Substance-Induced Disorders -Addictions

These conditions or symptoms are caused by the substance being abused and would not be present otherwise. They usually clear over time with abstinence.

Depression is common in people who are addicted. The condition often results from the many negative consequences of the addiction and the sense of hopelessness it engenders. But certain drugs, especially alcohol, cocaine, and amphetamines, are particularly likely to produce depressive symptoms.

Excessive use of alcohol can lead to a condition known as alcoholic hallucinosis, in which people hear derisive voices talking to them. The condition sometimes remits with longterm abstinence but may require treatment with antipsychotic medication. It is sometimes misdiagnosed as schizophrenia.

Heavy use of the hallucinogens, PCP, or amphetamines can cause psychosis that is indistinguishable from schizophrenia.

In most cases the condition will resolve with treatment, but it sometimes becomes chronic, especially following heavy PCP use.

Anxiety and panic attacks are often seen in people who abuse alcohol, sedatives, or marijuana. Symptoms of chronic withdrawal from alcohol and sedatives may be mistakenly thought to constitute an anxiety disorder. The mechanism for panic attacks in chronic marijuana users is unknown.

Substance-induced disorders often cause diagnostic problems for clinicians. These disorders and symptoms frequently resolve within a few weeks to months of abstinence and do not necessarily constitute a second primary diagnosis. When there have been distinct episodes of symptoms before the onset of the addiction, it is easier to rule out a substance-induced disorder. Otherwise, the passage of time usually clears up any questions about whether ongoing treatment for a second diagnosis is actually needed.

Elizabeth Connell Henderson, M.D.