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Drug-Induced Psychosis: Signs, Symptoms, and Treatment Options

Last Medical Review On: July 17, 2024
Updated On: June 15, 2024
7 min read
Written by:

Amanda Stevens, B.S.

Medical Review by:

Dr. Po-Chang Hsu, M.D., M.S.

Experiencing drug-induced psychosis can be daunting for those already struggling with substance abuse.[1] Psychosis, marked by a detachment from reality and experiencing hallucinations or delusions, can be triggered by drug use. Substance abuse can also exacerbate underlying mental health issues, creating a difficult cycle of dependency and psychological distress.[2]

Recognizing the potential interplay between substance abuse and psychosis is crucial for accessing the necessary support and intervention. Fortunately, there are various treatment approaches available to address drug-induced psychosis and support you in the journey towards recovery.

If you or a loved one is struggling with substance abuse, we can help. Reach out today.

Drug Induced Psychosis

Key Points

  • Experiencing drug-induced psychosis can be challenging for individuals already grappling with substance abuse, as psychosis involves a detachment from reality and may include hallucinations or delusions.
  • Substance abuse can exacerbate underlying mental health issues and contribute to a cycle of dependency and psychological distress.
  • There is a well-established link between substance abuse and the emergence of psychotic symptoms.
  • Several risk factors contribute to the development of addiction, including genetics, environmental influences, childhood trauma, peer influence, early substance use, stress, and neurobiological factors.
  • Dual diagnosis treatment for drug-induced psychosis and addiction takes a comprehensive approach to address both conditions simultaneously.
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    What Is Drug-Induced Psychosis?

    Drug-induced psychosis is a serious mental health condition characterized by a profound disruption in a person’s thoughts and perceptions, often resulting in hallucinations, delusions, and impaired reasoning.[3] Individuals experiencing drug-induced psychosis may exhibit erratic behavior, disorganized thinking, and a distorted sense of reality.

    Unlike transient experiences of altered perception, drug-induced psychosis involves a persistent and profound disturbance in mental functioning that can significantly impact an individual’s ability to function in daily life.

    According to research findings, there is a well-established link between drug abuse and the emergence of psychotic symptoms.[4] The prevalence of psychotic symptoms associated with various substances can vary widely, ranging from users without a formal diagnosis to those with severe substance dependence.

    For example, the prevalence rates of psychotic symptoms among users of different substances are as follows:[5]

    • Amphetamines: Ranges from 5.2% to 36.5%
    • Cannabis: Ranges from 6.7% to 20%
    • Cocaine: Ranges from 6.7% to 55.1%
    • Opiates: Ranges from 0.7% to 2.5%

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    How Are Psychosis and Addiction Related?

    Psychosis and addiction can often intersect, developing and influencing one another in several ways:[6]

    • Self-Medication: Individuals experiencing psychosis may turn to substances as a means of self-medication to alleviate distressing symptoms such as hallucinations or delusions. Drugs and alcohol may provide temporary relief from psychotic symptoms or help individuals cope with the emotional distress associated with psychosis.
    • Increased vulnerability: Substance abuse can increase the risk of developing psychosis or exacerbate existing psychotic symptoms. Certain substances, such as stimulants like methamphetamine or hallucinogens like LSD, have been linked to the onset or worsening of psychotic symptoms, particularly in susceptible individuals.
    • Neurochemical changes: Both psychosis and addiction involve disruptions in brain chemistry and neural pathways. Chronic substance abuse can lead to alterations in brain structure and function, which may contribute to the development or persistence of psychotic symptoms. Conversely, psychosis itself can affect neurotransmitter systems and neural circuits implicated in addiction, potentially reinforcing substance-seeking behaviors.
    • Shared risk: Psychosis and addiction often co-occur due to shared risk factors such as genetic predisposition, early life stress or trauma, and environmental influences. Individuals with a family history of psychosis or addiction may be at heightened risk for developing both conditions.
    • Dual diagnosis: Many individuals with psychosis also struggle with co-occurring substance use disorders, a phenomenon known as dual diagnosis or comorbidity. Managing both conditions simultaneously can be challenging, as they can interact and exacerbate each other’s symptoms, complicating treatment and recovery efforts.
    • Escalation: Psychosis and addiction can fuel a vicious cycle of escalation, with substance abuse worsening psychotic symptoms and vice versa. This cycle can lead to a downward spiral of deteriorating mental health, impaired functioning, and increased risk of adverse outcomes such as homelessness, incarceration, or suicide.

    What are the Risk Factors for Psychosis?

    Psychosis is a complex mental health condition influenced by a combination of genetic, biological, environmental, and psychological factors.

