Prescribed medications and recreational substances come with side effects, but what happens when they start to disrupt your perception of reality?

Psychosis is a lapse in your brain’s ability to distinguish what’s real.

Sometimes when you take a substance, you know you’re going to depart from reality for a brief time.

But not all drug-induced psychosis is deliberate or short term, and sometimes substance exposure can contribute to unintended mental health challenges, like schizophrenia.

Schizophrenia is a chronic mental health disorder that presents psychotic features, including:

  • hallucinations
  • delusions
  • disorganized speech

Drug-induced schizophrenia emerges after exposure to a substance. It often begins with drug-induced psychosis.

According to the Diagnostic and Statistical Manual of Mental Disorders, 5thedition (DSM-5), drug-induced schizophrenia may be diagnosed when symptoms of drug-induced psychosis:

  • persist past 1 month of exposure to the substance in question
  • continue for a significant amount of time after acute withdrawal or intoxication
  • were present in some form prior to substance exposure

Drug-induced psychosis and drug-induced schizophrenia aren’t the same.

The DSM-5 indicates drug-induced psychosis is the presence of delusions or hallucinations soon after substance intoxication or withdrawal.

Schizophrenia is a lifelong mental health condition that can sometimes manifest after an episode of drug-induced psychosis.

You can experience drug-induced psychosis without the development of schizophrenia, even though both conditions present similar symptoms.

The main difference between the two, according to research, is that drug-induced psychosis is acquired, while drug-induced schizophrenia can be linked to heredity and other complex factors.

A growing body of research suggests that substance use doesn’t create mental health conditions such as schizophrenia — underlying causes are likely present.

In a 2015 study, for example, no link was found between psychedelic use and the development of mental health conditions, despite the common belief that drugs like LSD could cause mental health conditions.

But if you’re living with other factors that increase your chances of schizophrenia, drug-induced psychosis might be what tips the scales.

A 2020 review found that approximately 25% of people who experienced drug-induced psychosis eventually received a schizophrenia diagnosis.

Drug-induced schizophrenia is schizophrenia, just schizophrenia in which symptoms have emerged or worsened due to substance exposure.

Schizophrenia symptoms may include:

  • hallucinations
  • delusions
  • disorganized speech
  • disorganized or catatonic behavior
  • negative symptoms (a loss of function or ability, such as a diminished experience of joy)

For a clinical diagnosis, at least two symptoms must be present. Of those, one must be hallucinations, delusions, or disorganized speech.

Symptoms of drug-induced psychotic disorder

Drug-induced psychosis can evolve into a drug-induced psychotic disorder.

This might occur if symptoms of psychosis persist beyond a drug’s expected state of delirium or impair essential areas of functioning.

For a diagnosis, symptoms of drug-induced psychotic disorder need to include only hallucinations or delusions.

Symptoms are directly related to substance use or withdrawal.

Drug-induced psychotic disorder can last weeks and might continue as long as there is substance exposure.

This condition isn’t caused by an underlying mental health condition. While they may require medical attention, symptoms tend to resolve after withdrawal or at the end of intoxication.

What is withdrawal and intoxication?

Withdrawal is the process your body goes through when it’s deprived of a substance it’s accustomed to. It often creates cravings and feelings of illness.

Intoxication, on the other hand, is when a substance gains enough influence in the body to change central nervous system function.

These changes are often seen in:

  • perception
  • motor skills
  • mood
  • decision making
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While substance use may not cause schizophrenia directly, some may kick-start symptoms of underlying schizophrenia through drug-induced psychosis.

Substances that have been linked to drug-induced psychosis through intoxication include:

  • cannabis
  • alcohol
  • hallucinogens
  • inhalants
  • sedatives
  • hypnotics
  • anxiolytics
  • stimulants (including cocaine)

Substances that have been linked to psychosis through withdrawal include:

  • alcohol
  • sedatives
  • hypnotics
  • anxiolytics

Other medications that may cause symptoms of psychosis, particularly with abuse, include:

Toxins that may cause symptoms of psychosis include:

  • organophosphate insecticides
  • nerve gases
  • carbon monoxide
  • carbon dioxide
  • anticholinesterase
  • volatile substances (fuels, paints, and adhesives)

The effect a substance has on you can be unique.

You may experience symptoms of psychosis with substances not on these lists, especially if they aren’t taken as intended.

Drug-induced psychosis may require immediate medical attention, especially if there’s a chance of drug overdose or behaviors that compromise safety.

Supervised care can help ensure you and those around you remain safe and help relieve withdrawal symptoms or overdose you might be experiencing.

If drug-induced psychosis has contributed to a diagnosis of schizophrenia, treatment can help you manage long-term symptoms.

You might benefit from a combination of antipsychotic medications and psychotherapy, including psychosocial supports, to help with stress management, interpersonal skills, and self-sufficiency.

While symptoms of drug-induced psychosis can resolve completely, drug-induced schizophrenia can be a lifelong condition.

Drug-induced schizophrenia is schizophrenia that emerges due to exposure to a substance.

You may notice symptoms begin with drug-induced psychosis, but these two conditions aren’t the same.

Drug-induced schizophrenia is a lifelong condition with symptoms that can persist before and after substance exposure.

Not everyone who experiences drug-induced psychosis will go on to develop schizophrenia.

If you’re experiencing symptoms of schizophrenia after drug-induced psychosis, a mental health professional can help you discover which treatment options are right for you.