Substance Abuse & First Episode Psychosis


Research from Italy “adds to previous evidence” of the role that substance abuse plays in first episode psychosis.  The researchers point to substance abuse as a “potentially modifiable” environmental factor that could ameliorate the course of psychosis if identified at the outset.

Abstract →

Tarricone, I., Boydell, J., Panigada, S., Allegri, F.; The impact of substance use at psychosis onset on First Episode Psychosis course: Results from a 1 year follow-up study in Bologna. Schizophrenia Research. Online February 11, 2014.

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Kermit Cole
Kermit Cole, MFT, founding editor of Mad in America, works in Santa Fe, New Mexico as a couples and family therapist. Inspired by Open Dialogue, he works as part of a team and consults with couples and families that have members identified as patients. His work in residential treatment — largely with severely traumatized and/or "psychotic" clients — led to an appreciation of the power and beauty of systemic philosophy and practice, as the alternative to the prevailing focus on individual pathology. A former film-maker, he has undergraduate and master's degrees in psychology from Harvard University, as well as an MFT degree from the Council for Relationships in Philadelphia. He is a doctoral candidate with the Taos Institute and the Free University of Brussels. You can reach him at [email protected].


  1. For a wile many clients were coming into the drug and alcohol treatment centers after falling down the rabbit hole of psychosis from smoking that fake marijuana called Spice and K2. The numbers started to fall after the stuff was pulled from the shelves in most states.

    One guy I remember was always talking about the “Illuminati” and the 911 conspiracy theories when he first came in but in a few weeks seemed to get over it.

    Check out these google results

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  2. Of course, hospitals (psych hosp) that a person ends up in when their mind goes into an altered state and given the FEP diagnosis do tests for substances. But running a toxicology report and then ignoring the findings is exactly what happened to my son in 2009. The hosp deemed my son “just a recreational cannabis user” as if this drug has no mind-altering effects so the adverse effects were dismissed as though the report was negative. Would my than 23 y/o son in that frightened state, especially after being beaten by the night staff once he went voluntarily inside, admit he had taken any other substance prior to being admitted (which upon d/c 10 days later my son later opened up to several other substances he did use but were not picked up by the tox report because of shorter half life…)? No, he was too afraid of saying a word to the staff again for fear what else they would do to further harm him. So, my son was saddled with a MI in the blink of an eye, meds for life. Even though I believed my son’s “recreational” use of today’s pot was the trigger along with many stressors he had been dealt in a short time period (“negative life experiences” per the CASPER Foundation- Maria Bradshaw, NZ) no “expert” agreed, in fact preached “recreational” use is not addiction. Oh, so many blunders. My son suffered taking the toxic meds, eventually weaned off the meds, agreed to see a psychologist but wasn’t a big proponent of psychotherapy. Eventually he returned to the culture with his wife and friends of “recreational” substance use and 18 months after the FEP, suffered a second. It’s tough on a proud young male ego, who was known for his strong will and out-going personality to be struck twice with “psychosis”. As his world collapsed the second time, another 10 wks to come out of that altered state (same time frame as the first time), tox report once again + for “THC”. The second hosp was more damaging emotionally than the first as we, his family, sought only drug rehab because after all he returned to “substance use” but this bastardly facility just were licking their chops at another “psychotic” with PPO ins and parents willing to cough up thousands. Drug rehab that was promised before my son was admitted, never occurred. What that hospital in Pasadena, CA did was reprehensible. Not only did they not help him, but made him far, far worse then “dumped” him from a locked ward after 13 days held against his will (and the medical records support this). Why would “the system” not want to help a beautiful young man in the prime of his life and make the assoc how substances cause mental health changes to the young brain? Maybe, my son would have felt “hope” instead of “hopeless” upon discharge. Maybe, the outcome since we were kept in the dark that once inside his thoughts turned dark, suicidal and homicidal- never before had these thoughts which he kept a secret (and so did the locked unit) until 7 months after release, he took his life.

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  3. My FEP occurred two weeks after being put on Risperdal to cure adverse effects from Wellbutrin withdrawal (for smoking cessation), Ultram, Voltaren (for “bad fix” on ankle). It was terrifying, I wouldn’t leave my bedroom for three days.

    What’s pathetic, however, is psychiatrists claim it’s impossible for antipsychotics to cause psychosis. But I’ve found medical journal articles proving that antipsychotics have been known to cause psychosis for 50 years now, since 1964.

    I’m so sorry about your son, larmac. No one deserves the terror, abuse, and torture the psychiatrists are perpetrating, they’re sadistic psychopaths. I’m so sorry your baby was attacked.

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