Meth Psychosis: How is This Treated?

Methamphetamine is also commonly referred to as meth or crystal meth. It is a powerful and extremely addictive stimulant. This drug has many side effects, including high blood pressure, weight loss, chest pain, confusion, seizures, and meth psychosis.

So, what is psychosis?

Let us illustrate this with a case example.

Case Scenario of  Psychosis

Jack is a 23-year old male who uses meth recreationally.  This habit was introduced to him by friends at a party two months ago. His use was initially sporadic, but this habit grew rather quickly. Jack began to use daily, and then several times a day.

Subsequently, he developed side effects to meth use. One of such adverse issues was inadequate sleep. Eventually, Jack became psychotic. He started hearing and seeing things that were not real.  This condition started gradually. Initially, it was a phone ringing in his bathroom. Faint and quietly, but continuously. Over time, however, the ringing got louder. He also began to hear it everywhere in his house.

Jack also began to feel paranoid. He came to an irrational and illogical conclusion that someone put a bug in his house. “They are spying on me. The government wants to take me out.” He stopped watching TV as he felt the networks were working with the government. He locked his doors and windows. To avoid detection, he even put black bin bags over his windows.

No one could reach Jack as he also stopped using his phone. “The government is tracking me on my phone.” His mom raised the alarm after she was unable to reach Jack for a few days. Eventually, he was taken to a psychiatric hospital where he received treatment.

What is Psychosis?

Psychosis is a mental condition in which an individual’s thoughts and emotions become very impaired. Such individuals develop hallucinations and delusions.

Hallucinations cause people to see, hear, smell, taste, or feel things that don’t exist. This presentation is common in mental illness like schizophrenia, bipolar disorder, and can also occur in depression. The commonest experiences are usually of hearing voices and seeing things. They can be frightening, but also sometimes soothing.

Delusions are firmly held beliefs that conflict with reality. There are several different types. Paranoid delusions tend to be the most common in several mental illnesses.

As a result of such impairment, contact is lost with external reality. Such a situation can be very disabling. Impairments can occur in social, academic, and work life. Ingesting meth can cause such a disability.

What is Meth Psychosis?

Meth psychosis is also known as meth-induced psychosis. The correct DSM-5 terminology, however, is Methamphetamine-Induced Psychotic Disorder. This condition arises when the consumption of meth leads to hallucinations and delusions. Recent estimates indicate that up to 40% of meth users develop psychosis.

Methamphetamine is sold mostly as a pill, white powder or crystals. It is predominantly consumed by smoking, snorting, swallowing, or injecting.

This drug is widespread, as it is quite easy to obtain. The reason for this is because of the ease of manufacturing it. People make meth in their homes with substances bought from pharmacies and grocery shops.

Crystal meth is similar to amphetamines – prescribed for Attention Deficit Hyperactivity Disorder (ADHD) and narcolepsy. While such amphetamines are legal prescriptions, crystal meth is illegal.

Users of meth report feeling a sudden “rush” of pleasure and a prolonged sense of increased well-being. They also experience increased confidence, more energy, improved focus, sexual prowess, and feelings of desirability. Interestingly, the pleasurable effects of meth seem to disappear over time. This lack of pleasure applies not only to meth but also to other sources of pleasure.

The loss of pleasure from meth occurs even with high blood concentrations of meth. As a result, individuals take more and more to get the same effect. This increase in use is known as tolerance. Meth users have been known to forego sleep and food while they binge for several days.

Unfortunately, the use of this substance can lead to impairment in thoughts and emotions. Methamphetamine-induced psychotic disorder can be very disabling.

What are the Symptoms of Meth-Induced Psychosis?

In general, psychosis presents with hallucinations and delusions. The presentation can, however, be quite varied. These symptoms can differ widely from one person to another. In Jack’s case, he experienced hallucinations and paranoid delusions.

For some individuals, it starts with seeing shadows and hearing strange sounds. In some cases, non-living objects transform into moving things. There may be multiple snakes seen indoors, bugs crawling on the individual’s skin, or strange patterns on the wall.

The delusions may center around paranoia. For example, feeling the government is spying on you. Also, you may think people are trying to poison you or kill you. Some people feel like they can read people’s thoughts or that others can read their minds. You may even become hyper-religious. Again, the presentation can be very varied.

Initially, such experiences may be understood as not real. This means you still have insight. At some point, though, there may be a loss of insight. This means you are unable to differentiate between reality and psychosis — a dangerous state.

Psychosis can be traumatic. This mental condition can also create a lot of confusion, fear, irritability, and anger. In addition, physical symptoms are prevalent. These effects are usually due to drug use, persistent over-stimulation, and poor nutrition.

Some individuals may have muscle tension, headaches, fatigue, cracked lips, hypertension, alteration in sleep patterns, and dehydration.

How Long Does Meth Psychosis Last?

Again, this will vary from one individual to another. Just as psychosis tends to present differently, the duration also varies.

