Psychosis is an ancient disorder and humans have pointed out its challenges and mysteries throughout history. It was first mentioned in Egypt in 1,500 BC and later described by Hippocrates, the father of medicine, in the fourth century. Psychosis can be caused by a number of different factors, but can it be caused by drugs or alcohol?
Learn more about how some drugs could affect your mind and cause symptoms of psychosis.
Psychosis is a psychological condition that blurs the line between reality and false beliefs and even perceptions. It’s characterized by a wide range of psychological and cognitive conditions including visual or auditory hallucinations, incoherent speech, illogical thinking, and false ideas and beliefs. Psychosis is a common symptom of mental illnesses including schizophrenia, bipolar disorder, and sleep disorder because of severe anxiety or insomnia. It can also be caused by certain medical conditions, especially head injuries.
Drugs work in the brain in various ways and some have a serious impact on your cognition and brain chemistry. In some cases, drugs can cause short and long-term psychosis, especially as a result of long-term use and abuse. In some cases, drug use can exacerbate pre-existing mental disorders that cause psychosis, even if it wasn’t previously apparent that the disorder existed. People who suffer from drug-induced psychosis experience symptoms that are slightly different from psychosis caused by mental illness. Drug users often seem to have more of an awareness of their psychotic states but they are also more likely to experience suicidal thoughts and actions.
Psychosis is not an extremely widespread problem with only three percent of the U.S. population experiencing psychosis at some point in their lives. However, that represents over nine million people, meaning that it is a significant issue.
If you or a loved one has experienced symptoms of psychosis, it’s important to speak to a professional, especially if it accompanied by suicidal thoughts.
Psychosis can sometimes be difficult to notice in yourself. It changes your perception of reality and, by nature, that means you may not realize what’s happening. However, people that experience drug-induced psychosis seem to have a better understanding that something is wrong than people who experience it as a result of mental illness.
There are a few telltale signs that point to the existence of a psychotic episode or symptoms. You may be able to notice them in yourself or in a loved one. Symptoms include:
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Marijuana isn’t usually high on the list of the most dangerous or health-threatening drugs. However, it does contain a naturally occurring psychoactive substance called tetrahydrocannabinol (THC) that has shown to have a link to the development of psychosis in some users. This chemical is the drug’s active ingredient and gives it the desired effects. Also, with high traces of THC, marijuana has shown to cause symptoms of psychosis in a significant number of users.
However, marijuana also contains a naturally occurring chemical that counteracts psychosis called cannabidiol (CBD). It is thought to stop or soften the effects of THC in causing psychotic thinking and anxiety. It’s even currently being tested as a potential medication for psychosis. However, if such a chemical exists alongside THC, why does marijuana sometimes cause psychosis?
In the illegal trade of marijuana, the drug has become more and more potent over time. In the illegal drug trade, it’s often less risky and more cost effective to increase the potency of drugs. It’s harder to detect a small amount of highly potent drug in an illegal shipment than it is for large amounts of less potent drugs to be found and seized. For the same reason, hard liquor became more popular than beer and wine during prohibition and highly-potent fentanyl is more prevalent today.
Because CBD in marijuana decreases the effects of THC, clandestine drug manufacturers have created strains that are high in THC and low in CBD, leading to an increased risk of psychosis.
Alcohol has been known to cause psychosis during intoxication and withdrawal. The phenomenon of “drunken hallucinations” or alcoholic hallucinosis has been recorded for as long as alcohol has been consumed by humans. One of the first descriptions of alcoholic hallucinosis dates back to 1907 in a book by German psychiatrist Emil Kraepelin, who first identified it as a psychosis. The phenomenon has been described with a number of euphemisms, including “seeing pink elephants” which was referenced in Disney’s Dumbo, after the title character accidentally drinks champagne.
Despite our long-lasting knowledge of alcohol-induced psychosis, we are still not sure what causes psychotic symptoms in alcohol use. It is thought that it has something to do with the dopamine, which is responsible for feelings of excitement and alertness. In the limbic system, it plays a role in identifying things that we find important and it also affects motivation. It is theorized that the way alcohol alters dopamine plays some role in the development of psychotic symptoms.
Apart from intoxication, alcohol can also cause psychosis during Delirium tremens (DT) a condition that can sometimes occur during alcohol withdrawal. Delirium tremens is characterized by confusion, tremors, irregular heartbeat, seizure, and hallucinations. Without medical attention, DT can be deadly in up to 25 percent of cases. Its most commonly caused when alcohol abuse is stopped suddenly.
Cocaine is another drug that can cause psychosis. As a stimulant, it works to create feelings of excitement, power, and alertness. Unlike marijuana and alcohol, one of cocaine’s many functions is to work on dopamine receptors (parts of the brain that bind and are activated by dopamine).
Cocaine stops dopamine reuptake, which means that the chemical is left in the brain without being removed and recycled. This causes a buildup of dopamine, which results in an intense high. If psychosis has to do with dopamine imbalance, then the effects of cocaine would explain the possibility of developing psychotic symptoms.
Drugs like cocaine are associated with a specific type of psychosis called stimulant-induced psychotic disorder or stimulant psychosis.
It’s characterized by hallucinations, paranoia, and delusions.
Cocaine, specifically crack cocaine, is associated with long periods of binging.
Crack is a free-base form of cocaine that offers an intense but brief high. During a binge, the user experiences intense pleasure for a brief moment and then takes another hit to feel the same high. However, your brain can only provide so much dopamine at a time and each hit of the drug is weaker than the last. This sometimes results in compulsive binging that can last for more than a day, sometimes several days at a time.
The steady supply of the stimulant causes people who are binging to remain awake for days, which can contribute to psychosis even without the drug’s effects on dopamine.
Together, the sleeplessness and excessive cocaine use can cause significant psychosis.
Another drug that can cause psychosis is methamphetamine, which is also a stimulant like cocaine. However, while cocaine simply stops the reuptake of dopamine, meth does this in addition to causing an increase in dopamine production. This floods the brain with so much of the chemical, it can actually damage dopamine receptors. Heavy meth users may lose their ability to feel pleasure outside of drug use. The resulting dopamine imbalance may cause psychosis in some users. In some cases, psychological symptoms that are caused by meth use can take years before returning to normal, especially without adequate treatment.
Drug-induced psychosis can be a short-term effect of drug abuse and addiction, but it can also cause more long-lasting effects. However, the prognosis seems to be affected by early intervention. If you or a loved one is suffering from a substance use disorder or an addiction, treatment may be able to help you avoid serious long-term consequences like psychosis.
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Hellerman, C. (2013, August 09). Not your father’s weed? Marijuana potency stronger than ever. Retrieved from from https://www.cnn.com/2013/08/09/health/weed-potency-levels/index.html
National Institute of Mental Health. (n.d.). RAISE Questions and Answers. Retrieved from from https://www.nimh.nih.gov/health/topics/schizophrenia/raise/raise-questions-and-answers.shtml
Psychosis. (2016, December). Retrieved from from https://www.nhs.uk/conditions/psychosis/causes/