Drug-Induced Psychosis: Can You Get Permanent Psychosis From Drugs?

Psychosis, a state of detachment from reality, is often associated with mental illnesses like schizophrenia and bipolar disorder. However, it can also have other causes, including substance use. Mind-altering substances like marijuana and methamphetamine may lead to psychotic symptoms in some people. Sometimes, these symptoms may continue after the effects of the drugs have worn off, but drug-induced psychosis usually isn’t permanent. However, substance use may trigger the development of a psychotic disorder like schizophrenia in some individuals. Both drug-induced psychosis and psychotic disorders can usually be treated with medication and therapy.

Understanding psychosis

Psychosis is a mental state generally involving a break from reality. A period of psychosis is sometimes referred to as a “psychotic episode.” During a psychotic episode, a person might experience changes in their thoughts, behaviors, and perceptions. This can be distressing for both the person and their loved ones. 

Common symptoms of psychosis

Psychosis may not look the same for everyone. Some of the common signs and symptoms of psychosis include the following:

• Hallucinations: People having hallucinations might see, hear, smell, taste, or feel things that aren’t there. These experiences may seem real, even though they aren’t actually happening.
• Delusions: People experiencing delusions may develop strongly held false beliefs. For example, someone with psychosis might become convinced that they can fly, that the government is spying on them, or that people are trying to hurt them.
• Changes in thoughts and speech: Psychosis can make people’s thoughts nonsensical, hazy, or jumbled. This may come across in the way they speak. For example, someone experiencing psychosis might go off on tangents, make up new words, or say things that don’t make sense to others. 
• Changes in mood and behavior: Psychosis may also affect the ways people feel and act. Someone experiencing psychosis might withdraw from friends and family members, act unpredictably, or stop doing things they used to enjoy. They might also lose the motivation to go to work or take care of themselves. 

Psychosis is often, though not always, caused by mental illness. Some common examples can include bipolar disorder, schizophrenia, and depression with psychotic features. 

Other risk factors for psychosis

Other risk factors for psychosis may include the following:

• Dementia
• Head trauma
• Epilepsy
• Stroke
• Certain medications
• HIV and other illnesses

Some people may only experience a single episode of psychosis. Others, such as people with schizophrenia, may have multiple episodes throughout their lifetime. 

What is drug-induced psychosis?

Psychosis isn’t always due to an underlying mental health condition. It can have a range of possible causes, including the use of mind-altering substances. Certain drugs have been found to cause psychotic symptoms in some people, such as:

• Marijuana
• Hallucinogens (such as LSD, ecstasy, or PCP)
• Stimulants (such as cocaine or meth)
• Opiates (such as heroin)
• Alcohol

Duration of drug-induced psychosis

Substances like these can affect the way the brain works in the short and long term, which may trigger psychosis. When a psychotic episode occurs due to substance use, this is sometimes called “drug-induced psychosis” or substance-induced psychotic disorder.

For some people, these psychotic symptoms only last as long as the drugs are in their system. Others may continue to experience symptoms after the drugs have worn off. According to some reports, people may also develop psychosis due to substance withdrawal. 

It might be worth noting that some drugs, like LSD, can be expected to cause characteristic symptoms of psychosis, like hallucinations, due to the ways they impact brain function. In these cases, a doctor might wait to diagnose substance-induced psychosis until after the drug has worn off to see if the effects remain. 

How drug-induced psychosis differs from other psychotic disorders

Drug-induced psychosis and other psychotic disorders can involve similar symptoms, as in both cases, someone may experience hallucinations, delusions, and changes in behavior. However, drug-induced psychosis remains distinct from other psychotic disorders. While primary psychotic disorders, such as schizophrenia, involve persistent or chronic psychosis symptoms as a core feature, psychotic disorders induced by substances involve psychosis symptoms that result from the use of certain substances, with the symptoms arising during or soon after substance intoxication or withdrawal.

Can drugs cause permanent psychosis?

Drug-induced psychosis often resolves after a person has been sober for a while, although this process can take time. Some people may continue to experience psychotic symptoms even after the drug has left their system. But can drug-induced psychosis be permanent?

Factors contributing to long-term psychosis from drugs

The answer can depend on a few factors, such as the type of drug. Some substances, like methamphetamine, may cause longer-lasting symptoms in some cases.

This doesn’t necessarily mean that drug-induced psychosis is permanent. Sometimes, drug-induced psychosis may act as a trigger for the development of longer-term psychotic disorders, like schizophrenia. In this case, it’s not that the drug-induced psychosis itself is permanent, but that it activates chronic mental illness in people who are vulnerable. 

What the research says

There’s still a lot we don’t know about the connection between substance use and long-term psychosis. It’s possible that people who develop long-term psychosis due to drug use were already vulnerable to it, and the drugs were simply the trigger. People with underlying psychotic disorders may also be more likely to self-medicate with drugs in the first place. Future prospective studies may give us more insight into this relationship. 

Getting help for drug-induced psychosis

Drug-induced psychosis can be distressing. However, it can often be managed with medication, supervision, and relapse prevention strategies.

Diagnosis and evaluation

Receiving a proper diagnosis is often a key step in determining an appropriate treatment plan for psychosis, as the most effective approach may differ depending on whether a person is experiencing drug-induced psychosis or a psychosis from a primary psychotic disorder. 

Immediate treatment and stabilization

In the short term, treatment for drug-induced psychosis often involves addressing immediate intoxication and withdrawal, therapeutic intervention, and monitoring. In some cases, medications such as antipsychotics may be suggested for short-term use; it is important to consult with a healthcare provider to determine the most appropriate treatment plan for you. If you have concerns about drug-related psychosis or want to learn more about immediate treatment options, you may want to talk to your healthcare provider.

Long-term treatment and recovery support 

According to the Yale School of Medicine, approximately 25% of people who have a psychotic episode will never have another one. However, this may depend on having professional help, especially if the psychosis is drug-related. With ongoing support from a therapist, it may be possible to identify and address the underlying mental health factors that could be contributing to substance use. 

That said, long-term mental health support may not always be easily available or affordable for those who need it.

Online therapy as a treatment for substance use disorders

Platforms like BetterHelp offer online therapy starting at $70 per week, which may be a more affordable alternative to in-person therapy. Online therapy can also offer availability and convenience by allowing users to schedule sessions outside of typical office hours and attend them via video conference, phone call, or online chat.

Studies have found that online therapy may be an effective treatment for substance use disorders. In a 2023 review, researchers analyzed details from 373 studies of internet-based therapy for substance use. They found that patients treated through online therapy normally saw similar results as patients treated through in-person therapy. Please note that individuals experiencing acute psychosis may require in-person treatment to address psychotic symptoms.