Can Cocaine Cause Psychosis?

Cocaine use brings a number of possible risks including the potential for addiction and strain on the cardiovascular system. But can cocaine cause psychosis?

The short answer is that yes, cocaine use can trigger psychotic symptoms in some people. Symptoms can occur during intoxication, following heavy use or, in some cases, after the immediate effects have worn off. Cocaine-induced psychosis is not common but it can be very serious when it does occur.

What Is Cocaine-Induced Psychosis?

Cocaine-induced psychosis refers to a set of psychological symptoms that can occur during or after cocaine use. It may involve losing contact with reality following cocaine use, with possible symptoms including paranoia and hallucinations. The experiences and duration of effects can vary between individuals though, and even for the same individual on different occasions.

Psychosis is distinct from altered perceptions and emotions commonly associated with the use of cocaine, such as temporary increases in confidence, alertness or agitation.

Symptoms of Cocaine Psychosis

Paranoia is a very common symptom in people experiencing cocaine-related psychiatric issues. One study reported that paranoia was reported in 68% to 84% of patients experiencing psychiatric symptoms related to cocaine. This often incorporates or is accompanied by feelings of intense suspicion. Delusions, disorganised thinking and severe confusion and agitation are more possible symptoms.

Some people with cocaine-related psychosis may also experience auditory, visual and tactile hallucinations. Tactile hallucinations are those related to touch and the sensation or belief that insects are crawling on or beneath the skin have been reported.

Symptoms of cocaine psychosis can vary quite widely between individuals and can be very frightening and unpredictable.

Why Can Cocaine Cause Psychosis?

Cocaine has a number of effects on the neurochemistry of the brain. One of the main effects is on dopamine and other signalling systems in the brain. Dopamine is associated with the reward systems and is sometimes known as the ‘feelgood chemical’, but it excess levels of dopamine may be associated with anger, aggression, hallucinations, delusions, and other psychotic symptoms.

Overstimulation and sleep deprivation and the cumulative effects of repeated or high-dose use and associated comedowns may increase psychological strain.

Who Is Most at Risk?

Some risk factors can include heavy use, frequent use, binges and the use of high-potency forms of the drug such as crack cocaine. Sleep deprivation and mixing cocaine with other substances can also have an effect on overall mental health.

In some cases, cocaine use may trigger mental health episodes, but in some cases it may also impact existing mental health conditions. A personal or family history of psychosis or another mental health condition could also increase vulnerability, even if the condition is currently in remission.

It is worth remembering, though, that cocaine-related psychosis could potentially affect anyone who uses the drug and can still occur without known or common risk factors.

How Long Does Cocaine Psychosis Last?

Symptoms may resolve as cocaine leaves the body and the person sleeps but they can sometimes persist for days or even longer. Cocaine use and cocaine-related psychosis could also, in some cases, trigger or exacerbate longer-term mental health conditions.

Ongoing symptoms require urgent professional assessment. It’s safest not to assume that any symptoms that do arise will always resolve or disappear without treatment or professional advice.

Is Cocaine Psychosis a Medical Emergency?

Cocaine-related psychosis can be a medical emergency, and you should seek urgent help if you or someone you are with is hallucinating, severely confused, extremely agitated or unable to recognise reality.

Psychological and physical symptoms can sometimes occur at the same time. You should call 999 immediately if there appears to be an immediate risk of harm, suicidal behaviour, chest pain, seizures, overheating, breathing difficulty or loss of consciousness.

Follow any instructions from the emergency services call handler and try to stay calm, reduce stimulation and avoid confrontation while awaiting professional help.

Can Cocaine Psychosis Lead to Long-Term Mental Health Problems?

Cocaine use is associated with a number of mental health issues including depression, anxiety and paranoia, as well as psychosis. In some cases cocaine may worsen an existing mental health condition or trigger symptoms in someone who is vulnerable. Even if symptoms subside, there may be recurring episodes with continued cocaine use.

Not every person who uses cocaine will experience mental health issues and not every episode will lead to a longer-term psychiatric condition. Where they do occur, a clinician may need to distinguish substance-induced psychosis from a primary psychotic disorder.

Treatment for Cocaine Use and Psychosis

The immediate treatment for cocaine-related psychosis may initially need to focus on safety and stabilisation. This could include medical and psychiatric help and possible hospitalisation.

It’s important to address ongoing cocaine use after the acute episode, which may involve relevant addiction treatment and support. Cocaine is extremely psychologically addictive and can be very difficult to quit without expert help.

This could include detoxification support, a range of psychological therapies, relapse prevention sessions and dual diagnosis care. Dual diagnosis refers to treatment of co-existing addiction and mental health conditions, which can interact in various complex ways. It can be very important to address mental health and substance misuse issues at the same time, as leaving one element untreated could potentially lead to a future relapse in the other.

Getting Help for Cocaine Addiction

Asana Lodge’s specialises in addiction treatment, including cocaine rehabilitation programmes, along with dual diagnosis support for co-occurring addiction and mental health issues.

We offer personalised treatment to match individual circumstances and needs, incorporating evidence-backed therapies such as cognitive behavioural therapy (CBT), relapse prevention and comprehensive aftercare. Early intervention is always advisable before cocaine-related harms can escalate, but it’s never too late to seek help.

Reach Out for Cocaine Addiction Support Today

Remember that an active psychotic episode will require immediate help through 999 or A&E.

If you are concerned about ongoing cocaine use or recurring mental health symptoms, you can contact Asana Lodge confidentially and speak to our friendly, experienced team about your options.