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Psychosis

Alcohol and drug use with psychosis

Many people either didn’t talk about - or use - alcohol or illegal drugs. In fact, some people talked about avoiding alcohol and/or drugs altogether because they feared harm to their mental health. Annie said that when she was in her teens people thought she was ‘doing drugs,’ when she was actually just becoming mentally ill.
 
However, others talked about using alcohol and illegal drugs. Many spoke of cannabis use, fewer about their using LSD (acid), amphetamine (speed), methamphetamine (crystal meth), heroin or pills (e.g. ecstasy). People used drugs and alcohol for all kinds of reasons, e.g. to get high or cope with emotional and mental problems.
 
People described different experiences of alcohol and drug use, both positive and negative. Several believed that alcohol/drugs had caused their mental distress, or at least made their distress harder to cope with. A few people had drunk alcohol with their medication and felt drowsy.
 
Cannabis use
Cannabis use was common among people we talked to. They smoked it for various reasons: to feel more relaxed, to deal with their emotions, for religious reasons, to relieve pain and as a social activity with friends and partners.
 

Andrew describes how his pain was badly managed after he lost a limb, so he self-medicated with...

Andrew describes how his pain was badly managed after he lost a limb, so he self-medicated with...

Age at interview: 59
Sex: Male
Age at diagnosis: 24
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And when I was starting to waste my money on drugs. Which I think will be quite evident to people at the university, people in my hall of residence, people in my teaching department. I think they’d have known that you know, I was taking a lot of drugs. And also I wasn’t turning up for lectures. I wasn’t turning up for seminars even. At one point I think my programme in my second year at [place] University I had two engagements a week. I think that’s one lecture and one seminar. I didn’t even go to them. And when I did go, I felt very paranoid. I felt paranoid being on buses in the town centre. Because I’d been smoking drugs. I was given no support with the psychological effects of losing my leg and things and also I had a lot of pain, lack of mobility with my leg, and I could have turned for help.
 
I mean I’ve heard of people with artificial legs who are on a maintenance dose of morphine even you know. I mean I could have sort of had some sort of help. Instead I did it illegally and you know, drugs subculture. I got paranoid and I failed my finals that just decimated me you know 
 
 

Nada hadn’t learnt how to cope with her thoughts without smoking cannabis.

Nada hadn’t learnt how to cope with her thoughts without smoking cannabis.

Age at interview: 26
Sex: Female
Age at diagnosis: 22
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Obviously I did smoke in a way to kind of control, you know, you know in a way it was a medicating thing, you know, obviously when you stop that you stop doing that, you know that overactive thoughts and stuff but they all come flooding back don’t they? And everyone has that in different ways of like coping like whether it be exercise or whatever it is you know. But I hadn’t really learnt a way of coping with all those thoughts because I’d been smoking for the last eight years or whatever ten years maybe even.
Many people initially believed that cannabis relaxed them. But they later felt that cannabis actually worsened their mental state, or for one person created ‘a living hell’. Some even felt that cannabis had caused their mental problems.
 

Janey has no idea whether cannabis ‘messed up [her] brain’, and stopped it because it was hard to...

Janey has no idea whether cannabis ‘messed up [her] brain’, and stopped it because it was hard to...

Age at interview: 52
Sex: Female
Age at diagnosis: 29
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I suppose one ought to say I was messing with drugs, so I was… smoking a fair bit of cannabis and had dabbled in one or two other things. Which is probably not sensible. I have absolutely no idea whether that messed my brain up so.
 
What was your experience of that?
 
Cannabis is quite good fun. It makes music better definitely, that’s really good fun. In the end this was...
 
In the end I found that with alcohol I could kind of sober up if I absolutely had to. With cannabis I couldn’t do that. I stayed stoned and I didn’t like it. So just stopped smoking it. From one day to the next though right now I’m not doing this any more. 
 
People talked about smoking weed and skunk (a strong variety of cannabis containing more THC), believing that the strong varieties were particularly dangerous for them. A few people said they had smoked too much, particularly at university.
A few people smoked with friends and hadn’t noticed how much they were smoking over time. Using cannabis with friends could make it hard to give up when friends continued to smoke it. A few mentioned the paranoia they experienced as a result of using cannabis.
 

Green Lettuce had felt paranoid and explained to his friends why he hadn’t been out.

Green Lettuce had felt paranoid and explained to his friends why he hadn’t been out.

Age at interview: 25
Sex: Male
Age at diagnosis: 20
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They were a bit like wondering why I hadn’t been out. And I just explained it.
 
Just said that I had really bad like paranoia and stuff.
 
And what was their reaction?
 
I can’t really remember but... They said it was probably to do with how much, weed I smoked. It definitely was.
 
