We share a lot with the people we love. We share meals, time, kindness, and even living spaces. But what happens when we stop sharing the same reality?
A psychotic episode can cause the person you love to begin living in an environment — and reality — that is much different than the one you are accustomed to. That can be an incredibly scary thing to experience, and you may be desperate to create an opportunity to reunite the person you love with the world you are living in. If drugs are at the root of that psychosis, you might be even more motivated to step in and deliver relief.
Understanding how drug-induced psychosis develops can help you determine how you can help.
Psychosis is defined by the National Institute of Mental Health as a loss of contact with reality. People in the midst of a psychotic episode are experiencing some aspect of the world that remains hidden to others. Some experience sights others cannot see, some hear things others cannot hear, and some have sensations (like a feeling of bugs burrowing under the skin) that others do not experience. Psychosis can also cause delusions — beliefs that others consider to be false.
These symptoms are intensely private, as they pertain to a person’s senses, thoughts, and feelings. But people in the midst of a psychotic episode may feel compelled to share their newfound reality with the people around them. They may demonstrate various symptoms, such as:
Psychosis is often associated with mental illnesses such as schizophrenia, but these symptoms can also be prompted by the use of drugs. According to research published in the journal Experimental Neurobiology, illegal drugs associated with psychosis include amphetamines, PCP, ketamine, and LSD. Other studies have demonstrated a link between psychosis and the use of marijuana and synthetic drugs that work on marijuana receptors within the brain.
A U.S. Pharmacist article suggests that some prescription medications can also cause hallucinations, including medications used for pain control, gastrointestinal disorders, muscle relaxation, and bacterial infection.
According to research highlighted by the National Association of State Mental Health Program Directors, as much as 25 percent of people who get help for psychosis are in that state because of drug use or abuse. Those who abuse substances heavily are at the highest risk, but anyone who abuses drugs with a hallucinogenic quality could experience an episode of drug-induced psychosis.
There is a clear and strong link between drug-induced psychosis and psychosis caused by schizophrenia. As Psychiatry Advisor points out, many studies have shown that people who experience a drug-induced psychosis episode transition into schizophrenia in time. In research cited within the article, about 50 percent of those who used marijuana and developed psychosis also developed schizophrenia later in life.
There is no real difference between schizophrenia-based psychosis and drug-induced psychosis in terms of signs and symptoms. The main difference involves the trigger for the episode. People with schizophrenia may develop episodes based only on stress and brain chemistry. People who take drugs have drug use as the primary trigger. Converting to schizophrenia may mean little more than experiencing more episodes even without the use of drugs.
But experts writing in Psychiatric Times point out that people who abuse drugs and people who develop schizophrenia may share underlying risk factors. These people may take drugs early in life as a way to self-medicate schizophrenia symptoms. Their drug use may not trigger the illness as much as demonstrate the difficulties the person is dealing with before an official diagnosis. Research on this issue is ongoing.
An episode of drug-induced psychosis can be brief, lasting for a few days or even just a few hours. But the consequences of that episode can persist long after the original symptoms have faded away.
For example, people in the midst of a drug-induced psychotic episode can be held legally responsible for the actions they take while under the influence of drugs. Their decision to take drugs in the first place makes them legally at risk for any action they might choose to take until the drugs have worn off. Since psychosis often causes hallucinations of a violent nature, people in the midst of psychosis can choose to harm themselves or others, and that can lead to long jail sentences.
Drug-induced psychosis can return even when the person is sober. According to the National Institute on Drug Abuse, it isn’t unusual for those who develop drug-induced psychosis due to substances like methamphetamine to experience intermittent psychotic symptoms for months or years later, often triggered by stress.”
Psychosis can be incredibly disorienting and upsetting. People in the midst of an episode simply cannot tell the difference between what is real and what is not. The messages they receive from their senses may be so jumbled and confused that they are terrifying. The mental distress psychosis causes is hard to overstate.
It is natural to feel the urge to help someone in distress due to psychosis. As an outsider, it may be easy enough for you to determine that drugs are at the heart of the problems the person is facing, and you might reasonably assume you can explain this to the person and prompt them to get sober.
It’s important to remember, according to NHS, that a person in the midst of psychosis is experiencing a reality that is different than yours, but no less strong. That person may simply disagree with the idea that there is a problem and that help is required. To the person in the middle of the psychosis, what is happening is very real. Adjusting drug use may not seem like a way to make that reality change.
