Unspecified psychosis and stimulant drugs: A commentary on current trends

With the increasing potency of substances in British Columbia and ever-evolving substance use patterns, many British Columbians continue to present to hospitals with unspecified psychosis. It is unclear what portion of these cases is attributable to substance use or medical etiologies rather than a primary psychotic disorder on initial clinical presentation. Stimulants, in particular, account for many substance-induced psychosis cases. Differentiating stimulant-induced psychosis from other etiologies of psychosis in emergency department settings can streamline pharmacotherapy and health management decisions, such as addressing underlying substance use behaviors and using antipsychotic medications to improve patient outcomes. Further, many patients who experience stimulant-induced psychosis are at increased risk of later developing primary psychosis should their substance use continue. Psychoeducational and medical interventions may reduce the possibility of transformation. In this commentary, we discuss stimulant use trends and associated nuances in BC.