    Several risk factors have been identified that may increase the likelihood of developing psychosis in addition to substance use, including:[7]

    • Genetic predisposition: Individuals with a family history of psychosis or other mental health disorders, such as schizophrenia or bipolar disorder, are at increased risk of developing psychosis themselves. Genetic factors play a significant role in predisposing certain individuals to psychotic disorders.
    • Brain chemistry and structure: Imbalances in neurotransmitters (chemical messengers in the brain), such as dopamine and glutamate, have been implicated in the development of psychosis. Structural abnormalities in the brain, including changes in volume or connectivity in certain brain regions, may also contribute to the risk of psychosis.
    • Stress and trauma: Traumatic experiences, such as physical or sexual abuse, neglect, or severe emotional stress, can increase the risk of developing psychosis. Chronic stressors, adverse childhood experiences, and traumatic life events may contribute to the onset or exacerbation of psychotic symptoms.
    • Childhood development: Early developmental abnormalities or disruptions in childhood, such as prenatal exposure to infections or toxins, complications during birth, or neurodevelopmental disorders like autism spectrum disorder, may increase the risk of later developing psychosis.
    • Social and environmental factors: Social determinants of health, such as socioeconomic status, social isolation, migration, and exposure to social adversity or discrimination, can influence the risk of psychosis. Living in urban areas or experiencing social deprivation may be associated with higher rates of psychosis.
    • Psychological factors: Certain personality traits, cognitive vulnerabilities, or maladaptive coping strategies may increase the susceptibility to psychosis. Individuals with a history of trauma, early adversity, or maladaptive schemas may be at heightened risk.
    • Certain medical and neurological conditions: Certain medical conditions or neurological disorders, such as brain tumors, epilepsy, autoimmune diseases, or neurodegenerative disorders, may be associated with an increased risk of psychosis due to their effects on brain function and structure.

    It’s important to note that while these risk factors may increase the likelihood of developing psychosis, not everyone with these risk factors will experience psychotic symptoms. Additionally, multiple risk factors may interact and compound the overall risk. Early identification and intervention for individuals at risk of psychosis can help mitigate these factors and improve outcomes.

    What are the Risk Factors for Addiction?

    Many potential factors can contribute to the development of addiction—some of which overlap with the risk factors for psychosis:[8]

    • Genetics: Genetic predispositions significantly influence addiction susceptibility. Individuals with a family history of addiction inherit genetic factors that elevate their risk of developing addiction themselves.
    • Environmental influences: Exposure to substance abuse within the family or peer group, socioeconomic status, substance availability, and cultural attitudes toward substance use all play a role in addiction risk.
    • Childhood trauma: Adverse childhood experiences, such as abuse, neglect, or other traumas, can increase the likelihood of addiction later in life. Trauma may lead individuals to use substances as a coping mechanism to escape distressing emotions.
    • Dual diagnosis: Co-occurring mental health disorders, like depression, anxiety, trauma-related disorders, or personality disorders, are common among individuals with addiction, heightening vulnerability to substance abuse as individuals seek relief from symptoms.
    • Peer influence: Peer pressure and societal norms surrounding substance use influence an individual’s likelihood of experimenting with or developing addiction. Associating with peers who engage in substance use increases the risk of substance abuse.
    • Substance use at an early age: Initiation of substance use during adolescence, when the brain is still developing, can increase addiction risk. Early substance exposure may alter brain chemistry and heighten susceptibility to addictive behaviors.
    • Stress: Chronic stress, life transitions, and traumatic events can trigger or worsen substance abuse as individuals turn to substances to cope with challenging emotions or situations.
    • Neurobiological factors: Differences in brain structure and function, including alterations in neurotransmitter systems and impulse control, contribute to addiction vulnerability on a neurobiological level.

    Co-occurring disorder Treatment for Drug-Induced Psychosis and Substance Abuse

    Dual diagnosis treatment for drug-induced psychosis and addiction embraces a comprehensive approach designed to address the complex needs of individuals facing both substance use disorders and simultaneous mental health challenges.[9] The process usually begins with thorough assessments to gain insight into your situation.

    A personalized treatment plan is crafted to tackle the distinct hurdles presented by both addiction and co-occurring mental health conditions. This plan delineates specific goals, interventions, and modalities to facilitate your recovery journey and promote overall well-being.

    Depending on the severity of addiction, medical detoxification may be required to manage withdrawal symptoms and stabilize your physical health safely. Therapy and counseling play integral roles in dual diagnosis treatment, offering opportunities for individuals to explore underlying issues, develop coping strategies, and enhance emotional regulation.

