Substance-Induced Psychotic Disorder

Substance-Induced Psychotic Disorder: When Intoxication Imitates Insanity

What Is Substance-Induced Psychotic Disorder?

Substance-Induced Psychotic Disorder (SIPD) is a mental health condition in which an individual experiences hallucinations, delusions, or disorganized thinking directly as a result of using drugs, alcohol, or exposure to toxins. This psychosis is not due to an underlying mental illness like schizophrenia but is a direct physiological consequence of substance use, withdrawal, or intoxication.

The Diagnostic and Statistical Manual of Mental Disorders, Fifth Edition (DSM-5), recognizes SIPD as a distinct diagnosis. To meet the criteria, the psychotic symptoms must occur during or soon after substance use and must be severe enough to warrant clinical attention (American Psychiatric Association, 2013).

According to the National Institute on Drug Abuse (NIDA), certain substances such as methamphetamine, cocaine, cannabis, LSD, alcohol (especially during withdrawal), PCP, and even prescription medications can trigger psychosis (NIDA, 2022). The symptoms may resolve after the substance wears off, but in some cases, especially with repeated use or underlying vulnerabilities, they can persist or worsen.

Key Symptoms

• Hallucinations – Seeing, hearing, or feeling things that are not present.
  
  

• Delusions – Strong false beliefs, like being followed, poisoned, or having special powers.
  
  

• Disorganized thinking or speech – Jumping from one topic to another, incoherent talk.
  
  

• Paranoia – Believing others are plotting against or spying on you.
  
  

• Agitation and confusion – Especially during withdrawal phases.
  
  

These symptoms mimic those seen in primary psychotic disorders but differ in their direct connection to substance use.

What Causes It?

• Drug intoxication (e.g., from methamphetamine, LSD, cannabis, alcohol)
  
  

• Withdrawal from depressants like alcohol or benzodiazepines
  
  

• Toxic reactions to prescribed medications such as corticosteroids, anticholinergics, or stimulants
  
  

• Pre-existing vulnerabilities, such as genetic risk or prior mental health conditions, can make individuals more susceptible
  
  

Neuroscience research shows that substances such as amphetamines or hallucinogens can drastically alter the dopamine and serotonin systems in the brain, both of which are heavily implicated in psychotic symptoms (Murray et al., 2007; Volkow et al., 2014).

Societal and Environmental Triggers

• Widespread drug access in vulnerable communities
  
  

• Poverty and trauma increasing risk of self-medication
  
  

• Lack of mental health education, misdiagnosis as schizophrenia
  
  

• Stigma around both addiction and mental illness, making early help harder to access
  
  

According to the Substance Abuse and Mental Health Services Administration (SAMHSA), people who experience homelessness, incarceration, or early childhood trauma are disproportionately at risk for SIPD (SAMHSA, 2021).

Clinical Outcomes

While some individuals recover fully once the substance is eliminated from the body, others—particularly those with prolonged or repeated exposure—may develop long-term psychotic features or trigger underlying latent psychiatric disorders. Early diagnosis and cessation of the substance are critical to recovery.

HAQ’s Embrace

At the Home of Abrahamic Quiver, we understand that what may look like madness to one person is often the soul’s distress call. We do not view substance-induced psychosis as just a side effect of chemicals—it is a rupture in spiritual balance. While others treat symptoms, we listen for the silence behind them.

In many spiritual traditions, altered states of mind have been mistaken as demonic possession, divine punishment, or madness. At HAQ, we offer another way. We believe that even when the mind is unwell, the spirit can still reach for healing. We do not label, condemn, or abandon.

Through prayer, ritual cleansing, and sacred counsel, we help individuals restore what drugs and suffering tried to steal: clarity, purpose, and peace. Science may stop at symptoms, but we go further—into the soul’s dark night, guiding it back into light.

References

• American Psychiatric Association. (2013). Diagnostic and Statistical Manual of Mental Disorders (5th ed.). Arlington, VA: American Psychiatric Publishing.
  
  

• National Institute on Drug Abuse. (2022). Common Comorbidities with Substance Use Disorders. Retrieved from https://nida.nih.gov
  
  

• Murray, R. M., Morrison, P. D., Henquet, C., & Di Forti, M. (2007). Cannabis, the mind and society: the hash realities. Nature Reviews Neuroscience, 8(11), 885–895.
  
  

• Volkow, N. D., Koob, G. F., & McLellan, A. T. (2014). Neurobiologic advances from the brain disease model of addiction. New England Journal of Medicine, 374(4), 363–371.
  
  

• Substance Abuse and Mental Health Services Administration. (2021). Key Substance Use and Mental Health Indicators in the United States: Results from the 2020 National Survey on Drug Use and Health.
  
  

“I Couldn’t Tell What Was Real Anymore”
A fictional narrative from the mind of a 24-year-old man spiraling through substance-induced psychosis

It started with parties. Just a few hits here and there—weed, then pills, then the hard stuff when I wanted to keep the high going.

I never thought I’d end up like those people.

But one night, I smoked something I shouldn't have. The walls started to breathe. My friend's voice turned into a hiss. I saw my brother’s face melt into someone else's. I locked myself in the bathroom for hours, convinced someone was in the mirror waiting to pull me through.

After that, it didn’t stop. Even when I was sober.

The voices came back—telling me the cops were watching me, that my phone was bugged, that someone had put something in my food. My mom found me standing in the backyard barefoot, yelling at the sky at 3 AM. I hadn’t slept in days. I couldn’t even remember what was real.

I went to the ER once. They gave me antipsychotics, said it might be temporary. Said it was “Substance-Induced Psychosis.” But I didn’t understand what that meant. I thought I was being punished. Or maybe chosen. I couldn’t tell anymore.

I tried to get clean, but the paranoia made it impossible. I didn’t trust anyone. Not even myself.

HAQ’s Embrace

At HAQ, we know that psychosis brought on by substance use is more than a medical event—it is a spiritual unraveling. The soul, under the weight of trauma and escape, starts speaking in visions and delusions when it is no longer heard.

We do not isolate those who come to us with fragmented minds. We do not drug their symptoms into silence. Instead, we sit beside the brokenness. We read what the world calls madness as a signpost toward a deeper wound—and a deeper healing.

Through sacred purification, protective prayer, and constant spiritual presence, HAQ helps those afflicted find their way back—not just to sanity, but to wholeness. We believe the spirit is never lost. Only waiting to be seen.