experience with addictive substances, it is essential to avoid them in everyday life. The places or the circle of friends associated with the use of the respective drug should also be avoided for the time being. Instead, rest is appropriate and a daily routine that is as stringently organized as possible: rhythm must be created, for example through consistent wake-up and bedtime. Short daily meditation exercises can calm the mind and strengthen body awareness. Everyday rituals and mindfulness practices have a centering effect.
