Drug-Induced Psychosis vs. Mental Health Disorder Psychosis

Drug-Induced Psychosis vs. Mental Health Disorder Psychosis

Determining whether psychosis is drug-induced or a symptom of a mental health disorder involves considering the onset, duration, and context of symptoms.

Methamphetamine-Induced Psychosis

Methamphetamine use can cause acute psychotic symptoms such as paranoia, hallucinations, and delusions, typically occurring during or shortly after drug use. These symptoms often resolve with abstinence, although prolonged use can lead to persistent psychosis (Fiorentini et al., 2021). For instance, a user experiencing auditory hallucinations after a meth binge may see symptoms diminish after detoxification.

Cannabis-Induced Psychosis

Cannabis causes a psychotic response, especially in persons with a predisposition to mental illnesses. Signs like paranoia and illusions often reduce once the individual stops using the substance. However, abuse of the substance can worsen existing mental illness (Wilkinson et al., 2014). For instance, a patient who has a genetic predisposition for schizophrenia may develop a paranoid schizophrenic episode following the regular use of cannabis.

Cocaine-Induced Psychosis

Cocaine can induce psychotic features such as paranoia and, therefore, hallucinations during periods of intense use, which are usually reversible once the substance is withdrawn. Chronic users, however, show early-, middle-, and late psychosis that is often persistent in nature and adds to the diagnostic challenge (Palma-Álvarez et al., 2019). For instance, a chronic cocaine user might have paranoid psychosis, which revolves around cocaine use but lasts long after the phases of cocaine intoxication. A systematic approach of evaluating the patient’s history of drug use and either a psychiatric evaluation or referral to a psychiatrist can help differentiate between these causes.

References

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). https://doi.org/10.3389/fpsyt.2021.694863

Palma-Álvarez, R. F., Ros-Cucurull, E., Ramos-Quiroga, J. A., Roncero, C., & Grau-López, L. (2019). Cocaine-induced psychosis and asenapine as treatment: A case study. Psychopharmacology Bulletin, 49(1), 92–97. https://www.ncbi.nlm.nih.gov/pmc/articles/pmc6386431/

Wilkinson, S. T., Radhakrishnan, R., & D’Souza, D. C. (2014). Impact of cannabis use on the development of psychotic disorders. Current Addiction Reports, 1(2), 115–128. https://doi.org/10.1007/s40429-014-0018-7

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Drug-Induced Psychosis vs. Mental Health Disorder Psychosis

Oftentimes, those addicted to methamphetamine, cannabis, cocaine, and other illicit drugs often also suffer from mental health effects such as psychosis (delusions and/or hallucinations). Based on your readings, how would you decide if the symptoms of psychosis are related to a mental health disorder or through acute drug-induced psychosis? Examples?