A Politically Incorrect Diagnosis
Substance Dependency-Induced Psychosis (SDIP) is an important idea for researchers in psychiatric illness
Since New York City Voices last reported on the disorder/diagnosis of “Substance Dependency-Induced Psychosis” (SDIP), additional very strong evidence for its validity has developed. I recently learned that the California Mental Health Department has been using knowledge of the diagnosis in its mental health system planning for several years. This had to be a direct result of my informing its medical director of the diagnosis in 2000. It is still considered a very politically incorrect diagnosis by the worldwide Psychiatric Establishment (PE). Certainly, they don’t officially mention the diagnosis to hide their “heresy” from the PE. A few years ago, the Psychiatric Chairman of the University of California at Davis kept me waiting for ten minutes to come to the telephone before hanging up. He had already ignored a couple of emails from me, and I realized that he was taking the easier and safer position of “no response” rather than trying to defend a political/unscientific position. I was trying to contact him to persuade him to organize the clinical research on the diagnosis, which is necessary for it to become officially established and available for the public welfare.
SDIP is nearly as common as schizophrenia, which it’s usually diagnosed as. Its victims are usually less ill, and most cases of “full recovery from schizophrenia” are actually cases of SDIP where the person has stopped their addictive substance use. However, in most SDIP cases where this happens, the person remains locked in their psychosis indefinitely.
The most common substances involved are alcohol, marijuana, tobacco, cocaine and amphetamines. Unlike the case with other substances, most SDIP sufferers can get a remission while still using tobacco. But like other addictive substances, withdrawing from it can trigger a relapse or an initial case of SDIP. The public has been let down by not being informed that tobacco use is not only very addictive, but like cocaine, it can facilitate the addition of other substance addictions, for example, alcoholism. The use of multiple substances and progression of the addiction all increase the risk of a SDIP. It is a particular shame that knowledge of the diagnosis is not available for persons undergoing treatment for substance dependency. Returning to even moderate substance use after a significant period of abstinence can quickly trigger the first appearance of SDIP. The initial onset of SDIP usually occurs during regular use of the substance(s). The patients’ admission of their dependency and realizing its causal role in their mental illness is critically important. Using largely an individual and group therapy (usually 12 step) approach, I have been able to achieve a full remission of SDIP in one-third of cases I have treated.
Psychiatrist Steven Sharfstein, the President of the APA, is to be respected for an article he wrote for their Journal. It had the whimsical title: “American Psychiatry and Big Pharma: The Good, The Bad, and The Ugly.” But it had the serious message of the much too close relationship between the two. The pharmaceutical industry views the SDIP diagnosis as being “anti-drug.” It isn’t though it does have strong implications for the overuse and overrepresentation of the effectiveness of antipsychotic drugs. The most impressive example of political/economic (pharmaceutical) incorrectness in the PE was the complete ignoring of the stunning implications of a World Health Organization report that found that undeveloped countries had better schizophrenic case outcomes than developed countries. The only reasonable explanation for this finding was the much lesser use of antipsychotic drugs in the former. This explanation was actually supported by the earlier Soteria Project -- which was carried out by a NIMH agency. It involved the residential treatment of acutely schizophrenic young males in a residential setting. They received no medication or formal psychotherapy, but did receive compassionate mentoring by intelligent volunteers. The results were significantly better than those of standard drug treatment. However, the Project was still soon ended by funding cuts. Psychiatrist Leonard Mosher, its designer, realized that the NIMH administrators had a “clubby relationship” with pharmaceutical representatives. He later stated: “Today’s psychiatric science is largely wish, myth and politics.”
The power of pharmaceutical advertising money has acted to censor any adequate media reporting on the diagnosis. Such would almost certainly soon result in outraged public pressure “persuading” a medical school to do the necessary research on the diagnosis. My efforts for the diagnosis are now focused on getting that media coverage. I am asking the readers of this message to spread the word about the diagnosis, and to try to get additional media coverage.