Permanent Psychosis From Drugs: What To Know For Your Mental Health

Medically reviewed by Nikki Ciletti, M.Ed, LPC and Julie Dodson, MA, LCSW
Updated November 25, 2024by BetterHelp Editorial Team
Content warning: Please be advised, the below article might mention substance use-related topics that could be triggering to the reader. If you or someone you love is struggling with substance use, contact SAMHSA’s National Helpline at 1-800-662-HELP (4357). Support is available 24/7. Please see our Get Help Now page for more immediate resources.

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 meth 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.

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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. 

Psychosis may not look the same for everyone. 

Common symptoms of psychosis

  • 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 ways 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 may include the following:

Other risk factors for psychosis

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
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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.”

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. 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. 

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 permanent psychosis from drugs

The answer can depend on a few factors, such as the type of drug. Some substances, like amphetamines, may cause longer-lasting symptoms. According to a research report from 2015, people with psychosis caused by methamphetamine (meth) may continue experiencing symptoms after more than six months of sobriety

This doesn’t necessarily mean that drug psychosis is permanent. Sometimes, drug-induced psychosis acts 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

In a 2020 review, researchers analyzed details on over 34,000 people who experienced drug-induced psychosis. They found that approximately 25% of them went on to develop schizophrenia, which is usually considered a lifelong mental illness. Marijuana-induced psychosis tended to be the most likely to transition into schizophrenia, followed by psychosis from hallucinogens and amphetamines.

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 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. If you have concerns about drug-related psychosis, you may want to talk to your healthcare provider. 

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 drug use. 

Long-term mental health support

That said, long-term mental health support may not always be available. A 2023 report from Mental Health America found that for the majority of U.S. adults who couldn’t get necessary mental healthcare, cost was the reason

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Online therapy as a treatment for substance abuse disorders

Platforms like BetterHelp offer online therapy starting at $65 per week, which may be a more affordable alternative to in-person therapy. It 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.

Effectiveness of online therapy

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.

Takeaway

When you have a psychotic episode, you’ve generally become detached from reality to some degree. This may involve hallucinations, delusions, or other changes in your thoughts and behavior. While psychosis is often associated with mental illness, it can sometimes be caused by drug use. Psychosis from drugs often resolves after a period of sobriety, but certain substances, like meth, may cause longer-lasting symptoms. Some people may also transition from drug-induced psychosis to a longer-term psychotic disorder, like schizophrenia, but this relationship is still being studied. Psychosis, including drug-related psychosis, can often be managed with proper treatment and support. Those recovering from a psychotic episode or living with substance use disorder may benefit from working with a therapist in person or online.
Are you living with symptoms of psychosis?
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