Psychotically Sheltered

Three Blunts Later

Many psychotic patients have lost everything or never had much to begin with. Their home is the shelter or a psychiatric supportive house where they spend their days doing whatever they want. Many don’t have any requirements; they can sleep all day, create music, go to work . . . it’s up to them. Many continue to abuse drugs on the streets: popular ones in New York City are crack, cocaine and heroin; don’t count out marijuana.

But this is the problem with these shelters: they don’t drug test and even if they did, would they just kick out psychotic residents? They would all just turn homeless and nothing productive would be accomplished. So they continue to abuse drugs and take advantage of the free room and board. The problem with psychotic patients is that drugs impair their judgment and insight.

In the moment while they’re getting high, they’ll report to you that they feel better and that their symptoms have calmed down, depending on which drug they are using. If it’s crack or meth, their symptoms tend to get worse: they become paranoid, start hearing voices commanding them to commit violent acts and may even start experiencing visual hallucinations.

If it’s marijuana, many psychotic patients will report that the weed relaxes them and clears their mind. It may very well do that, but marijuana is prone to cause and worsen psychosis, especially the highly potent strains going around these days. Three blunts later and many of these patients start hallucinating, experiencing disorganized thoughts and behavior and freaking out.

Keep in mind that many psychotic patients are noncompliant with medications because they believe that they don’t have a mental illness. Add three blunts a day on top of poor insight and it turns into a recipe for a mental health disaster. It’s not usually the patient that brings himself into the hospital; it’s the residents or staff at the shelter that escalate the process due to their disruptive and dysregulated behavior.

There is no psychotic patient or mental health patient who I have met that benefited from drug use, including marijuana. They may tell me that they like weed and it calms them down, but then why are they in the hospital in the first place? What’s surprising is that many schizophrenic patients inform me that they’ll probably go back to using marijuana despite being hospitalized.

This is how powerful drugs are and we must continue to spread awareness for drug addiction and advocate for more resources devoted to the treatment and healing of drug addicts. But first we must continue to call on all the drug addicts to come out of the shadows and provide them with a safe and supportive environment and this platform is known as The DSM Ready Community.

Are you Ready? (This is Defeating Stigma Mindfully)