Diagnosis and Associated Issues Substance use and psychosis
The use of street drugs or the excessive use of alcohol can be harmful to the physical and mental health of anyone; however, the risks associated with drug use are even greater for people who have experienced psychosis.
Some stimulating drugs, like amphetamines, can cause psychosis, while other drugs, including marijuana, can trigger the onset of psychosis in someone who is already at increased risk for developing psychosis.
It is also believed that some drugs such as amphetamines and cocaine can cause a condition known as a drug-induced psychosis. This psychosis can last up to a few days, and is often characterized by hallucinations, delusions, memory loss and confusion. This usually results from prolonged or heavy street-drug use; and it responds well to treatment.
Impact of drug use after psychosis has begun
The risks associated with drug use for a person with psychosis include:
- an increased risk of relapse
- the development of more secondary problems (including depression, anxiety or memory problems)
- slower recovery and more persistent psychotic symptoms.
DrugCocktails.ca is a great resource to find the facts of mixing medicines like antipsychotic drugs with alcohol and street drugs.
Certain drugs, and alcohol, may interact with antipsychotic medications. A doctor or pharmacist can advise about this.
Being honest about drug and alcohol use is essential for recovery from psychosis, even if there is no immediate desire to change usage. Drug use can have negative interactions with treatment, therefore, those on the treatment team need to know the details of the drug use so that they can provide the safest and most effective treatment recommendations.
Crystal methamphetamine ("crystal meth", "jib", "ice", "chalk", "fire") is a street drug that has increased significantly in popularity throughout British Columbia over the past several years, especially in youth and young adults. It is cheap and easy to find, as it can be made in simple home laboratories (although often what is sold on the streets as crystal meth is not pure methamphetamine but a mix of drugs).
"Crystal meth" is a potent stimulant. It creates a tremendous rush, or powerful feeling, and increases energy and activity. There is also an increased sexual drive, which can result in prolonged sex and an increased chance of engaging in higher risk sexual activities. "Crystal meth" can be smoked, ingested, snorted, or injected. It can also have other effects like agitation, paranoia, confusion and violence. Grinding of teeth and obsessive picking at one's body are physical signs of use. These acute effects can last anywhere from 8 to 24 hours. Withdrawal effects include anxiety and depression, and feeling "sketchy".
The more a person uses 'crystal meth', the more they crave it, making it very difficult to quit. Continued use can result in rapid weight loss and malnourishment. Although longer term research needs to be done to verify the effects of "crystal meth", it is currently believed that long term heavy use can impair the brain's ability to process information and may create structural changes to the brain.
It is estimated that 10-20% of "crystal meth" abusers develop psychosis.
Typical symptoms include paranoia and auditory hallucinations, which cannot be distinguished from other psychotic disorders such as schizophrenia or bipolar disorder.
The onset of psychosis often occurs gradually with continued use but can sometimes occur suddenly even with very little use. Using 'crystal meth' can trigger the psychosis, but that doesn't necessarily mean that the psychosis will end when the drug use stops. The use of crystal meth in someone who already has a psychotic disorder can make treatment less effective.
Resources for cutting down or quitting are available at mindcheck.ca