Learn / Drug-Induced Psychosis: Causes, Symptoms, and Treatment

Drug-Induced Psychosis: Causes, Symptoms, and Treatment

Kayla Gill
 October 9th, 2023|   Clinically Reviewed by 
Rajnandini Rathod

Drug-induced psychosis can be caused by a number of substances, and can trigger underlying mental health conditions. Here’s how to recognize a psychotic episode, what to do if someone you know is having one, and how to go about getting treatment for long-term recovery.

Definition and Causes

According to the United Brain Association, “Drug-induced psychosis (DIP)1 is an episode in which a person experiences a disconnection from reality caused by a drug or other intoxicating substance.” Whether from prolonged use, high levels of use, or substances that are more likely to cause a negative reaction, DIP is an extreme reaction that requires immediate care. Substances alone can cause psychotic episodes, or they can trigger underlying mental health conditions. Drug-induced psychosis can also happen during withdrawals. 

Certain substances are known to more commonly trigger psychosis.

Common Substances Linked to Psychosis

Substances like hallucinogens, stimulants, and some prescription drugs can trigger psychotic episodes. While a variety of factors may lead to this acute mental state, certain substances have a known history of being linked with psychosis. 

Stimulant or Amphetamine Psychosis

It’s not uncommon for people who use stimulants like meth regularly to experience psychosis, usually as a result of sleep deprivation combined with the drug’s effects. This “transient psychosis2 usually takes place during use and subsides after coming down. Using sedatives like opioids or benzos to sleep off a meth binge can also increase this risk. Researchers say “There is ongoing debate about whether the amphetamines themselves produce the psychotic symptoms,3 if they unmask vulnerabilities in individuals already susceptible to psychosis, or both.” 

Synthetic Drugs

Also known as bath salts, designer drugs, or novel psychoactive substances (NPS) in the clinical world, these chemical compounds are known to cause intense, unpredictable effects. As synthetic drug use continues to rise, so do a range of “new psychoses4 that differ from psychotic episodes clinicians have seen in the past. 

The adverse effects of synthetic cannabinoids5 (such as K2 and Spice) can include “paranoia, catatonia, dissociation, auditory, and/or visual hallucinations.” These drugs can also trigger psychosis in people with underlying psychotic disorders. 

Marijuana and Schizophrenia

Consuming high doses of cannabis can sometimes result in a form of drug-induced psychosis that includes symptoms like “delusions of being controlled by an outside force,6 grandiose identity, persecution, thought insertion, auditory hallucinations, altered perceptions, and emotional blunting.” There’s also a possibility that marijuana can trigger schizophrenic episodes,7 or cause earlier onset of schizophrenia. 

A range of other substances can also cause drug-induced psychosis:

  • Alcohol 
  • Cocaine 
  • Dissociatives such as PCP and ketamine 
  • Hallucinogens such as LSD or mushrooms 
  • Prescription drugs (opioids, antidepressants, etc.) 

Your likelihood of psychotic symptoms may have to do with your individual sensitivity to certain drugs. Some substances, like synthetic drugs, can cause severe reactions within just one use—regardless of your tolerance.

Symptoms of Drug-Induced Psychosis

Drug-induced psychosis symptoms can be grouped into 3 categories: 

1. Thoughts 

Someone experiencing psychosis might have delusions like thinking they have special powers, or being paranoid that someone is following them. Hallucinations—sensory experiences that aren’t based in reality—are also very common.  

2. Feelings

Drug-induced psychosis usually involves some combination of fear, agitation, and confusion. Someone might experience a roller coaster of emotions: being angry one minute, and depressed and lethargic the next. 

3. Behaviors  

Someone in this state might have a hard time remembering things or being present in conversations. They may laugh at things that aren’t funny or otherwise respond inappropriately to situations. They’ll likely have trouble interpreting social cues or being aware of their surroundings.  

Drug-induced psychotic episodes can be highly dangerous. They can even be fatal if someone is seriously injured due to erratic behavior, or has a physiological response to their heightened state, such as cardiorespiratory collapse.8 

That’s why it’s important to recognize early warning signs. The most common symptoms of DIP9 include distorted perceptions, hallucinations, disorientation, and memory problems.

How Long Does Drug-Induced Psychosis Last?

Drug-induced psychosis symptoms typically appear quickly, setting in shortly after use. In most cases, they go away within a few days or so—but not always. Some people experience lingering symptoms for weeks or even months after the episode. And for those who have an underlying mental health condition triggered by DIP, the experience can be life-changing. 

Can DIP Be Permanent or Long-Term?

Whether or not you incur long-term effects of drug-induced psychosis has to do with a few factors. One study found that while most people with substance-induced psychotic disorders eventually recovered,10 “those who started illegal drug use early, used drugs for prolonged periods, or had a family history of psychiatric illnesses were more likely to develop a chronic psychosis.” The same study found that 60% of patients’ symptoms went away within a month, 30% had symptoms lasting 1-6 months, and 10% had long-term symptoms or a diagnosis of schizophrenia. Those patients more commonly had a family history of mental illness, and had been using drugs longer. 

