substance-induced psychosis substance-induced psychosis substance-induced psychosis (commonly known as toxic psychosis or drug-induced psychosis) is a form of psychosis that is attributed to substance use. it is a psychosis that results from the 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. substance-induced psychosisother namessubstance-induced psychotic disorder, drug-induced psychosis, substance/medication-induced psychotic disorder, toxic psychosisspecialtypsychiatry, addiction psychiatry signs and symptoms psychosis manifests as disorientation, visual hallucinations 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's demands. while there are many types of psychosis, substance-induced psychosis can be pinpointed to specific chemicals. substance use and schizophrenia rates of drug use amongst people with schizophrenia are higher than the general population; 50% of those diagnosed with schizophrenia use substances over their life.: 495, 496 there is a model that this arises because those with schizophrenia self-medicate with psychoactive drugs.: 500 transition to schizophrenia a 2019 systematic review and meta-analysis found that the 25% (18–38%) of people diagnosed with substance-induced psychosis went on to be diagnosed with schizophrenia, compared with 36% (30–43%) for brief, atypical and not otherwise specified psychoses. the substance present was the primary predictor of transition from drug-induced psychosis to schizophrenia, with highest rates associated with cannabis (34% (25–46%)), hallucinogen (26% (14–43%)) and amphetamines (22% (14–34%)). lower rates were reported for opioid-(12% (8–18%)), alcohol- (9% (6–15%)) and sedative- (10% (7–15%)) induced psychoses. transition rates were slightly lower in older cohorts but were not affected by sex, country of the study, hospital or community location, urban or rural setting, diagnostic methods, or duration of follow-up. class of substance number of studies rates of transition to schizophrenia estimate lower bound upper bound brief, atypical and nos 34 36% 30% 43% combined - 25% 18% 38% cannabis 6 34% 25% 46% hallucinogens 3 26% 14% 43% amphetamines 5 22% 14% 34% opioid 3 12% 8% 18% sedative 3 10% 7% 15% alcohol 5 9% 6% 15% substances psychotic states may occur after using a variety of legal and illegal substances. substances whose use or withdrawal are implicated in psychosis include the following: international classification of diseases psychoactive substance-induced psychotic disorders outlined within the icd-10 codes f10.5—f19.5: 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 excessive alcohol use 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. f11.5 opioid: studies show stronger opioids such as fentanyl are more likely to cause psychosis and hallucinations f12.5 cannabinoid: some studies indicate that cannabis may trigger full-blown psychosis. recent studies have found an increase in risk for psychosis in cannabis users. f13.5 sedatives/hypnotics (barbiturates; benzodiazepines): it is also important to this topic to understand the paradoxical effects of some sedative drugs. serious complications can occur in conjunction with the use of sedatives creating the opposite effect as to that intended. malcolm lader at the institute of psychiatry in london estimates the incidence of these adverse reactions at about 5%, even in short-term use of the drugs. the paradoxical reactions may consist of depression, with or without suicidal tendencies, phobias, aggressiveness, violent behavior and symptoms sometimes misdiagnosed as psychosis. however, psychosis is more commonly related to the benzodiazepine withdrawal syndrome. f14.5 cocaine f15.5 other stimulants: amphetamines; methamphetamine; methylphenidate.