Substance-induced psychosis (commonly known as Toxic psychosis) is a form of substance-related disorder where psychosis can be attributed to substance use. It is a psychosis that results from the poisonous effects of chemicals or drugs, including those produced by the body itself. Various psychoactive substances have been implicated in causing or worsening psychosis in users.
Psychosis manifests as disorientation and visual (and/or haptic) hallucinations. It is a state in which a person's mental capacity to recognize reality, communicate, and relate to others is impaired, thus interfering with the capacity to deal with life demands. While there are many types of psychosis, substance-induced psychosis can be pinpointed to specific chemicals.
Psychotic states may occur after using a variety of legal and illegal substances. Usually such states are temporary and not irreversible, with fluoroquinolone-induced psychosis being a notable exception. Drugs whose use, abuse, or withdrawal are implicated in psychosis include the following:
F10.5 alcohol: Alcohol is a common cause of psychotic disorders or episodes, which may occur through acute intoxication, chronic alcoholism, withdrawal, exacerbation of existing disorders, or acute idiosyncratic reactions. Research has shown that alcohol abuse causes an 8-fold increased risk of psychotic disorders in men and a 3 fold increased risk of psychotic disorders in women. While the vast majority of cases are acute and resolve fairly quickly upon treatment and/or abstinence, they can occasionally become chronic and persistent. Alcoholic psychosis is sometimes misdiagnosed as another mental illness such as schizophrenia.
F12.5 cannabinoid: Some studies indicate that cannabis, especially certain strains containing large proportions of THC and low proportions of CBD, may lower the threshold for psychosis, and thus help to trigger full-blown psychosis in some people. Recent studies have found an increase in risk for psychosis in cannabis users. It is not clear whether this is a causal link; it is possible that cannabis use only increases the risk of psychosis in people already predisposed to it.
The code F11.5 is reserved for opioid-induced psychosis, and F17.5 is reserved for tobacco-induced psychosis, but neither substance is traditionally associated with the induction of psychosis.
The code F15.5 also includes caffeine-induced psychosis, despite not being specifically listed in the DSM-IV. However, there is evidence that caffeine, in extreme acute doses or when severely abused for long periods of time, may induce psychosis.
JWH-018 and some other synthetic cannabinoids, or mixtures containing them (e.g. "Spice", "Kronic", "MNG" or "Mr. Nice Guy", "Relaxinol", etc.). Various "JWH-XXX" compounds in "Spice" or "Incense" have also been found and have been found to cause psychosis in some people.
Mephedrone and related amphetamine-like drugs sold as "bath salts" or "plant food".
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