Misuse of drugs and alcohol can cause mental states that resemble mental illness. When a person has used drugs, it can be hard to tell where the drugs’ effects stop and the person’s own mind begins. When a person exhibits signs of mental illness because of substance use, that person may have a substance-induced disorder (SID).
Intoxication is first stage of substance-induced disorder. For example, using methamphetamine might make a person feel anxious or cause violent or hyperactive behaviors. Once the drug begins to wear off, the person might experience a hangover or crash. Further symptoms can appear when a person enters withdrawal from a substance. For example, a person might hallucinate while withdrawing from prolonged alcohol use.
“Bedridden, un-showered, unshaven and in a week’s worth of pooled sweat,” Don M. awoke from a “week-long storm of hallucinations. I had no idea if it was day or night, but it didn’t matter anymore. It would either kill me, or change my life forever.”
“An addict must experience both. The want to let drugs and alcohol kill your ‘self” and the want to have a changed life are inseparable desires for an addict. Now, clean, sober and two years later, much healing has taken place between myself and my children and family. Much is still left to accomplish.”
Most SID symptoms dissipate within hours, days, or weeks after the last substance use. However, there are times that the effects of the drug can be permanent. A chronic alcoholic might develop Korsakoff’s syndrome, a form of memory loss linked to the brain damage caused by alcoholism.1 Someone who uses psychedelics might develop hallucinogen persisting perceptual disorder (HPPD), characterized by continuing hallucinations or flashbacks long after the drug has cleared their system.2 The type of permanent effects will depend on which drugs are used and for how long.
Substance-induced disorders should not be confused with co-occurring disorders, which are mental illnesses that occur alongside substance use disorder. According to the National Alliance on Mental Illness (NAMI), one-third of people who abuse alcohol and one-half of people who abuse drugs also live with some form of mental illness. Although substance abuse can make mental disorders worse, these disorders would exist even without the substance use.
Types of Substance-Induced Disorders
According to the Diagnostic and Statistical Manual of Mental Disorders, there are various substance-induced disorders.
- Substance-induced delirium is characterized by a reduced level of consciousness, loss of clarity, and disorientation.
- Substance-induced persisting dementia can cause memory problems as well as personality changes, such as a continuing loss of inhibition.
- Substance-induced persisting amnestic disorder is the significant loss of memory, both the ability to form new memories and to recall existing memories. It persists beyond the memory problems seen in delirium and dementia.
- Substance-induced psychotic disorder, also known as toxic psychosis, is characterized by disorientation, delusions and hallucinations.
- Substance-induced mood disorder can include feelings of depression, with symptoms like loss of pleasure or interest in activities (anhedonia). It also includes euphoria, heightened mood and irritability.
- Substance-induced anxiety disorder causes high levels of anxiety. These might present as general anxiety, panic attacks, phobia or obsessive-compulsive symptoms.
- Substance-induced sexual dysfunction is a loss of sexual function that causes distress or interpersonal problems.
- Substance-induced sleep disorder occurs when sleep is prominently disturbed, resulting in insomnia and fatigue.
- Hallucinogen persisting perceptual disorder (HPPD) is characterized by hallucinations, usually visual, and other sensory distortions.
Effects of Substance Use: Short-Term and Long-Term
The particular combination of conditions a person experiences will depend on what type of drugs the person has used, in what dosages, and for how long. Heavy or chronic users of drugs are at higher risk for developing a substance-induced disorder. Consider the following two examples:
- Alcohol can cause intoxication and withdrawal symptoms, both of which can result in delirium. Alcohol intoxication can cause hypomanic symptoms like euphoria, emotional outbursts, lowered impulse control, and boosted social confidence, as well as impaired sexual function. At higher doses, dizziness, loss of balance, nausea, and amnesia (blackouts) are common. Excessive alcohol use can result in fatigue, nausea, low mood, difficulty sleeping, and flu-like symptoms. Alcohol withdrawal can cause anxiety, tremors, jumpiness, rapid heartbeat, high blood pressure, sweating, insomnia, and nausea. Severe alcohol withdrawal can even include hallucinations and seizures.
- Stimulant Drugs, such as amphetamines and cocaine, create temporary,sharp spikes in dopamine in the brain. Intoxication may temporarily boost mood and energy, but the crash after the high causes fatigue, depression and cravings. Regular, high-dose use of cocaine or amphetamines will cause short-term problems with concentration and memory. These drugs can also cause psychosis-like symptoms such as delusions and paranoia, which may mimic schizophrenic psychosis.When someone stops using stimulants, they may experience anxiety or depression that can last for weeks. Long-term, heavy amphetamine use can have a permanent effect on the user’s memory, concentration, and susceptibility to psychotic symptoms.4
Treatment of Substance-Induced Disorders
Detoxification and abstinence from substance use are the best ways to treat a substance-induced disorder, as many SIDs go away once the substance has fully cleared the person’s system. In some cases, medical intervention can help treat these symptoms and ease withdrawal. In other cases, these symptoms persist and may require longer treatment.
If you have a substance-induced disorder, we can help you stabilize and start on path to recovery. At Black Bear Lodge, our therapists excel in treating the disorders that co-occur with substance abuse. Detoxify in safety and comfort in our professional facilities with the assistance of consulting physicians. Individual and group therapy can help you build successful strategies for a better tomorrow. Call us today to learn how we can help.
1 U.S. Alzheimer’s Association. Korsakoff Syndrome. 2017. Accessed 16 Oct 2017.
2 Hermle, Leo, et al. Hallucinogen-Persisting Perception Disorder. Therapeutic Advances in Psychopharmacology. 2012. 199–205. Accessed 20 Oct. 2017.
3 National Alliance on Mental Illness. Dual Diagnosis. August 2017. Web. Accessed 16 Oct 2017.
4 Center for Substance Abuse Treatment. Substance Abuse Treatment for Persons with Co-Occurring Disorders. Rockville (MD). Substance Abuse and Mental Health Services Administration. 2005. Treatment Improvement Protocol (TIP) Series, No. 42.Accessed 20 Oct. 2017.
5 Diagnostic and Statistical Manual of Mental Disorders: DSM-5. Arlington, VA. American Psychiatric Publishing, 2013. Accessed 20 Oct. 2017.