Q: Dear Iron Shrink,
Can drugs make you insane? My mom and dad say that they can but I think it’s just a scare tactic. - Michael, Dallas
A: Dear Michael,
If by “insane” your parents are referring to hallucinations, delusions, wildly unpredictable behavior, self-destructiveness, and the potential to spend years in prison or a state hospital, then the answer is: yes, drugs can make you insane.
Take the example of Jack (that isn’t his real name, and details of his story have been changed). Jack first discovered methamphetamine, a powerful stimulant, during his teenage years. Meth is cheap, easy to buy, and highly addictive. By his mid-20’s Jack was using meth in high enough quantities that he experienced two long episodes (that he remembers) of Amphetamine-Induced Psychosis.
The word “psychosis” refers to a disconnection with reality. An individual suffering psychotic symptoms may experience hallucinations in which he hears, sees, or feels things that are not there, such as mumbling voices or bugs crawling on his skin. He might also experience delusions, which are strongly held irrational beliefs.
Jack, for example, held the delusional belief that his girlfriend had planted government listening devices around his home. A person suffering psychosis can also experience bizarre thought processes, such as answering questions by reciting words that begin with a certain letter. And psychosis often includes lack of insight, which is the inability to recognize that anything is wrong. Incidentally, psychosis is not a diagnosis, but a set of symptoms. Like a fever, psychosis can accompany many conditions, including substance abuse.
Imaginary men in black
One of Jack’s psychotic episodes included the belief that he was being pursued by the FBI. This led him to spend nearly a month frantically traveling the country in an attempt to escape imaginary government agents. He burned through his savings buying gas, hotel rooms, meth, and by paying people for protection and information about the FBI. He finally freed himself from his delusions when he publicly and conspicuously poured a bag of flour down a drainpipe, thereby fooling the imaginary FBI agents into believing that he had gotten rid of all of his drugs.
By the time I met Jack he had been off meth for more than a month, mostly because he was in prison. You might imagine that Jack’s psychotic symptoms were gone by then, but you’d be wrong. Jack still wasn’t sure whether the FBI had been pursuing him. He was still hearing voices, and he was still highly suspicious of those around him. In other words, Jack was still a little bit “insane.” (“Insanity” is actually a legal term, not medical, but I’ll let it slide this time since your parents are on my side.)
More than one way to go crazy
Here’s the deal with stimulant drugs like meth. Some stimulants act by increasing the amount of a chemical called dopamine in certain parts of brain. Schizophrenia, a serious mental disorder characterized by psychotic symptoms, is also associated with dopamine imbalances. Is there a connection? Some people think that the amphetamine-induced psychosis is similar in cause and nature to schizophrenia. Some people even think that using drugs like meth makes a person more susceptible to conditions like schizophrenia even after they stop taking the drug (see Adeyemo, 2002).
That’s all up for debate, but there is no doubt that Jack paid a heavy price for his meth use and it’s entirely possible that his addiction will have life-long psychotic effects. Why is he still having trouble? It could be that methamphetamine actually induced lasting psychotic symptoms in Jack, or it could be that running frantically from the FBI was such a powerful experience that his delusion seems real in retrospect. Either way, Jack has four to six years behind bars to figure it out.
Stimulants aren’t the only drugs that lead to psychosis. Another major class of drugs is the depressants (the first being stimulants like meth). These include such things as benzodiazepines, barbiturates, and alcohol.
These, too, can lead to any number of lasting mental problems. Drink enough booze, for example, and you may come down with a debilitating mental illness called Korsakoff’s Psychosis. This condition is characterized by a severe deficit in short-term memory, usually accompanied by confabulated imaginary experiences that fill in the memory gaps. Imagine forgetting what you did this morning and simply making up a story about your day – all without deciding to do so. Korsakoff’s Psychosis can also include delusions, delirium, confusion, anxiety, and depression. Is that insane enough for ya’?
The moral of today’s story, Michael? If you’re looking for a way to go crazy have kids, not drugs. At least you won’t end up in prison.
Adeyemo, S. A. (2002). Can the action of amphetamine on dopamine cause schizophrenia? Psychology & Education: An Interdisciplinary Journal, 39(1), 29-39.