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Various [[Psychoactive drug|psychoactive substances]] (both legal and illegal) have been implicated in causing, exacerbating, or precipitating psychotic states or disorders in users, with varying levels of evidence. This may be upon intoxication for a more prolonged period after use, or upon [[drug withdrawal|withdrawal]].<ref name="Cardinal_2011_diagnosis_psychosis" /> Individuals who experience substance-induced psychosis tend to have a greater awareness of their psychosis and tend to have higher levels of [[Suicidal ideation|suicidal thinking]] compared to those who have a primary psychotic illness.<ref name="pmid21728034">{{cite journal | vauthors = Grant KM, LeVan TD, Wells SM, Li M, Stoltenberg SF, Gendelman HE, Carlo G, Bevins RA | display-authors = 6 | title = Methamphetamine-associated psychosis | journal = Journal of Neuroimmune Pharmacology | volume = 7 | issue = 1 | pages = 113–139 | date = March 2012 | pmid = 21728034 | pmc = 3280383 | doi = 10.1007/s11481-011-9288-1 | author6-link = Howard E. Gendelman }}</ref> Drugs commonly alleged to induce psychotic symptoms include [[Alcohol (drug)|alcohol]], [[Cannabis (drug)|cannabis]], [[cocaine]], [[amphetamine]]s, [[cathinone]]s, [[psychedelic drug]]s (such as [[Lysergic acid diethylamide|LSD]] and [[psilocybin]]), [[κ-opioid receptor]] [[agonist]]s (such as [[enadoline]] and [[salvinorin A]]) and [[NMDA receptor antagonist]]s (such as [[phencyclidine]] and [[ketamine]]).<ref name="Cardinal_2011_diagnosis_psychosis" /><ref>{{cite journal | vauthors = Krebs TS, Johansen PØ | title = Psychedelics and mental health: a population study | journal = PLOS ONE | volume = 8 | issue = 8 | pages = e63972 | date = August 2013 | pmid = 23976938 | pmc = 3747247 | doi = 10.1371/journal.pone.0063972 | doi-access = free | bibcode = 2013PLoSO...863972K }}</ref> [[Caffeine]] may worsen symptoms in those with schizophrenia and cause psychosis at very high doses in people without the condition.<ref>{{cite journal | vauthors = Alasmari F | title = Caffeine induces neurobehavioral effects through modulating neurotransmitters | journal = Saudi Pharmaceutical Journal | volume = 28 | issue = 4 | pages = 445–451 | date = April 2020 | pmid = 32273803 | pmc = 7132598 | doi = 10.1016/j.jsps.2020.02.005 }}</ref><ref>{{Cite journal | vauthors = Beauchamp G, Amaducci A, Cook M |date=2017-09-01|title=Caffeine Toxicity: A Brief Review and Update |journal=Clinical Pediatric Emergency Medicine|series=Toxicology|language=en|volume=18|issue=3|pages=197–202|doi=10.1016/j.cpem.2017.07.002|issn=1522-8401}}</ref> Cannabis and other illicit recreational drugs are often associated with psychosis in adolescents and cannabis use before 15 years old may increase the risk of psychosis in adulthood.<ref name=":3" />
==== Alcohol ====
{{Further|Long-term effects of alcohol consumption#Mental health effects}}
Approximately three percent of people with [[alcoholism]] experience psychosis during acute intoxication or withdrawal. Alcohol related psychosis may manifest itself through a [[kindling (sedative-hypnotic withdrawal)|kindling mechanism]]. The mechanism of alcohol-related psychosis is due to the [[long-term effects of alcohol consumption]] resulting in distortions to neuronal membranes, [[gene expression]], as well as [[thiamine]] deficiency. It is possible that hazardous alcohol use via a kindling mechanism can cause the development of a chronic substance-induced psychotic disorder, i.e. schizophrenia. The effects of an alcohol-related psychosis include an increased risk of depression and suicide as well as causing psychosocial impairments.<ref>{{cite journal | vauthors = Castillo-Carniglia A, Keyes KM, Hasin DS, Cerdá M | title = Psychiatric comorbidities in alcohol use disorder | journal = The Lancet. Psychiatry | volume = 6 | issue = 12 | pages = 1068–1080 | date = December 2019 | pmid = 31630984 | pmc = 7006178 | doi = 10.1016/S2215-0366(19)30222-6 }}</ref> [[Delirium tremens]], a symptom of chronic alcoholism that can appear in the acute withdrawal phase, shares many symptoms with alcohol-related psychosis suggesting a common mechanism.<ref>{{cite journal | vauthors = Jordaan GP, Emsley R | title = Alcohol-induced psychotic disorder: a review | journal = Metabolic Brain Disease | volume = 29 | issue = 2 | pages = 231–243 | date = June 2014 | pmid = 24307180 | doi = 10.1007/s11011-013-9457-4 | url = http://link.springer.com/10.1007/s11011-013-9457-4 | access-date = 2021-01-20 | url-status = live | s2cid = 17239167 | archive-url = https://web.archive.org/web/20211018155817/https://link.springer.com/article/10.1007%2Fs11011-013-9457-4 | archive-date = 2021-10-18 }}</ref>
=== Medication ===
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