Analyzing Substance Induced Insanity Essay

Excerpt from Essay :

Substance Induced Insanity

Psychosis is a psychiatric state that can either be enduring or temporary. A person suffering from the condition may experience memory lapses, incoherent speech or thoughts, lack of concentration, delusions and/or hallucinations. Other symptoms that may manifest when one is suffering from psychosis include changes in personality and exhibition of unusual behaviors. It has been established that psychosis can be caused by various substances such as marijuana, methamphetamine and alcohol. Substance induced psychosis typically occurs when an individual has been continually using stimulants over a long period of time. The two most common substances or stimulants known to induce psychosis are methamphetamine and amphetamine. Apart from these drugs, the 'designer' drugs have also been found to induce the condition. Individuals suffering from substance-induced psychosis may exhibit loss of contact with reality and they may also become fixated on a certain action or place and may engage in repetitive action such as washing hands, pacing, sorting rubbish or searching for something. Individuals who have methamphetamine/amphetamine induced psychosis may also suddenly become violent towards others, they may also start exhibiting delusional behaviors such as removing imaginary bugs or feeling irritated over nothing (Alcoholrehab, 2016).

The case discussed in relation to this highlights how the patient was ill- treated which resulted in biological and psychological issues. The injuries caused by the Canadian pharmacy scam and doctors were chronic high blood pressure, diabetes, thrust mouth, weakness, poor salivation, obesity, erectile dysfunction, and inflammation as well the associated depression, and anxieties that are caused by the medical and social deficiencies. According to Barbara Schildkrout, more than one hundred medical conditions can be misdiagnosed as psychological conditions. In her work titled Unmasking Psychological Symptom, which is aimed at helping psychologists to improve their diagnostic skills, Barbara cited several examples to prove her argument. Other studies have shown that medical disorders are behind up to 25% of the mental health cases and that they may have a role to play in over 75% of mental illnesses (Beck, 2011). The patient's ill treatment led to the development of many problems. The document throws light on issues related to this.

Every year there are over one and a half million hospital admissions brought about by adverse drug reactions in the U.S. alone. As many as five percent of these hospitalizations are linked directly or indirectly to substance-abuse problems. Over 30% of all the individuals admitted for adverse drug reactions experience a second adverse drug reaction during their hospital stay. The second drug reactions often occur because many hospitals, usually misdiagnose the reactions in the beginning. If an individual does experience a second drug reaction, his hospital stay will likely be extended. It has been revealed that 3 billion dollars are spent every year in the U.S. alone to treat the adverse drug reactions. Adverse substance reactions have been found to be the cause of approximately 5% of all hospital deaths (Richard & Hall, 2012).

The dosage of steroid administered is directly linked to the possible instantiation of a patient developing a steroid psychosis. According to Richard and Hall (2012), the incidences of psychiatric disturbances increase significantly when the amount of steroid doses administered is increased. For instance, in the Boston Collaborative Drug Surveillance Study, patients who were given a daily dose of less than40 milligrams per day were found to have incidences of psychotic disturbances of about 1.3%, while those who were given a daily dose of between 41 and 80 milligrams a day were found to increased incidences of psychotic disturbances of 4.6%. Patients treated with over 80 milligrams per day of the drug had recorded up to 18.4% incidence of psychotic disturbance. The mean daily dose of steroids for patients who later developed psychosis was 59.5 milligrams per day of Prednisone compared to the daily average of 31.1 milligrams per day for patients who did not become psychotic (Richard & Hall, 2012).

Quite a number of studies have revealed that there is no link between the reaction to the 1st course of steroid dose and the reaction to the 2nd course of the drug i.e. the presence or lack of development of psychosis during the first course of steroid administration, cannot predict the reaction to the second course of treatment. The high level of co-morbidity between substance abuse disorders and mental conditions does not mean that one leads to the other. This is because establishing directionality or causality is difficult for a couple of reasons. One is that the diagnosis of a mental illness may not be possible until the symptoms have developed to a specific DSM level; however, other clinical symptoms may also prompt the use of drugs. Imperfect recollections of when one started to use drugs may also create confusion as to which between a mental illness and a substance abuse disorder came first. Nevertheless, there is a need to take into account the following:

1. Use of substances might force individuals to experience one or a couple of symptoms of mental illnesses. For instance, the increased likelihood of developing psychotic symptoms among users of marijuana has been offered as an example of this possibility.

