Substance misuse

Substance-induced psychotic disorder, also known as drug-induced psychosis is a mental health condition in which any psychotic episodes or psychotic disorder symptoms are related to the use of substances. This could be individuals who use alcohol and other psychoactive drugs. In addition, some medication use can cause the same effects. The onset of a psychotic episode can occur when using the substance, when not using, during withdrawal or even when in recovery.

Psychoactive Substances

A wide variety of psychoactive substances can trigger substance-induced psychotic disorders including

• Alcohol
• Phencyclidine (PCP)
• Hallucinogens
• Inhalants
• Sedatives
• Hypnotics
• Amphetamines
• Stimulants

Symptoms of drug induced psychosis includes:

• Hallucinations. A person might see, smell, or hear things that aren’t there.

Types of Hallucinations	Drugs	Alcohol
Auditory	Verbal (hearing voices) and hearing sounds or noises.	Alcoholic hallucinosis is predominantly auditory hallucinations, paranoid symptoms and fear that occur either during or after a period of heavy alcohol consumption.
Visual	Flashes of light or abstract shapes, which may take the form of an animal or person	Spiders are a common hallucination for people who are suffering from alcohol withdrawal symptoms.
Tactile	The sensation of insects crawling on, biting, or stinging on the skin tends to occur in people that have used potent stimulants, such as cocaine, narcotics, and amphetamines.	In some rare cases, tactile hallucinations may occur.

• Delusions. A person experiences false beliefs.

Persecution delusions – where you believe that someone is spying on you.

Jealousy delusions – where you may believe your partner has been unfaithful, but there is no evidence to support this.

Grandiose delusions – where one has false beliefs or inaccurate beliefs that one has special powers, famous, wealth, mission or identity.

It is important to note that one common feature of psychosis is when you lose some contact with reality.

Specifically, high levels of toxicity, and taking too much of a certain drug/alcohol provoke a psychotic episode. The use of substances could exacerbate or trigger the onset of mental health problems such as bipolar disorder and schizophrenia, due to being predisposed to the condition.

• Disconnect from reality. A person may appear catatonic (affects a person’s movements, behaviour and ability to communicate) or withdrawn.

Other symptoms of alcohol and drug-induced psychosis may include:

• Agitation
• Confusion
• Fear and paranoia – A person might feel threatened in some way, although there is little to no evidence to support this.

Types of threats: 

• Threats of Physical harm
• Social/Interpersonal threat
• Threat of persecution/spying
• General suspiciousness/distrust/mistrust e.g. being robbed, plagiarised, irritated by neighbours etc.

• Loss of interest in regular activities
• Trouble holding a coherent conversation
• Difficulty maintaining hygiene or performing regular daily activities
• Laughing or crying inappropriately
• Inappropriate behaviour
• Becoming angry, upset, or energized for no apparent reason
• Becoming lethargic, inactive, or experiencing anhedonia for no apparent reason