Were you smoking skunk?
 
Yeah.
 
Stu… well quite a lot of it at the time, like two ounces a week. Which is like it’s about £40 a day for quite a few years. And if I couldn’t get that, if it was like hash it would be half an ounce a day or like, well just double the amount, equivalent to skunk, because hash is so much weaker. This didn’t, it wasn’t right.
 
And can you remember why you were smoking that much skunk?
 
I actually thought I needed to. Because my friends did, and I started smoking it as well, and then I smoked it all the time. Because I lived around it basically. Just smoked it as soon as I got up. Soon as I went to, well soon as I got up all day, well my hours changed, I was awake all night and I slept in the day like. I was, I went to sleep at like 9 a.m. in the morning and then got up at like 7 p.m. and it worked like that for a couple of years.  
However one person described ‘seeking out’ psychosis through smoking weed as a way of distancing himself from reality
 

David liked the emotional distance produced by smoking weed.

David liked the emotional distance produced by smoking weed.

Age at interview: 31
Sex: Male
Age at diagnosis: 17
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Some days I’d be all right, some days I wouldn’t. I never recognised anything as psychosis. In some ways I liked it and I sought it out at times. That’s why at times I used to smoke weed. I used to find it. I used to find that comfort of I could talk. So I know now that it activates part of speech and hearing and that sort of thing to action part of the brain. And I think I used to find comfort in that. Because I didn’t feel like I was on my own any more. I had something or some part of me with me. And…
 
I also know, a lot of people try and access psychosis element, because they’re given the edge because it’s given them a confidence boost. So they don’t feel threatened, so you’ve got that little street edge sort of to life, and I know I sought after that for quite a while as well.
 
And when you say it activates the speech and voice part of it, was it then you started to hear voices?
 
Yes. Yes. I used to think I was communicating with things and people and I’d play conversations through my head. I also found it easier to think. I don’t know if that was actually an illusion or not, but it felt like it at the time, and it was nice to have that feeling of not caring as well. Just that emotional distance. It sort of combined with self-harm and everything I was sort of into. It all sort of went together.  
Escapism and getting ‘out of control’
Several participants described heavy use of alcohol and non-prescribed substances at certain times in their lives. Some people began to use alcohol or drugs to escape past abuse, traumatic events, first hearing voices, or as a way of coping with stress in their lives. Some of them thought this kind of escapism was useful in coping at the time, but later concluded that drug use could be destructive in the long run, as well as very expensive. Metamphetamine (crystal meth) was singled out as particularly dangerous.
 

After the first time Ron heard voices he got ‘completely drunk’.

After the first time Ron heard voices he got ‘completely drunk’.

Age at interview: 51
Sex: Male
Age at diagnosis: 23
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I remember sitting in my office and this voice behind me saying, “You’ve done it wrong.” I was in-putting some data into a computer and in those days computers were still on tapes.
 
So it used to take ages for it, them to wind around and bring everything together for you, [coughs] and I looked around and there was nobody there and so I went to the pub and got absolutely drunk, and I guess drink then became my second coping strategy.
 
And then when I was drunk of course I would do stupid things and, get into really weird, situations that, and I thought that the voices would disappear, well the voice initially, but that it didn’t the, I got more voices and I ended up that I was going to work and, but I wouldn’t work I’d just sit there and listen to all this nonsense going on and, some of it quite, vile. 
 
 

Jenni says with drugs and alcohol ‘you can just get so out of your depth’.

Jenni says with drugs and alcohol ‘you can just get so out of your depth’.

Age at interview: 30
Sex: Female
Age at diagnosis: 26
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Like it just, I had friends, but I just didn’t feel very comfortable or secure. I don’t know what it was. I think it was the first part of my illness, but it’s hard to say, what exactly was going on. I think it’s like a circle, like I felt isolated, so I wasn’t making friends, so I felt unwell, and that made me feel further isolated and so I wasn’t making friends and it just went on like that. Yes.
 
And was this from your first year onward?
 
Yeah. It happened from the beginning. And I got involved with this guy, and he was like, just, not, we were in love, but he wasn’t, like he was a good boyfriend, and that we liked to talk about things and feelings and stuff. But he was a bad boyfriend in that he wasn’t very loving and caring and he wasn’t very supportive. He needed a lot of support himself. And we, drank a lot. I drank a lot. We smoked a lot of marijuana. We tried all sorts of drugs, which weren’t very good for my health at all. Got in really bad states from drugs and alcohol. So, yes, there was that as well.
 
And what was your experience of that?
 
