Substance-Induced Delirium

Substance induced disorders (SID) can be differentiated from independent co-occurring mental disorders in that the presenting symptoms in a SID are a direct result of substance use, intoxication or withdrawal, as opposed to an underlying mental illness.  This is not to suggest that substance induced disorders preclude co-occurring mental disorders, and it is entirely feasible that a client with a well established mental disorder may also experience a substance induced disorder that is distinct from their diagnosis.

One of the most prevalent substance induced disorders is substance induced delirium.  Delirium is a medical term that refers to abnormal fluctuations in consciousness that can precipitate rapidly shifting mental states. These shifts, which are unpredictable and labile, will often cause some amalgam of confusion, anxiety, euphoria agitation, depression, anger and/or irritability.  Delirious individuals also typically display symptoms of short term amnesia, along with an inability to moderate their actions or behaviors or speak coherently.

Substance-Induced Delirium

According to the guidelines set forth by the American Psychiatric Association, individuals with substance induced delirium display classic symptoms of delirium as a result of the use of alcohol, medication or drugs.  In order to qualify as a distinct disorder, the symptomatology must induce greater mental discord than the amount of disruption normally associated with consumption of said substance.  In addition to alcohol, the types of substances that are most frequently associated with substance induced delirium are PCP, amphetamines, opiods, inhalants, sedatives, hallucinogenics, cocaine, and anti-anxiety medication.  When the symptoms manifest is largely contingent on the type and quantity of the substance consumed.  For example, whereas symptoms of SID may occur immediately following the consumption of hallucinogens or cocaine, the same symptoms might not occur for several days in someone who is consuming only alcohol.


Most individuals who present with substance induced delirium will experience a reduction in symptoms once the inducing substance has left the body. However, in certain circumstances the symptoms of delirium can persist for long periods of time.  Certain population groups, like those with pre-existing brain damage and people of advanced are especially susceptible to prolonged symptoms of delirium.


If you suspect that an individual is suffering from substance induced delirium, it is important to understand their proclivity toward unpredictable, impulsive and dangerous behavior.  It is best to maintain a safe distance from the patient and secure the surrounding areas so that the individual does not cause further harm to self or others.  Subsequently, one should immediately notify the authorities and the individual should be transported to the nearest medical facility where they can undergo a monitored detox.