People who experience psychosis regularly are often advised to speak with a trusted friend or family member. They are encouraged to describe what they are experiencing and ask if this matches what the other person is also experiencing.
It can be horrifying to hear someone you love to describe a world that you do not recognize. It is vital to:
With all information gathered, you can contact an outside authority to help with next steps. If the person is considering self-harm or harming others, a call to 911 is appropriate. If the person seems stable but just troubled, a call to a doctor or a rehabilitation center is a wise next move. The sooner the person gets the appropriate help, the better.
It is also vital to remember this may not be a passing episode. For people with drug-induced psychosis, the symptoms can linger for years. The singer Fergie experienced visual hallucinations for a year after she achieved sobriety. You may need to continue discussions about hallucinations and psychosis for long after the person is sober. By serving as a trusted outsider, you can deliver a great deal of help and comfort to the person you love, and that could be key to the recovery process.
Psychosis is real, and it is dangerous. That means you should not simply discount what the person tells you during your conversation. The thoughts and sensations the person describes may not seem real to you, but they are very real to the person you are speaking with. Take those comments seriously and make sure you take appropriate next steps to keep the person you love and your community safe.
In addition, it is important to remember that you should not dismiss warning signs if they are subtle or slow to appear. Not all cases of psychosis emerge with strong, clear symptoms. You may only notice a subtle shift in behavior. Acting on those small changes could be key to helping to stop the damage before it grows too strong to control.
As mentioned, you should reach out for help when someone you love is dealing with psychosis. This is not something you can treat at home, and it is not something that is likely to go away despite all the love and support you give. Someone in the grips of drug-induced psychosis needs treatment to stop the drug use, and they may need ongoing support to address those symptoms when they come back.
That means you need to get help for your family when someone experiences these symptoms. In some cases, the police can help. In others, medical professionals are also required. Do not be afraid to get that help. The person you love is relying on you.
What is Psychosis? National Institute of Mental Health. from https://www.nimh.nih.gov/health/topics/schizophrenia/raise/what-is-psychosis.shtml
(February 2017). Drug Abuse and Psychosis: New Insights into Drug-Induced Psychosis. Experimental Neurobiology. from https://www.ncbi.nlm.nih.gov/pmc/articles/PMC5326711/
(November 2014). Nonpsychotropic Medication-Induced Psychosis. U.S. Pharmacist. from https://www.uspharmacist.com/article/nonpsychotropic-medicationinduced-psychosis
Substance-Induced Psychosis in First Episode Programming. National Association of State Mental Health Program Directors. from https://www.nasmhpd.org/sites/default/files/DH-Substance-Induced-Psychosisin-First-Episode-Programming%20_0.pdf
(May 2018). Substance Abuse and Primary Psychosis: A Closer Look. Psychiatry Advisor. from https://www.psychiatryadvisor.com/schizophrenia-advisor/risk-for-primary-psychosis-increased-with-substance-abuse-disorder/article/767499/
(January 2007). The Link Between Psychotic Disorders and Substance Use. Psychiatric Times. from http://www.psychiatrictimes.com/schizophrenia/link-between-psychotic-disorders-and-substance-use
(October 2017). State: Woman Wasn't Insane; Had Drug-Induced Psychosis. Mail Tribune. from http://mailtribune.com/news/crime-courts-emergencies/state-woman-wasn-t-insane-had-drug-induced-psychosis
(September 2013). What Are the Long-Term Effects of Methamphetamine Abuse? National Institute on Drug Abuse. from https://www.drugabuse.gov/publications/research-reports/methamphetamine/what-are-long-term-effects-methamphetamine-abuse
(December 2016). Diagnosis: Psychosis. NHS. from https://www.nhs.uk/conditions/psychosis/diagnosis/#helping
(January 2016). How to Deal with Psychosis the Moment It Occurs. Psych Central. from https://psychcentral.com/blog/how-to-deal-with-psychosis-the-moment-it-occurs/
(December 2017). Fergie Shares What It's Like Living With a Symptom of Addiction We Don't Often Talk About. The Mighty. from https://themighty.com/2017/12/fergie-crystal-meth-psychosis-hallucinations-fbi-swat-team/
(September 2007). Recommended First Aid for Schizophrenia and Psychosis. Schizophrenia.com. from http://www.schizophrenia.com/sznews/archives/005561.html#