God, in moderation and with the right people, they’re okay. But you shouldn’t. You can just get so out of your depth with those kind of things. Yeah, that’s my experience.  
Mary's son had got into drugs when his father left and another two drank heavily after a relationship breakdown. Simon had been drinking when he was depressed and taking psychiatric medication, leading him to fall asleep in a pub. A few people talked about the frightening effect drugs had on them. Two people talked about several sleepless periods directly caused by taking drugs, impairing their mental health and having ‘racing thoughts’. However Robert said that taking heroin made him ‘not care’ about the voices in his head.
 

Simon had some bad trips and thinks that LSD was the ‘beginning of [his] schizophrenia’.

Simon had some bad trips and thinks that LSD was the ‘beginning of [his] schizophrenia’.

Age at interview: 61
Sex: Male
Age at diagnosis: 20
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At the age of 16 I got into drugs. You know, sort of cannabis, and that graduated to LSD, and I think that was the beginning of me problems, I think, you know. I had some bad LSD trips. Yeah, and that, yeah, yeah.
 
What were the bad trips like?
 
Oh... Well they were really weird, yes. It was all the rage, and I thought you know, you thought you could see God by taking LSD or something in those days [laughs]. And and yes.
 
So what happened next after at the age of 16 you were getting into drugs and so on?
 
Well... I had a bad acid trip, I think at the age of 18. And that was, yes, I was sort of, I was 18 in the summer of 67 so that was quite good, you know. And then I went to university, at university and I was studying the wrong subject.
 
A so-called friend of mine advised me to do this. And, it was all the rage, and I did it, and I couldn’t really get into the work. So I got into the sort of social scene there.
 
And that was disastrous and I took another LSD trip and that was the beginning of my schizophrenia I think. Yes.  
 

Robert's mental health deteriorated dramatically when he started talking methamphetamine.

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Robert's mental health deteriorated dramatically when he started talking methamphetamine.

Age at interview: 45
Sex: Male
Age at diagnosis: 43
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Robert' It’s the amphetamine that done me.
 
Most definitely. I mean methamphetamine, a terrible bloody time. I mean years ago it used to be called speed. I mean to say there might have been a few mental health issues with speed, but nothing like there is with this methamphetamine. It, I don’t know, it just gets into, it gets in your head in a way that I’ve never experienced. Literally running around scared of your own shadow but …
 
Are you able to tell me what it feels like?
 
Robert' Exhales. Well it’s like, it’s all right at first, you know, the first few times you use it, but when you start getting used to it…. I don’t know, how do I put this? You’re literally scared of your own shadow half the time, most of the time you’re using the stuff. You don’t have much control over things, do you? Don’t have no control over the thoughts in your head or …
 
Partner' I don’t help because it don’t give you much sleep neither, because it keeps you awake don’t it? It keeps you awake 24 hours and puts you off food and everything.
 
Robert' Of course, so when you don’t eat or sleep for about six or seven days, you imagine state of me at the end of it like, after sort of six or seven days, and, that, that’s what really started my mental health issues. I’m 99% positive. No medical, I’ve got medical proof of it, but I know in myself that’s where it come from. 
 

Nada ‘lost control’ and she didn’t know what to do about finishing university.

Nada ‘lost control’ and she didn’t know what to do about finishing university.

Age at interview: 26
Sex: Female
Age at diagnosis: 22
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January early February whatever of my final year [laughter] you know, and I guess part of this was also an excuse to not be able deal with my finals because I had no idea how I was going to, what I was going to do after, no way could I have returned to any, you know, to, you know the thing that terrified me the most was in a way finishing uni and what the hell was I going to do then. You know, so I almost created this complete insane kind of like, you know drama again in a way to kind of like avoid sort of dealing with yes reality or whatever. but I remember having a trip with this person I was with and it was quite a full on trip as well and after that I never properly managed to leave that, that trip kind of thing, I’d done so much as well by this point as well that trips had started to affect me quite negatively as well even though I didn’t maybe stop doing them. They weren’t always this incredible wow experience that I’d had off them of like experiencing things like, you know what I mean it was, you know, they’d become quite dark too, because you can’t help but introspect and yes I don’t know. I guess went through sort of the emotions of it all at the time or something but I kind of wanted to shut down, if that makes sense. 
Aside from frightening experiences and worsening mental health, a couple of people said they’d been concerned about their behaviour whilst under the influence of alcohol and/or drugs.
 

Kirsty’s problem with alcohol led her to being promiscuous which she now feels is a form of self...

Kirsty’s problem with alcohol led her to being promiscuous which she now feels is a form of self...

Age at interview: 40
Sex: Female
Age at diagnosis: 24
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Previously I had, I had a slight problem with alcohol, but I’m virtually teetotal now, and that. It certainly is a long time since I’ve been bladdered. And you know, as you’ve heard I don’t really like going up the pub, unless it’s sort of, during the day and that where things are quite light atmosphere. Yes.
 
