“Ice-induced psychosis has become part of their story”
By the time the addict is displaying signs of ice addiction and unmanageability or is presenting at treatment centres you can be sure that ice-induced psychosis has become part of their story. What we must understand is that the far-fetched, highly paranoid delusions they are experiencing in the psychosis are very real for the addict. Experiencing visual and audible delusions are no different to experiencing them in reality. This is demonstrated by the fact that we can explain to them that there is no one communicating with them through the television until we are blue in the face but are unable to convince them.
A client of mine was facing multiple years in jail for a three hour police pursuit through the eastern suburbs of Melbourne. During the pursuit he drove his car directly at police, drove into oncoming traffic and kept two police helicopters and a dozen police vehicles busy. He was finally apprehended and taken into custody after his car was rammed by another police car. We were lucky to have this well-educated, articulate young man from an affluent family bailed into treatment pending his criminal trial.
In treatment he confessed to me and his counsellor that during the pursuit he had had no understanding that it was police chasing him. He thought that the blue lights and vehicles were alien life forms that had come to extract him and take him to alternative planets for human testing and analysis. He never thought for one second he was evading police – he truly believed he was fighting for his life. Even after coming out of psychosis it is the delusional events that are imprinted on one’s memory. It took weeks and weeks for this young man to truly accept that he wasn’t in fact being abducted by aliens. The event was so tangible in his mind that counsellors needed to repeatedly go over the details and logic of the event with him in order for his consciousness to acknowledge the reality of the situation.
It’s a miracle this young man didn’t kill himself or other innocent people while in this deep psychotic ice-induced state. This type of deep psychosis is demonstrated time and time again by violent offenders, who after being arrested and hospitalised are found to have been in psychosis and defending themselves against fictitious threats. Many of them don’t make it out unscathed, being injured or killed by police in what can be a misunderstanding of their condition and intentions and end in over-zealous self-defence.
Another client, who after being on an ice binge for a week was convinced that people in his neighbourhood had a contract out on him, was convinced that he was destined to die before the end of the day. Unfortunately this man also had access to a handgun, which he armed himself with and proceeded to roam the streets of Port Melbourne seeking to find these people before they found him. This highly dangerous scenario climaxed with him walking down the centre of a main road firing into the air and screaming for these fictitious people to show themselves. The swat team arrived and covered his chest and back with red dots. Confused and bewildered he slumped on the median strip and held the gun to his head, finger on the trigger. A friend of his appeared from the pub and, refusing directions by police, went and sat next to him and begged him for the weapon. Thankfully he handed the gun over, at which point the police arrested him.
I visited this man a week after the event in prison to assess his suitability for rehab. He was detoxed, fully present and alert and had an awareness of his situation that made it hard to believe that only a week before he had been sitting on the street with a gun to his own head. It was only when I was about to leave that I realised he was still experiencing audible delusions – he confessed that he kept hearing other prisoners calling out his name and asked for my help. We got him bailed out and into treatment in a couple of days and after proper stabilisation and intensive treatment he fully recovered. Two years later, having been abstinent from all drugs he now has a young baby, a loving relationship, full time employment and spends his spare time mentoring newcomers in the recovery community.
Often when we hear of tragic events involving the violent deaths of drug users or death caused my ice addicts we make judgements of what type of people they must have been. In fact they are usually people exactly like you and me, people with families, dreams and ambitions. The only difference is that they suffer from ice addiction and have become victims to the horrific mental deterioration that it causes.
There are many theories as to why ice-induced psychosis occurs. Methamphetamine obviously has a devastating effect on brain chemistry but, beyond that, the best way I have found to understand it is that after filling the brain with copious amounts of chemicals and denying it sleep, the brain loses the capacity to accurately translate information; the filter becomes scrambled. It’s like placing a device over a telephone and speaking into it to distort your voice into something unrecognisable and menacing. For example, the rustling of trees in the wind, which we would usually subconsciously file away as insignificant background noise, suddenly becomes people hiding in the trees with cameras, following your every move. Or the subtle changes of shadows due to the slow movement of the sun across the sky become people hiding behind bushes wanting to harm us. These episodes can last for days and sometimes weeks. They are self-propelled by ever increasing drug consumption and fuelled by the escalating level of fear created by these mistranslations and misperceptions of our surroundings.
In one of my psychotic episodes,
I was convinced that there were people attempting to kill me. I had been awake for days and was experiencing both visual and audible delusions. I was running down a suburban street attempting to evade attackers and every time a car passed I was convinced it was the car that was going to shoot me. I would duck onto the ground, commando style, ravaged with fear. Within a short period of time the fear became overwhelming and I was found by passers by in the foetal position rocking back and forward, unable to stand up and move on.
Another time I spent two days barricaded in a hotel room convinced the people from the room next door were in the ceiling of my room. They had burrowed their way through the roof and were taunting me; holding me hostage until they killed me for their pleasure. I vividly remember being so overcome with terror I was vomiting and dry reaching.
In another psychotic episode I went to a friend’s house to hide. He took pity on me and put me to bed in his spare room. However, my delusions were so intense that he later found me on my knees, hands behind my head, face pressed against the wall because I thought there was someone with a gun pressed against the back of my head interrogating me.
What is frightening is that in the last few years of my ice consumption I was acutely aware that each time I binged I was possibly going to experience traumatic psychosis. But the extreme discomfort I felt sober and the allure of an extreme high made the fact that I would probably experience unpredictable trauma and horror an acceptable trade. Unfortunately the enjoyable highs got shorter each time I binged and the last year of my using I would only get four or five hours of clean high before my mind would disintegrate into psychotic paranoia, which could last for days. The usual remedy of sleep to cure my psychosis also ceased to work. I would fall asleep psychotic and wake up hours later still in psychotic delusion. This cycle lasted for over a year until a friend took pity on me and showed me how to use heroin to settle my psychotic episodes. However, being a drug addict who liked euphoric highs, I simply added heroin to the mix and became an ice and heroin addict. Like all pharmaceutical solutions, this heroin and ice mix worked for a short period of time but then simply allowed me to use more and more ice. After that not even heroin could block the psychotic episodes.
Many families interpret drug-induced psychosis as permanent mental illness or the rising up of an underlying mental illness and direct their loved one into the care of the mental health system. While it is true that some addicts have underlying or pre-existing mental health disorders these are not the cause of their ice addiction and must be treated concurrently with their addiction. Families often fall into the trap of thinking that resolving the mental illness will resolve the drug addiction. This is a complete fallacy. I see clients time and time again who have been in and out of acute care psychiatric hospitals for drug-induced psychosis. They have been held in care where they are sedated and stabilised and released back into society only to use ice again. And the cycle continues. In drug rehab ice addicts can be stabilised and have their addiction treated so that they don’t relapse into using and, in turn, not trigger psychotic episodes.