The duration of symptoms can also depend on what substance that caused the episode. One study on psychosis from synthetic cannabinoid use11 said “The protracted presence of psychotic symptoms well beyond acute intoxication—sometimes lasting months—is concerning.” Other research found that for those who have psychotic reactions to synthetic cannabinoids,12 the “effects are usually transient and resolve within 5 to 8 days; however, up to one-third of patients will transition to schizophrenia.”

It’s important to keep in mind that for most people who experience DIP, symptoms resolve relatively quickly. If you’re concerned about symptoms you have, it’s vital to get an accurate diagnosis from a professional.

Risk Factors and Vulnerability

Drug Sensitivity

Some people simply have stronger reactions to substances. “People who have experienced psychosis tend to be particularly sensitive to the effects of drugs13 and can experience negative effects even at very low levels of use,” explains researcher Frances Kay-Lambkin.

Using the Same Substance Again

Chances of another psychotic episode14 also go up drastically if you use the same drug again. The good news is that this can be avoided by abstaining from that drug. One study on cannabis-related DIP15 found that “patients who completely abstained from cannabis after the 1st episode of Cannabis-Induced psychosis had no relapse of psychiatric illness.”   

Genetics and Environment

Genetics can also play a role. “Primary and drug-induced psychosis seems to be genetically interlinked,”16 say neuropathology researchers Vahid Farnia and Senobar Golshani. For example, “Relatives of amphetamine users with a history of amphetamine psychosis are five times more at risk of developing schizophrenia compared with amphetamine users without a history of psychosis.” 

Pre-Existing Mental Health Conditions

People with pre-existing mental illnesses are at higher risk of drug-induced psychosis.17 Some people with psychotic disorders—whether or not they’re diagnosed—self-medicate with drugs or alcohol. Substance use, in turn, worsens symptoms of mental health conditions. Some symptoms of drug-induced psychosis overlap with those of some mental health disorders, making it hard to tell what the exact cause is. 

Differentiating From Underlying Mental Illness

Drug-induced psychosis symptoms are similar to other psychotic disorders, but they typically come on suddenly (after drug use) and go away faster. But underlying conditions, co-occurring disorders and the unpredictable nature of DIP makes it complex to diagnose. Untangling the difference between a drug-induced psychotic episode and a primary psychotic disorder can be difficult, even for professionals. 

“A struggling clinical dilemma is how to clearly identify a substance-induced psychosis from a primary psychotic illness or a psychotic illness with comorbid substance use,” say researchers on substance-induced psychoses.18 And differentiating between the two is necessary for effective treatment. 

Because symptoms of psychoses can be similar19 regardless of their origin, clinicians may use a patient’s clinical history, as well as detailed assessments, to make a diagnosis. If you’ve experienced symptoms of psychosis, it’s important to get a comprehensive evaluation by a qualified mental health professional.  

Treatment Approaches

What to Do Immediately Following

The National Alliance on Mental Illness (NAMI) recommends these steps if you see a loved one having a psychotic episode:20

  • Stay calm 
  • Listen 
  • Be empathetic to what they’re going through
  • Focus on the person, not the delusion
  • Offer support 
  • Seek professional help

Professional Treatment With Medication

Often, doctors will prescribe medication like benzodiazepines or antipsychotics21 to help patients stabilize until the substance leaves their system. Medications may be prescribed longer-term if someone has an ongoing psychotic disorder. 

*Please note that this is not medical advice, simply an idea of what you might expect in follow-up treatment. Treatment plans should be created by qualified professionals, based on an in-depth assessment. 

Detoxing and Managing Withdrawals

Susbtance withdrawal can be dangerous under normal circumstances, but the situation is even more delicate when psychosis is involved. It’s important to detox from drugs or alcohol under medical supervision. Make sure you find a reputable facility with everything you need in place for a safe and supported detox. 

And remember, detox is just the first step. Following up with an intensive treatment program, like inpatient drug rehab, is an effective way to set the stage for long-term recovery. 

Long-Term Recovery and Support

Whether or not it results in a formal diagnosis, drug-induced psychosis can have a significant impact on your mental well-being. That’s why it’s important to find comprehensive support for your recovery. 

Rehab can be a great place to start. Quality addiction treatment programs not only provide intensive treatment for immediate concerns, but also teach strategies to prevent relapse and equip you with coping tools for the future. 

Search for addiction treatment centers to compare programs and contact admissions staff directly.

Frequently Asked Questions About Drug-Induced Psychosis

What is drug-induced psychosis?

Drug-induced psychosis (DIP) is an episode where a person experiences a disconnection from reality due to the influence of drugs or alcohol. It can occur as a result of prolonged or high-level substance use, or can be triggered by specific substances, often leading to acute mental health disturbances.

Which substances are commonly associated with drug-induced psychosis?

Several substances are known to be linked to drug-induced psychosis. These include hallucinogens, stimulants (such as methamphetamine), synthetic drugs, marijuana (especially in high doses), alcohol, cocaine, dissociatives (such as PCP or ketamine), and certain prescription drugs (such as opioids or antidepressants).

How long does drug-induced psychosis typically last, and can it be permanent?

Drug-induced psychosis symptoms usually appear quickly after substance use and often subside within a few days. However, for some people, symptoms can persist for weeks or even months. Whether it becomes long-term or permanent depends on various factors, including the substance used, individual sensitivity, duration of drug use, and genetic predisposition. It’s essential to seek professional evaluation and treatment for a precise diagnosis and appropriate care.

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