So what was it like, you said you had a problem, why was it a problem?
 
I think it was bec… I think it was propping me up every day. I didn’t feel as if I could function without it, sort of thing, you know. And it wasn’t doing me any favours. I wasn’t you know, popular with my friends and that, I wasn’t a particularly nice person to know, always when I’d had a few drinks and that. And certainly when I was younger if I’d had a few drinks than I was all free and easy, which wasn’t doing my reputation or my self-esteem much good, you know.
 
Yes. So it was destructive behaviour. And perhaps more, socially acceptable than cutting yourself up or whatever, but destructive behaviour all the same. Yes.  
 

Green Lettuce had extreme and confusing reactions to smoking weed and drinking alcohol.

Green Lettuce had extreme and confusing reactions to smoking weed and drinking alcohol.

Age at interview: 25
Sex: Male
Age at diagnosis: 20
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I’ve had like weird things happen before like when I was smoking really quick, and really strong stuff I was... I was blacked out, hit my head on concrete, and like apparently I was like kicking a door because I was in like an archway thing. And I was like unconscious for like five or ten minutes. Then I woke up, and it was like a bit of my brain just vanished into thin air. It’s ridiculous. I don’t know why. But that’s happened before, although it was different circumstances. It was in a concert and I had a beer and someone must have put something in it. Because I drank some, and then I, within like two minutes I’d blacked out and I was on the floor, and then my mates didn’t know, but I think I was unconscious for like ten minutes.
 
Well they couldn’t see me, because they was just packed. People were probably walking all over me. 
 
Well-being and recovery
Many people who had misused alcohol and drugs in the past were now reducing their use of them or even avoiding them altogether. Several talked about their struggles to change their habits, and avoid particular people or stressful situations, e.g. certain friends, or going to pubs. A few people said that finding other things to do (e.g. sport) or moving to another city helped reduce their drug use.
 

Jenni can now cope with people doing drugs around her.

Jenni can now cope with people doing drugs around her.

Age at interview: 30
Sex: Female
Age at diagnosis: 26
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Well I think that smoking marijuana just was making me more and more depressed, and yes, it just got on top of me, and it was like a bad feeling that wouldn’t go away, and it was a feeling that I was like clinging onto because my worth was so low. Yeah. Yeah. But like, I can handle people doing drugs now. They can do drugs around me, they can drink around me, and I don’t necessarily stigmatise them into thinking that it’s doing bad things for them, because they might be totally comfortable with it and just enjoying the high. But for me it went out of control.
 
Did the high go out of control or did the …?
 
The lows. I just got like… I got addicted to a bad thing. To a thing that was bad for me. Like I checked I was it, even though it wasn’t making me feel very well. It’s strange what I was doing, but that’s just what I did. I thought it looked good. Yeah. 
 
 

Simon gave up alcohol, LSD and cannabis but still smokes cigarettes.

Simon gave up alcohol, LSD and cannabis but still smokes cigarettes.

Age at interview: 61
Sex: Male
Age at diagnosis: 20
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I think I took my last LSD trip when I was about 22 I think. I even took some LSD trips after I came out of hospital. Which was a bit silly. And I stopped smoking cannabis, I think at the age of 35. [2 sec pause] I was smoking with a friend, and I just thought, I thought my friend might be going to kill me and I thought oh my God. So I stopped taking it. I gave up drinking at the age of 40. I still smoke cigarettes a lot though. 
 
Yes, when I was in hospital I thought people kept giving me drugs [laughs]. It was funny and I was so desperate I was just taking them, you know, it was a crazy situation. Yes.
 
As an in-patient?
 
Yes. Yes.
 
What were they giving you?
 
Cannabis. God knows what. They just gave me stuff and I took it. And it was terrible [laughs]. It’s against my religious vows not to take any street drugs. I wouldn’t go back on that anyway. Yes. 
 
 

Mary says her son finds it hard not to socialise without drinking too much when on psychiatric...

Mary says her son finds it hard not to socialise without drinking too much when on psychiatric...

Age at interview: 61
Sex: Female
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I know it has been a long struggle.
 
But I mean I know it’s, [clears throat] early days, and it’s something that he’s going to have to live with and sort of try and manage himself. Which he is, which he is doing [coughs]. He knows he can’t drink too much whenever he’s… and I mean young men that socialise… well I don’t know in this town anyway, no matter what town you’re in, you do end up going out for drinks and so forth. And I think its also trying to manage that as well. That he can’t drink too much. But he seems to be doing all right at the moment. 
 


Last reviewed July 2017.
Last updated April 2014.
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