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The use of street drugs or the excessive use of alcohol is harmful
to the physical and mental health of all people; however, the risks
associated with drug use are even greater for people who have experienced
psychosis.
Psychosis-inducing drugs
Psychosis can be induced by drugs or can be "drug assisted".
Some stimulating drugs, like amphetamines, can cause psychosis,
while other drugs, including marijuana, can trigger the onset of
psychosis in someone who is already at increased risk because they
have "vulnerability".
It is also believed that some drugs such as amphetamines and cocaine
can cause a condition known as a drug-induced psychosis. This psychosis
can last up to a few days, and is often characterized by hallucinations,
delusions, memory loss and confusion. This usually results from
prolonged or heavy street-drug use; and it responds well to treatment.
Impact
of drug use after psychosis has begun
 The risks associated with drug use for a person with psychosis
include an increased risk of relapse, the development of more secondary
problems (including depression, anxiety or memory problems), a slower
recovery and more persistent psychotic symptoms.
Certain drugs, and alcohol, may be harmful because they interact
dangerously with psychosis medications. Although alcohol in small
quantities is usually okay while taking most medications, there
are certain medications that must not be combined with alcohol.
A doctor can advise about this.
Being honest about drug and alcohol use is essential for recovery
from psychosis, even if there is no immediate desire to change usage.
Drug use can have negative interactions with treatment, therefore,
those on the treatment team need to know the details of the drug
use so that they can provide the safest and most effective treatment
recommendations.
Evaluating
if there's a substance use problem
The individual must come to the conclusion, him or herself, that
there is a substance use problem.
Questions such as the ones below may help the person evaluate their
drug use situation. It is best to do this exercise with a mental
health professional who can be there to increase objectivity and
base the answers on accurate information.
- What do you think are the immediate and long-term negative effects
of your drug use?
- How do these negative effects compare to the desired effects
you experience?
- Can you see any advantages to reducing your current drug use?
Crystal Meth
Crystal methamphetamine (“crystal meth”, “jib”, “ice”, “chalk”, “fire”)
is a street drug that has increased significantly in popularity throughout British
Columbia over the past several years, especially in youth and young adults. It
is cheap and easy to find, as it can be made in simple home laboratories (although
often what is sold on the streets as crystal meth is not pure methamphetamine
but a mix of drugs).
“Crystal meth” is a potent stimulant. It creates a tremendous
rush, or powerful feeling, and increases energy and activity. There
is also an increased sexual drive, which can result in prolonged sex and an increased
risk of HIV. “Crystal meth” can be smoked, ingested, snorted,
or injected. It can also have other effects like agitation, paranoia, confusion
and violence. Grinding of teeth and obsessive picking at one’s body
are physical signs of use. These acute effects can last anywhere from
8 to 24 hours. Withdrawal effects include anxiety and depression,
and feeling “sketchy”.
The more a person uses ‘crystal meth’, the more they crave it, making
it very difficult to quit. Continued use can result in rapid weight loss
and malnourishment. Longer-term use of “crystal meth” can have
a serious impact on the brain’s ability to process information, and can
even result in structural changes to the brain. It can also lead to the
development of a psychotic condition that is difficult to treat.
It is estimated that 10-20% of “crystal meth” abusers
develop psychosis. Typical symptoms include paranoia and auditory
hallucinations, which cannot be distinguished from other psychotic
disorders such as schizophrenia or bipolar disorder. The onset
of psychosis often occurs gradually with continued use but can
sometimes occur suddenly even in very little use. Using ‘crystal
meth’ can trigger the psychosis, but that doesn’t
necessarily mean that the psychosis will end when the drug use
stops. The psychosis may continue on even after quitting.
Hints
to reducing use or risk of harm
Reducing drug use is not simply a matter of willpower. Effectively
reducing drug use requires setting goals and solving problems.
It is the desired effects that give a person the urge to continue
use. Most people find that these urges are triggered by certain
feelings (such as stress, boredom, depression or anxiety) or situations
(such as being with friends who use regularly or being at a party
where it is encouraged). By recognizing and anticipating what feelings
or situations may trigger use, and by coming up in advance with
possible solutions for handling them, the person can increase the
chance of avoiding use at those times.
Another way to decrease drug use is to find activities that substitute
for some of the desired effects of the drug. For example, if one
of the desired effects is relieving boredom, the person could instead
try an enjoyable activity, such as exercise, seeing a movie or meeting
a friend for coffee. The key is to develop a plan to handle the
social pressures to use. Even working out a script on what to say
when offered drugs can be helpful. These "refusal skills"
become easier with practice.
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