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Schizophrenia is a serious mental illness that is characterized by an individual experiencing a break from reality. Psychotic symptoms, such as auditory or visual hallucinations, delusional thoughts, and paranoia are features associated with this mental health disorder.
While schizophrenia is an organic mental health affliction separate from any involvement with drugs or alcohol, certain substances can actually trigger the symptoms of schizophrenia. The use or overuse of psychoactive substances, drugs like methamphetamine, cannabis, cocaine, opioids, and alcohol can cause the psychosis. Likewise, the schizophrenic symptoms may also emerge as a reaction to substance withdrawal.
Drug-induced schizophrenia is not usually a lasting condition, like the mental health disorder, schizophrenia is. Instead, it is a dangerous but temporary state through which the individual must pass. However, in some cases, long-term drug use can result in the development of the mental health disorder, schizophrenia.
Substances That Can Cause Temporary Symptoms of Schizophrenia
There are several drugs that are associated with a powerful reaction of psychosis. The first obvious drug that comes to mind is LSD. LSD and other psychedelic drugs, such as mushrooms, peyote, PCP, and MDMA. Not so obvious is the fact that today’s potent marijuana when taken in too high a dose can also lead to someone experiencing the symptoms of schizophrenia. Other drug-induced schizophrenia can be triggered by high doses of stimulants, such as cocaine, amphetamines, and methamphetamine. Not as well known is that some prescription medications can also cause signs of psychosis. These include:
- Muscle relaxants
- Cardiovascular medications
- Chemo drugs
- Blood pressure medications
- Medications for Parkinson’s disease
Methamphetamine and Schizophrenia
Methamphetamine is a powerful illicit stimulant that interacts with the limbic region in the brain. This is the part of the brain that regulates such things as decision-making, judgment, impulsivity, and the fight or flight response. When the limbic system is over-stimulated through the recreational use of meth, intense symptoms of psychosis can result. These include paranoid delusions, aggression, and hallucinations.
There are usually signs that a problem with methamphetamine is escalating out of control. Individuals regularly using meth begin to experience intense irritability, angry or violent outbursts, anxiety symptoms, hypersexuality, agitation, and impulsive behaviors. Some may start binging on methamphetamine, a practice referred to as tweaking, leading to the sensation of bugs crawling under the skin, insomnia, loss of appetite, twitching, and intense drug cravings.
Sustained use of methamphetamine will eventually have dramatic effects on both mental and physical health. When meth-induced psychosis or schizophrenia develops it can have serious long-term consequences. Individuals with a long history of methamphetamine use who develop drug-induced schizophrenia may still struggle with the mental health disorder for months or years after abstinence. At this point, a doctor is likely to diagnosis their condition as schizophrenia, versus a temporary psychosis caused by the drug.
It is notable that other stimulants, like Adderall, cocaine, and amphetamines, when abused or overdosed on, can also lead to the same type of psychotic symptoms.
How Substance Abuse Can Lead to Mental Illness
A study published in the American Journal of Psychiatry reported that about one-third of patients with drug-induced psychosis transitioned to bipolar disorder or a schizophrenia-spectrum disorder. While true that an underlying mental health disorder can be a risk factor for developing a substance use disorder, this study concludes that a high percentage of addicts acquired a psychotic disorder as a result of the substance abuse. In the study anyone who had a history of mental illness was removed from the pool of study participants. Their findings found this prevalence, from highest to lowest, of substance-induced schizophrenia by substance:
- 47.4% cannabis-induced
- 32.3% amphetamine-induced
- 27.8% hallucinogen-induced
- 22.1% alcohol-induced
- 20.9% cocaine-induced
- 20.2% cocaine-induced
- 19.9% sedative-induced
This phenomenon is especially high with regards to individuals that experience cannabis-induced schizophrenia. As many as 50% of these individuals converted to the sustained mental health disorder following the event, according to data provided by The British Journal of Psychiatry. This study revealed that young male cannabis users were at highest risk for this outcome.
Withdrawal From Substances Can Also Cause Psychotic Symptoms
Substance-induced schizophrenia also appears when people attempt to detox from a drug or alcohol. Psychotic symptoms, such as auditory, visual, and tactile hallucinations, delusions, and paranoid thinking are not uncommon during the withdrawal phase of detox. Indeed, drugs that list psychotic symptoms as part of the possible withdrawal effects include cocaine, benzodiazepines, opiates, and methamphetamine.
