The term “psychosis” describes an altered mind state during which a sufferer experiences a loss of contact with reality. Psychosis is a descriptive term that does not give any clues as to the cause of the symptoms, the DSM-IV manual of psychiatric illness differentiates between “Psychosis Due to General Medical Conditions”, and “Substance Induced Psychosis” (DSM-IV Codes 293.81 & 292.11).
Psychosis manifests with hallucinations(false sensory perceptions, eg of hearing, smelling, seeing, tasting, feeling) and delusions(false beliefs about the state of oneself or the world around, eg being followed, poisoned, deceived by a spouse, loved, having a disease), as well as disorganised speech or behaviour(catatonia), with varying degrees of insight into the condition. Typically in schizophrenia and often in drug-induced psychosis, sufferers lack any insight into their predicament.
A lot of substances are capable of causing psychotic symptoms, for example alcohol, marijuana, LSD, steroids, Ketamine, anti-Parkinson drugs, anaesthetics, the list is long. One of the most common suspects in this regard has for a long time been Metamphetamine, street name Ice.
A recent study from Australia, published in the Journal of the American Medical Association, has now demonstrated that indeed Ice is responsible for a 5-fold increase in the risk of developing psychotic symptoms when consumed regularly, independently from any prexisting psychiatric illness. The effect was even stronger when Ice was consumed together with alcohol or marijuana:
Participants A total of 278 participants 16 years of age or older who met DSM-IV criteria for methamphetamine dependence on entry to the study but who did not meet DSM-IV criteria for lifetime schizophrenia or mania.
Main Outcome Measures Clinically significant psychotic symptoms in the past month, defined as a score of 4 or more on any of the Brief Psychiatric Rating Scale items of suspiciousness, hallucinations, or unusual thought content. The number of days of methamphetamine use in the past month was assessed using the Opiate Treatment Index.
Results There was a 5-fold increase in the likelihood of psychotic symptoms during periods of methamphetamine use relative to periods of no use (odds ratio [OR], 5.3 [95% CI, 3.4-8.3]; P < .001), this increase being strongly dose-dependent (1-15 days of methamphetamine use vs abstinence in the past month: OR, 4.0 [95% CI, 2.5-6.5]; ≥16 days of methamphetamine use vs abstinence in the past month: OR, 11.2 [95% CI, 5.9-21.1]). Frequent cannabis and/or alcohol use (≥16 days of use in the past month) further increased the odds of psychotic symptoms (cannabis: OR, 2.0 [95% CI, 1.1-3.5]; alcohol: OR, 2.1 [95% CI, 1.1-4.2]).
From my personal experience, Ice is a bane on society. A lot of the violence and injuries that I see in my work, especially on weekends, and a lot of the psychiatric presentations in young people, seem at least partially attributable to Metamphetamin use. Too many teens or young adults find themself on a psychiatric ward scratching invisible skin bugs, or end up a hysterical screaming anxious bundle on the floor of the Emergency Department, after a big weekend out consuming Ice.
We must improve knowledge about the dangers of Metamphetamine in the general population, and in particular in young people. It’s not as harmless as many people seem to think.