    Individual, group, and family therapy sessions provide support and guidance while fostering resilience against relapse. Medication management may be incorporated to address psychiatric symptoms, curb cravings, and enhance prospects for long-term recovery.

    After the formal treatment program, aftercare planning begins to maintain progress in recovery. This may involve linking you to community resources, participating in outpatient therapy, supporting groups, and continuing psychiatric care. By delivering integrated care that addresses both addiction and co-occurring mental health conditions, dual-diagnosis treatment aims to empower individuals to achieve sustained recovery and improve their overall quality of life.

    Drug-Induced Psychosis and Substance Abuse Treatment Levels of Care

    Due to the personalized approach to treatment, dual diagnosis facilities usually offer a range of care settings tailored to meet your specific needs:

    • Medical Detoxification (Detox): Detoxification, commonly referred to as detox, entails the deliberate elimination of detrimental substances such as drugs or alcohol from the body. Typically conducted under close supervision in medical facilities or specialized detox centers, this process aims to safely address the physical symptoms of withdrawal, thereby readying individuals for subsequent stages of treatment and rehabilitation.
    • Medically Managed Care: Medically managed care integrates medical expertise with therapy to provide comprehensive support to patients throughout their recovery journey. This level of care ensures continuous monitoring by medical professionals who customize treatments and collaborate closely with other team members. This integrated approach fosters holistic healing and supports long-term well-being by addressing patients’ physical and psychological aspects of their conditions.
    • Inpatient Addiction Treatment: Inpatient treatment, also known as residential treatment, involves individuals residing in a facility for the duration of their care. This level of care is ideal for severe addiction or mental health concerns that require intensive, round-the-clock attention. Patients participate in various therapeutic activities, including individual and group therapy, and receive medical and psychiatric assistance. The structured environment facilitates focused recovery, with program durations varying from weeks to months to accommodate individual needs and progress.

    Therapies Used in Drug-Induced Psychosis and Addiction Treatment

    Alpas offers several evidence-based approaches to treat co-occurring mental health and substance use issues:

    • Cognitive Behavioral Therapy (CBT): CBT is commonly employed to tackle negative thought patterns and behaviors associated with mental health disorders like depression and addiction. Through collaborative sessions with a therapist, individuals are taught to challenge distorted thinking, acquire coping skills, and effectively manage cravings. This empowering approach encourages insight into thought processes and behavior patterns, empowering individuals to enact positive changes and attain enduring recovery.
    • Dialectical Behavior Therapy (DBT): DBT blends mindfulness, acceptance, and behavior change strategies within a cognitive-behavioral framework. Initially developed for borderline personality disorder (BPD), DBT has evolved to address various mental health concerns, including addiction. It prioritizes skill acquisition in emotion regulation, interpersonal effectiveness, and distress tolerance. Therapists employ a blend of individual sessions, group training, coaching, and assignments to furnish individuals with coping mechanisms and foster emotional stability throughout treatment.
    • Motivational Interviewing (MI): MI focuses on enhancing motivation for behavior change. Therapists engage in collaborative discussions, display empathy, and utilize reflective listening techniques to aid individuals in aligning their actions with their aspirations. MI empowers individuals by strengthening their readiness and dedication to making substantial life changes.
    • Contingency Management: Contingency management is a therapeutic strategy that employs rewards to incentivize desired behaviors, such as maintaining sobriety. Individuals are rewarded for meeting treatment milestones, such as attending sessions or passing drug tests. These incentives, which may consist of vouchers or prizes, are designed to boost motivation and promote adherence to treatment goals.
    • Motivational Enhancement Therapy (MET): MET is a counseling method to amplify motivation and dedication to behavior modification. Using structured conversations and feedback, MET tackles uncertainty about altering behaviors by assisting individuals in clarifying their values and objectives. By instilling confidence in their capacity for change, MET emphasizes internal motivation for constructive transformation, prioritizing personal drive over delving into the root causes of addiction.
    • Experiential Therapy: Experiential therapy utilizes interactive activities to facilitate emotional processing and encourage personal development. Diverging from conventional talk therapy, it incorporates hands-on techniques such as role-playing and art therapy. These activities enable individuals to express emotions and nurture coping mechanisms in a supportive setting that attends to the holistic aspects of the body, mind, and spirit, fostering significant personal growth.
    • Relapse Prevention: Relapse prevention work aids individuals in recognizing triggers, formulating coping strategies, and establishing plans to prevent relapse. This therapeutic approach facilitates participants’ understanding of warning signs such as stress and emotional triggers, equipping them with the skills to manage these challenges effectively. By cultivating self-awareness and furnishing practical tools, relapse prevention therapy addresses the underlying factors contributing to addictive behaviors, thereby fostering long-term sobriety.
    • Twelve-Step Facilitation: Twelve-step facilitation is a fundamental aspect of addiction recovery. It guides individuals through programs such as Alcoholics Anonymous (AA) or Narcotics Anonymous (NA). These programs promote community and accountability through group meetings, step work, and peer support. By actively engaging in these programs, individuals can establish and sustain sobriety while acquiring valuable tools for long-term recovery.
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    Frequently Asked Questions about Drug-Induced Psychosis and Substance Abuse


    What are the symptoms of drug-induced psychosis?