However, among the most serious psychotic withdrawal responses occurs in individuals experiencing the delirium tremens (DTs) during alcohol detox. The DTs affects about 5% of individuals going through alcohol detox, especially among those with a long history of alcohol abuse. Other factors that could put someone at risk of developing the DTs include age and a history of alcohol detoxes.
The DTs is a medical emergency, with the symptoms suddenly and unpredictably emerging on days 3-4 during alcohol detox. Symptoms of the DTs include:
- Severe confusion
- Rapid heart rate
- High blood pressure
- Intense shaking or trembling
- Excessive sweating
- Sleep disturbances
- Loss of consciousness
An emergency response team will treat the individual, stabilizing the patient until he or she can be hospitalized. Treatment may include IV hydration and electrolytes, antipsychotic medications and other measures to improve the chances for survival. Approximately 1-4% of individuals who experience the DTs will have a fatal outcome.
Drug-Induced Schizophrenia is a Mental Health Emergency
Whenever someone experiences a break from reality, whether they have the mental illness schizophrenia or they are going through drug-induced schizophrenia, it is considered a psychiatric emergency. The most important thing to do for the individual is to protect them from harming themselves. Many individuals experiencing substance-related schizophrenia attempt suicide.
Individuals experiencing this kind of mental breakdown should be transported immediately to an acute care facility or a residential mental health treatment center. In this type of environment they will receive the one-on-one care and support needed to work through the psychotic event and become stabilized.
Detox and Withdrawal
When the psychotic event is directly related to a substance, such as a hallucinogenic substance or other illicit drugs, they will begin treatment with the first phase of recovery, detox and withdrawal. This should only be undertaken in a supervised detox facility where professional, medically trained detox experts can safely guide the individual through the detox timeline. In some cases, a tapering schedule will be appropriate, as this helps to minimize the severity of withdrawal symptoms.
Each substance of abuse has its own set of withdrawal symptoms, and the intensity of those symptoms will have a lot to do with how long the individual has been engaged in the substance abuse. The type of drug, or alcohol, the person’s age, how much of the substance is consumed regularly, and co-occurring mental health issues are all factors that influence the severity of the withdrawal symptoms.
During detox and withdrawal, as the symptoms emerge a few hours after the last dose, the individual will be closely monitored for adverse withdrawal symptoms that could pose a health risk. In addition to the medications used to help subdue the symptoms, psychiatric support is also provided. This mental health support is needed should any unpredictable outbursts occur, as is common with psychotic events.
Treatment For Drug-Induced Schizophrenia
Completing the detox portion of the recovery process is a cause for celebration. This means that the individual has conquered the difficulty of detox and has begun to stabilize both physically and mentally. Arriving at this place of stability is critical for approaching the next phase of treatment, which requires active participation in a medley of therapeutic activities. The thrust of these treatment elements is to make fundamental shifts to disordered thought patterns and behaviors that have kept the person trapped in the addiction cycle. To overcome the core addiction that led to the substance-induced schizophrenia the following treatment elements include:
- Psychotherapy. Integral to addiction treatment are the private sessions with a psychiatrist or licensed clinical therapist. Using a variety of evidence-based behavioral therapies helps guide the individual toward adopting more positive responses to triggers, and to be able to recognize dysfunctional thought patterns that had led to the substance abuse.
- Group therapy. Groups participate in conversations about struggling with addiction and provide encouragement and support to each other under the guidance of a licensed clinician.
- Dual diagnosis treatment. Psychiatric support is provided alongside addiction treatment when substance addiction led to psychosis or even a lasting diagnosis of schizophrenia. This likely includes medications that will provide additional stability in recovery.
- Psychoeducation. Classes teach coping skills, emotion regulation, stress reduction, and organization skills that assist someone recovering from a psychotic episode due to drug addiction.
- Recovery meetings. Many rehabs integrate a 12-step or a 12-step alternative into the rehabilitation plan, which often involves attending recovery meetings. Discussions often include relapse prevention and ways to achieve a lasting sober lifestyle.
- Holistic. Teaching individuals to work through stress and emotional issues is intrinsic to reaching a sustained recovery. Holistic activities can be useful in promoting relaxation and reducing stress. These might include yoga, mindfulness meditation, journaling, acupuncture, equine therapy, and art therapy.
- Aftercare. After rehab is completed, the individual engages in aftercare strategies, including outpatient therapy, life skills classes, and ongoing recovery meetings. In some cases, transitional housing is also supportive during early recovery.
Drug-induced schizophrenia is a serious condition, but with a commitment to recovery and an evidence-based treatment approach it is entirely possible to turn your life around.
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