Treating Substance-Induced Psychosis and Psychotic Disorders
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Updated On : August 1, 2024
Welcome to Engage Wellness Acton’s page on Dual Diagnosis Psychotic Disorders.
A dual diagnosis is a group of diagnoses typically including addiction or substance use disorder and a co-occurring mental health condition. Since one often feeds on the other, individuals with a dual diagnosis of addiction and a psychiatric disorder may need ongoing support in the form of rehab to overcome both conditions.
With the right approach to treatment, individuals with dual diagnoses can successfully recover and go on to live healthy and happy lives.
On this page, you will learn what a dual diagnosis is, why psychotic disorders are often accompanied by addiction, and various approaches to psychotic disorders and addiction treatment.
Psychiatric disorders, also known as mental health conditions, range in severity, some being mild and only needing therapy to overcome and others being more severe, requiring medication and hospitalization for treatment. While a psychiatric disorder does not cause addiction directly, it can make developing one more likely.
Common reasons that psychiatric disorders lead to addiction include:
Addiction is the most severe form of a substance use disorder.[1] It causes problems with impulse control and changes that lead to drug or alcohol cravings despite their negative effects. Over time, these changes may cause permanent brain damage and lead to episodes of drug-induced psychosis.
According to research published by the National Institute on Drug Abuse, data shows high rates of comorbid substance use disorders and psychiatric disorders, such as:[2]
Depending on the psychotic disorder, the signs and symptoms of a dual diagnosis will differ. Additionally, symptoms differ from person to person. However, the most common signs and symptoms of a dual diagnosis include the following:
Additional signs of addiction include:
Diagnosing an addiction with a co-occurring psychotic disorder is difficult because they often have overlapping symptoms. For this reason, a licensed mental health professional must use comprehensive assessment tools to diagnose both conditions.
To gather information and help with diagnosis, the therapist may ask about the following:
Note on polysubstance use: Polysubstance use occurs when someone uses more than one substance at a time.[3] This can happen accidentally or intentionally. The National Institute on Drug Abuse states that polysubstance use is common amongst individuals with comorbid substance use disorders.[4] This can further complicate diagnosis.
The first step in a psychotic disorder and addiction treatment program is detoxification. A mental health treatment like behavioral therapy or a combination of therapies and medication-assisted treatment follows this. Some clients may also attend aftercare programs to support their recovery needs.
Detoxification is the first step in a dual diagnosis treatment program. It involves abstaining from drugs or alcohol or withdrawing from the substance. During this process, the person will discontinue using or drinking for a specified period. Depending on the substance, this may take several days to a few weeks.
Some people detox at home, but individuals with certain addictions will need supervision. Engage Wellness works with detox centers where medically trained staff provide supervision to ensure safe and comfortable withdrawal from substances. They continuously monitor the individual’s health and administer medication as needed to prevent serious withdrawal symptoms. Following detox, individuals continue their care at Engage Wellness Acton.
Depending on the severity of the addiction, individuals with dual diagnosis may require a medical workup that includes the following tests:
According to the National Institute of Health, withdrawal symptoms are part of withdrawal syndrome. Withdrawal syndrome occurs when a substance is overused and is removed rapidly.[5]
This causes the following effects:
Alcohol, barbiturate, and benzodiazepine withdrawal:
Opiate withdrawal:
Cocaine and amphetamine withdrawal:
After going through detoxification, most individuals with dual diagnosis will enter an inpatient treatment program. The length of time they must stay in an inpatient program depends on the severity of their addiction or mental health condition. However, the average stay in inpatient treatment ranges from 30 days to six months.
During inpatient treatment, clients receive behavioral therapy and may be able to sign up for other forms of treatment, such as nature, adventure, or experiential therapy. They will also attend group workshops or group therapy sessions.
Depending on the nature of the dual diagnosis, some individuals will receive medication-assisted treatment while in rehab.
Outpatient treatment is an alternative to inpatient care for individuals with outside obligations and a less severe form of dual diagnosis. Clients in an outpatient program can continue residing at home and visit the rehab to receive therapy, peer support, and other services to reach their treatment goals. After leaving therapy, some clients sign up for outpatient treatment to help them prevent relapses.