In many cases, the symptoms are only transient and go away quickly. A study showed an average recovery period of one week. Nevertheless, in some individuals, psychosis can last for months and even years. There are many cases of meth psychosis lasting for several years.

Meth is notorious in that it has the potential to cause psychosis, which lasts for years. This continuity is despite the individual no longer using crystal meth. Several studies report the possibility of persistent psychosis even after stopping meth use. Unfortunately, psychosis may become chronic despite adequate treatment.

Another concern is the fact that meth psychosis can recur. A study on the recurrence of meth-induced psychosis in a hospital showed interesting results. It revealed that up to 50 percent of the patients admitted had at least one previous episode. Some patients even had as many as ten previous psychotic breaks.

The ability of meth to trigger psychosis amongst individuals who have previously experienced psychosis can persist for several years. This is known as meth “sensitization.”

Treatment of Meth Psychosis

A comprehensive approach to treatment is required for meth-induced psychosis. Depending on the severity of symptoms, this may be in an outpatient clinic or an inpatient facility.

After stopping meth use, the first step to proper treatment involves a good psychiatric assessment. This evaluation helps to ascertain if the psychosis is actually due to meth ingestion. In addition to good history, psychodiagnostic assessment instruments, and urine drug screening are helpful. It is also essential to obtain information from the individual’s family and friends to help with an accurate diagnosis.

There are several helpful medications for treating this disorder. It is important to note, though, that many cases of meth psychosis are transient. This means that medications are not needed as the symptoms stop shortly after discontinuing meth use.

Antipsychotic medications are helpful for cases where psychotic symptoms persist. Several antipsychotics are useful. Some examples include Risperdal (risperidone), Invega (paliperidone), Abilify (aripiprazole),  and Seroquel (quetiapine).

In some cases, individuals also present with irritability and agitation. Due to the distress this causes, benzodiazepines can be a good treatment option. Such prescriptions are usually short-term. Examples of benzodiazepines include Xanax (alprazolam), Ativan (lorazepam), and Klonopin (clonazepam).

Psychosocial treatment is essential for meth users. This treatment looks at the effect of your psychological factors and the surrounding social environment. It takes into account how these affect your physical and mental wellness. There is also a consideration for your overall ability to function. Psychosocial interventions can include structured counseling, case management, care-coordination, psychotherapy, and relapse prevention.

Following the stabilization of the individual, proper treatment for meth use is crucial. Inpatient residential treatment is an option. Outpatient treatments include partial hospitalization programs (PHP) and Intensive Outpatient Programs (IOP).

Unlike alcohol and opioids, there are no FDA approved medications for treating addiction to methamphetamines. Behavioral therapies are currently the most effective treatments for addiction to meth. Such therapies include cognitive-behavioral therapy, motivational enhancement, and contingency-management interventions.

Many individuals with meth psychosis also have a co-occurring mental illness. Examples may include depression, anxiety, post-traumatic stress disorder, and bipolar disorder. It may well be that such individuals use meth to self-medicate. Thus, it is essential to treat these underlying conditions. Such treatment helps to prevent relapse on methamphetamine.

Importantly, support from family and friends is crucial to the recovery process. There is a tendency to regard people addicted to meth and other illicit substances as moral failures. This generalization is rather unfortunate for a condition that results from a disorder in brain chemistry. Addiction is a brain disease.

Conclusion

Methamphetamine is also commonly referred to as meth or crystal meth. It is a powerful and extremely addictive stimulant. The use of this illicit substance can cause many adverse effects. One of such conditions is psychosis.

Psychosis caused by meth use is usually referred to as meth psychosis or meth-induced psychosis. The correct DSM-5 terminology, however, is Methamphetamine-Induced Psychotic Disorder.

Psychosis is a mental condition in which an individual’s thoughts and emotions become very impaired. Such individuals develop hallucinations and delusions. As a result of such impairment, contact is lost with external reality. Such a situation can be very disabling.

This mental condition can also create a lot of confusion, fear, irritability, and anger. In addition, physical symptoms are prevalent. These effects are usually due to drug use, persistent over-stimulation, and poor nutrition.

In many cases, meth psychosis is transient and goes away quickly. A study showed an average recovery period of one week. Nevertheless, in some individuals, psychosis can last for months and even years. Another concern is the fact that meth psychosis can recur.

A comprehensive approach to treatment is required for meth-induced psychosis. Treatment can be inpatient or outpatient, depending on the severity. A good psychiatric evaluation is key to making an accurate diagnosis. Many cases of meth psychosis are transient and do not need medical treatment. Medications like antipsychotics are, however, required for chronic cases.

Psychosocial support is essential in the recovery process. Following stabilization, it is vital to have proper treatment for meth addiction. Unlike alcohol and opioids, there are no FDA approved medications for treating addiction to methamphetamines. Behavioral therapies are currently the most effective treatments for addiction to meth.

Treating co-occurring mental illness also helps to prevent relapse. Self-medication is quite common with a lot of methamphetamine users.

In addition to all the other treatment modalities, support from family and friends is crucial.

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