2. Drug abuse might be brought about by mental illnesses. Persons with subclinical, mild or overt mental illnesses may start using substances as self-medication. For instance, the use of cigarettes by individuals suffering from schizophrenia to enhance cognition and lessen other symptoms has been offered as evidence.

3. Both mental illnesses and substance abuse disorders are brought about by overlapping causes such as early exposures to trauma or stress, genetic vulnerabilities and/or underlying brain conditions (NIDA, 2010).

In 1854, Jules Falret coined the term folie circulaire (circular insanity) to describe a condition, which was characterized by heightened moods and episodes of depression. Less than 12 months later, the condition was renamed maniac depressive psychosis (Khouzam & Singh, 2006). This shows the difficulty in distinguishing between mental conditions and substance abuse disorders. The high co-morbidity between bipolar and other psychiatric and/or medical conditions also complicates diagnosis (McElroy, 2004; Regier, Farmer, & Rae, 1990). A research that was done on bipolar patients found that forty-six percent of them suffered from alcohol dependence and that forty-one percent of the patients' co-morbid drug abuse (Regier; Farmer, & Rae, 1990). Other studies have shown up to 60% and 69% rates of drug and alcohol abuse respectively for bipolar patients (Cassidy, Ahearn, Carroll, 2001). Studies have also proven high co-morbidity between bipolar disorder and ADHD, eating disorders, social phobias, OCD, and panic disorder (Chen & Dilsaver, 1995). The link between bipolar disorder and conditions such as multiple sclerosis and thyroid disease can also complicate diagnosis (Krishnan, 2005).

Use of medication to alleviate symptoms is a common among adolescents (Hanse, Holstein, Due, & Currie, 2003; Holstein, Hansen, Due, & Almarsdottir, 2003). The use of pain alleviation and psychotropic drugs is an important issue for health professionals, since such drugs are potentially toxic and might have harmful side effects (Sweetman, 2005). The patterns of medicine use are often based on age and gender and are usually consistent across different nations. The high use of drugs for treating psychological problems is often greater among adolescents, but its prevalence decreases with age (Hanse, Holstein, Due, & Currie, 2003).

The use of medicine is a behavior that may reflect coping strategies to overcome daily stressors such as bullying among boys, which would explain the high prevalence of drug use among adolescents. It has also been shown that health-related lifestyles are often rooted in childhood experiences. Thus, the early use of pain alleviating drugs and psychotropic drugs might prevent one from learning and adopting appropriate coping strategies (Kim, Koh, & Leventhal, 2005).

Within the realms of forensic psychiatry, an individual is frequently called upon to assess the accused so as to establish whether he is suffering from a mental condition, hence commencing a plea to criminal accusations. Towards this particular end, the evaluator ought to take into consideration, in his/her final assessment, if the accused might actually meet the examination for the insanity plea, bearing in mind the legal classification of insanity. In a number of jurisdictions, mitigating elements like reduced capacity and intoxication might result to lowered convictions. Drug-induced psychosis might show a more complicated clinical situation. It is often impossible to differentiate drug-caused psychosis from a first-occurrence psychosis within the framework of a primary mental disorder because of the high degree of co-morbidity. According to a recent judgment of the Supreme Court of Canada (R. v. Bouchard-Lebrun), drug-caused psychosis cannot be viewed as a mind disease within the legal realm when it is an outcome of self-started intoxication (Bourget, 2013).

The connection between criminal intent and intoxication is an intricate question that raises the probability of plea against certain offenses. The notion that one is able to form the intention to utilization a dug or substance has generally been adopted by the judicial system. In most instances, such an individual is held accountable for his conduct if he has carried out an offense when intoxicated. Such crimes…

Sources Used in Document:


Alcoholrehab. (2016). Psychosis and substance abuse. Retrieved from

Bal, B. S. (2009). An introduction to medical malpractice in the United States. Clin Orthop Relat, 467(2): 339-347.

Beck, M. (2011). Confusing medical ailments with medical illness. Retrieved from

Bourget, D. (2013). Forensic Considerations of Substance-Induced Psychosis. J Am Acad Psychiatry Law, 41(2), 168-173

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