Behavioral therapists focus on helping individuals change self-destructive or unhelpful behaviors. They assist in coping with troubling symptoms related to mental health, psychosis, or drug addiction and teach strategies and skills to overcome these symptoms.
The type of behavioral therapy someone will receive in rehab depends on their mental health treatment goals but may include any of the following:
Medication-assisted treatment involves the use of prescribed medications to reduce the severity of withdrawal symptoms or treat underlying or comorbid conditions such as psychosis.
Most individuals with addiction will need medication-assisted treatment to help them through the withdrawal process during detox. These medications may include pain relievers, glucose, selective serotonin reuptake inhibitors (SSRIs), and/or the following:
According to the Substance Abuse and Mental Health Services Administration (SAMHSA), these medications can contribute to lowering a person’s risk of contracting HIV or hepatitis by reducing their potential for relapse.[6]
Overall, the goal of medication-assisted treatment is to help individuals fully recover from addiction.
Peer support groups are often attended as part of an aftercare program; however, some attend them during their stay in rehab. In a peer support group, members help each other by sharing their experiences with addiction and mental health. They provide tools like coping strategies and tips for preventing relapse to support each other in achieving their recovery goals.
Examples of peer support groups are:
The benefits of dual diagnosis treatment include:
The dual diagnosis program at Engage Wellness provides a safe and supportive environment where clients receive 24/7 care, daily therapy, and medication support to help them overcome addiction and mental health conditions such as psychosis. We understand the difficulties individuals with dual diagnoses face and are here to help them reclaim their lives and reach a lasting state of sobriety.
If you’re ready to take the first step, we’re here to help you. Contact us to learn more.
Substance use can trigger psychotic episodes or worsen existing psychotic disorders. Drug-induced psychosis occurs when substances disrupt brain chemistry, potentially leading to hallucinations, delusions, and other psychotic symptoms. Common triggers include stimulants, cannabis, hallucinogens, and alcohol.
Medical professionals evaluate symptom patterns, timing, and family history. Drug-induced psychosis typically resolves within days or weeks after stopping substance use, while schizophrenia persists. A thorough assessment includes substance screening, psychiatric evaluation, and a review of medical history.
Methamphetamine, cannabis, LSD, PCP, and amphetamines frequently trigger psychotic episodes. Even prescription medications like benzodiazepines and opioids can cause psychotic symptoms in some people. The risk increases with higher doses and prolonged use.
Treatment combines antipsychotic medications with addiction recovery support. The approach includes medical detox, psychiatric care, and therapy. Treatment options range from inpatient programs to outpatient services, depending on symptom severity.
While drug-induced psychosis often resolves with abstinence, repeated episodes may increase the risk of developing chronic psychotic disorders. Some people, especially those with risk factors like family history, may experience lasting effects.
[1] National Institute of Mental Health. (2024, March). Substance use and co-occurring mental disorders. National Institute of Mental Health. https://www.nimh.nih.gov/health/topics/substance-use-and-mental-health on February 19, 2025
[2] National Institute on Drug Abuse. (2020). The connection between substance use disorders and mental illness. National Institute on Drug Abuse. https://nida.nih.gov/publications/research-reports/common-comorbidities-substance-use-disorders/part-1-connection-between-substance-use-disorders-mental-illness on February 19, 2025
[3] CDC. (2024, April 30). Polysubstance Use Facts. Stop Overdose. https://www.cdc.gov/stop-overdose/caring/polysubstance-use.html on February 19, 2025
[4] Ellis, J. D., Rabinowitz, J. A., Ware, O. D., Wells, J., Dunn, K., & Huhn, A. (2023). Patterns of polysubstance use and clinical comorbidity among persons seeking substance use treatment: An observational study. Journal of Substance Use and Addiction Treatment, 208932. https://pmc.ncbi.nlm.nih.gov/articles/PMC10035066/ on February 19, 2025
[5] Gupta, M., Gokarakonda, S. B., & Attia, F. N. (2020). Withdrawal Syndromes. PubMed; StatPearls Publishing. https://www.ncbi.nlm.nih.gov/books/NBK459239/ on February 19, 2025
[6] Substance Abuse and Mental Health Services Administration. (2024). Medications for Substance Use Disorders. Www.samhsa.gov. https://www.samhsa.gov/medications-substance-use-disorders on February 19, 2025