How to Safely Treat Drug-Induced Psychosis

A drug-induced psychosis is a psychotic state that can be triggered by drug use or withdrawal from drug or alcohol abuse. A substance like LSD or PCP can induce psychotic symptoms for a short time, while drugs like marijuana or opioids may trigger psychotic symptoms from long-term abuse. Alcohol withdrawal that becomes delirium tremens can lead to psychotic symptoms. Drugs like synthetic marijuana or cocaine may induce psychosis or related mental illnesses in people who have a predisposition to schizophrenia, bipolar disorder, or similar conditions.

Treatment of drug-induced psychosis can ease symptoms or allow them to stop completely. Entering a rehabilitation program specializing in the treatment of psychosis can determine whether the symptoms are temporary or long-term. If the psychosis stems from a long-term induced condition, a rehabilitation program can initiate treatment for the individual.

4 Steps to Treating Drug-Induced Psychosis

When a person enters a rehabilitation program, these are the basic steps taken to treat substance-induced psychosis.

Treatment Steps

  • Assessment
  • Detox
  • Medication
  • Psychotherapy

Step 1: AssessmentWhen a person enters a rehabilitation program or a hospital and presents with psychotic symptoms, they will receive an assessment from a medical professional and a psychotherapist. A doctor or physician will draw blood, if possible, or take other samples from the new patient to determine the source of the psychotic symptoms. If the person has traces of intoxicating drugs or alcohol in their system, the clinician will begin treatment assuming that the psychosis is induced, or worsened, by the chemicals.

A psychotherapist will determine the type of psychosis, which informs treatment with medication and therapy, and may begin to determine whether the person is experiencing short-term or long-term psychosis.

Step 2: DetoxEasing symptoms means ceasing drug or alcohol consumption. This means that the person must undergo medically monitored detox. This process occurs in hospital or rehabilitation programs, often simultaneously with medication treatment. Some of the medications, like benzodiazepines, work as both mood stabilizers and detox medications.

Detox is also a very important step because many psychiatric medications interact poorly with illicit drugs or alcohol. People with schizophrenia, bipolar disorder, or other mental health conditions that increase the likelihood of psychosis may already take medication to treat their condition; however, mixing recreational and prescription medication can lead to worsening symptoms or prevent the prescription drugs from working.

Step 3: MedicationAntipsychotic medications can reduce the impact of psychotic symptoms, like hallucinations, delusions, and disordered thinking. These medications can be prescribed for temporary use, or they may be taken long-term to ease psychosis.
Antipsychotics used to treat psychotic symptoms include:

  • Thorazine
  • Fluphenazine
  • Haloperidol
  • Loxapine
  • Thioridazine

A person may receive treatment with atypical antipsychotics if the usual types of antipsychotics do not work or they are not appropriate treatment for the presentation of psychotic symptoms. Some atypical antipsychotic medications include:

  • Abilify
  • Clozaril
  • Risperdal
  • Seroquel

There are other varieties of atypical antipsychotics that may be prescribed, and recent medical studies are finding that people with drug-induced psychosis may fare better on these medications than on other types. However, this depends on whether the person has a predisposition to a psychotic disorder like schizophrenia or if their symptoms are induced by substance abuse only.

Step 4: Psychotherapy. This is the most important component of drug rehabilitation and also a very important component in the treatment of any mental health condition. For those with long-term psychosis, Cognitive Behavioral Therapy (CBT) helps clients notice early warning signs of psychotic symptoms, so they can seek appropriate, unscheduled treatment. CBT also helps to manage mood symptoms like anxiety or depression, which otherwise may lead to self-medication with illicit substances.

For those undergoing treatment in a substance abuse rehabilitation program, psychotherapy helps to develop coping skills to avoid substance abuse and a plan of treatment for drug or alcohol relapse. If psychotic symptoms were induced by substance abuse and subsequently dissipate when use is stopped, medication and therapy around those conditions can end; however, treatment for substance abuse should continue. After the rehabilitation program is complete, support groups can provide continuous social support to maintain ongoing sobriety.