Delusion, in specific reference to addiction to alcohol and other drugs, is the ability of an individual to unconsciously trick themselves, through rationalising and justifying, enabling the continued use of narcotics or alcohol. It is usually in treatment that the patients awareness of the nature and severity of their condition become more clear and they can begin to assume responsibility for their recovery.

Delusion often manifests as denial or an inability to recognise the severity of one’s substance abuse problem. Addiction recovery professionals use the term delusion to emphasise the distorted thinking patterns commonly observed in individuals struggling with addiction. These individuals might convince themselves that they can control their substance use, despite experiencing negative consequences. They may also downplay the impact their addiction has on themselves and others around them.

It’s worth noting that delusion is not exclusive to addiction; it can be observed in various mental health conditions as well. However, within the context of rehabs and addiction treatment, delusion is particularly relevant due to its impact on the recovery process.

Drug-Induced Psychosis

Drug-induced psychosis can manifest in various ways, largely depending on the specific drug causing the symptoms. Common indicators include erratic responses to stimuli, such as screaming or wearing odd clothing for no clear reason and confusion. Delusions are a hallmark with individuals possibly believing they are persecuted, possess superhuman abilities or have other grandiose identities. Hallucinations, involving seeing or hearing things that aren’t there, often accompany these delusions, reinforcing them. Disorganised thinking might make it hard for the person to speak coherently or stay focused. In rare cases, catatonic behaviour can occur, where the individual is immobile and unresponsive. These symptoms, especially delusions and hallucinations, can lead to aggression or violence, necessitating careful management by those around them.

Delusional Disorders

Delusional disorder is a condition characterised by the presence of persistent beliefs that are either bizarre or non-bizarre, lasting at least a month. Unlike schizophrenia, individuals with delusional disorder may function normally in many aspects of life without significant impairment in social or occupational functioning. This disorder can manifest from a paranoid personality disorder with symptoms typically emerging in middle to late adulthood. Common signs include an obsession with loyalty, suspicion and perceiving non-existent threats, often leading to social isolation, relationship issues and legal or work problems if untreated.

The DSM-5 recognises both bizarre and non-bizarre delusions in delusional disorder, distinguishing it from previous criteria that only considered non-bizarre delusions. Mood disturbances and irritability can accompany the delusions, which, while not significantly disrupting life, can cause issues when provoked.

Co-occurring delusional disorder and substance abuse involve individuals experiencing persistent and often disturbing false beliefs, alongside problematic use of drugs or alcohol. Delusional disorder can manifest in various forms, such as somatic, erotomanic, jealous, grandiose, persecutory or mixed types of delusions, which can significantly impact a person’s ability to function and maintain relationships. Substance use may initially offer temporary relief from the distress caused by delusions but it ultimately leads to addiction without addressing the underlying delusional disorder. Denial often encompasses both addiction and delusional disorder with the affected individual potentially unwilling to acknowledge the presence of an issue.

Alcohol, being a central nervous system depressant, can temporarily alleviate the stress of delusions but reliance on it can quickly escalate into addiction. Similarly, drugs, whether stimulants like cocaine or depressants like opioids, provide only a brief escape from the symptoms of delusional disorder with addiction forming rapidly due to continued use. Cannabis, despite its reputation for mild euphoric effects, poses a risk for psychological dependency, especially when used as a self-medication strategy for delusional disorder.

The frequency of delusional disorder with substance abuse complicates the recovery process, necessitating comprehensive, evidence-based treatment that addresses both the addiction and the psychiatric condition. Dual diagnosis treatment plans are essential for individuals facing this combination of challenges offering a path to manage delusions and overcome addiction through focused, responsible treatment strategies.

The exact cause of delusional disorder is unknown but it may involve a combination of genetic, biological and environmental factors. A potential genetic link to schizophrenia suggests a familial predisposition, while biological aspects like brain chemistry imbalances or frontal lobe injuries and environmental stressors like job loss or legal troubles, might increase susceptibility. Treatment focuses on managing delusions to prevent them from interfering with daily life.

Founded in 2008, WeDoRecover has evolved from an advisory service for addiction treatment into a comprehensive provider of care, following its 2019 merger with Changes Addiction Rehab in Johannesburg. Specialising in connecting patients to top-tier addiction treatment centers in the UK, South Africa and supporting individuals in recovery world wide.

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