    Symptoms of drug-induced psychosis can vary but may include hallucinations, delusions, disorganized thinking, paranoia, agitation, and impaired cognition. Individuals may also experience mood disturbances, such as depression or anxiety, along with disruptions in sleep patterns and appetite.


    Can drug-induced psychosis occur after using substances only once, or does it usually require prolonged use?


    Drug-induced psychosis can occur after using substances only once, particularly with potent hallucinogens or stimulants. However, the likelihood of experiencing psychosis may increase with prolonged or chronic substance use, as well as with higher doses of certain drugs.


    Can drug-induced psychosis be prevented?


    While it may not always be possible to prevent drug-induced psychosis entirely, certain strategies can help reduce the risk. These include avoiding or minimizing substance use, particularly of potent hallucinogens or stimulants, and using substances in moderation. Seeking help for substance abuse and addressing underlying mental health issues can also lower the risk of experiencing drug-induced psychosis.


    Can drug-induced psychosis occur as a result of prescription medications, or is it primarily associated with illicit drugs?


    Drug-induced psychosis can occur as a result of both prescription medications and illicit drugs. Certain prescription medications, such as stimulants used to treat attention-deficit hyperactivity disorder (ADHD) or corticosteroids, may have psychotic side effects, particularly when used in high doses or for extended periods. Illicit drugs like cocaine, methamphetamine, and LSD are also known to induce psychosis.


    What are the long-term outcomes for individuals who have experienced drug-induced psychosis and substance abuse?


    The long-term outcomes for individuals who have experienced drug-induced psychosis and substance abuse can vary depending on factors such as the severity of psychosis, the type of substance(s) used, co-occurring mental health issues, and access to treatment and support services. Some individuals may experience full recovery with appropriate intervention, while others may continue to struggle with persistent psychotic symptoms or substance use disorders.


    [1] Baldaçara, L., Ramos, A., & João Maurício Castaldelli-Maia. (2023). Managing drug-induced psychosis. International Review of Psychiatry, 35(5-6), 496–502. on April 9, 2024

    [2] National Drug and Alcohol Research Centre. (2011). NDARC PYCHOSIS FINAL. on April 9, 2024

    [3] Fiorentini, A., Cantù, F., Crisanti, C., Cereda, G., Oldani, L., & Brambilla, P. (2021). Substance-Induced Psychoses: An Updated Literature Review. Frontiers in Psychiatry, 12(12). on April 9, 2024

    [4] Smith, M. J., Thirthalli, J., Abdallah, A. B., Murray, R. M., & Cottler, L. B. (2009). Prevalence of psychotic symptoms in substance users: a comparison across substances. Comprehensive Psychiatry, 50(3), 245–250. on April 9, 2024

    [5] Fiorentini, A., Cantù, F., Crisanti, C., Cereda, G., Oldani, L., & Brambilla, P. (2021). Substance-Induced Psychoses: An Updated Literature Review. Frontiers in Psychiatry, 12(12). on April 9, 2024

    [6] Health (UK), N. C. C. for M. (2011). PSYCHOSIS WITH COEXISTING SUBSTANCE MISUSE. In British Psychological Society. on April 9, 2024

    [7] Brasso, C., Giordano, B., Badino, C., Bellino, S., Bozzatello, P., Montemagni, C., & Rocca, P. (2021). Primary Psychosis: Risk and Protective Factors and Early Detection of the Onset. Diagnostics, 11(11), 2146. on April 9, 2024

    [8] Alhammad, M., Aljedani, R., Alsaleh, M., Atyia, N., Alsmakh, M., Alfaraj, A., Alkhunaizi, A., Alwabari, J., & Alzaidi, M. (2022). Family, Individual, and Other Risk Factors Contributing to Risk of Substance Abuse in Young Adults: A Narrative Review. Cureus, 14(12). on April 9, 2024

    [9] Cleveland Clinic. (2023). Dual Diagnosis: Definition & Treatment. Cleveland Clinic. on April 9, 2024

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