Characterizing the Impacts of Psychosis on Methamphetamine Use Patterns Among Individuals with Methamphetamine-Associated Psychosis

BACKGROUND: Psychosis is a complex neuropsychiatric state which can be induced by methamphetamine. How methamphetamine-associated psychosis (MAP) is perceived by those who experience it, and whether it increases or reduces motivation for recovery is unclear. OBJECTIVE: Using qualitative methods, our study explored the relationships between MAP and subjective changes in methamphetamine use among individuals with a history of MAP. We sought to identify salient experiences of MAP and relationships between these experiences and methamphetamine use patterns, to inform intervention development for persons with MAP. METHODS: As part of a larger observational study on MAP, we conducted semi-structured interviews with participants (n = 21) who had recently recovered from an episode of MAP. Interviews queried experiences with MAP, use of methamphetamine in relation to psychosis, and treatment experiences. We developed a codebook based on the interview guide, which was iteratively tailored using emergent data from the transcripts and field notes and applied to all data. RESULTS: In response to MAP, participants increased, decreased, or did not change their use. Participants reported a variety of reasons for their change in use patterns. As expected, some participants reduced their use to reduce psychosis, but this was far from universal; some participants did not find psychotic symptoms motivating enough to change their use. Some participants increased their use to stay safe from perceived threats, and others increased or decreased their use in an idiosyncratic manner, depending on the content of the psychosis. CONCLUSIONS: Despite the common perception of psychosis as an undesirable experience, participants described a variety of changes in methamphetamine use patterns in response to MAP. Reported changes in use were complex and idiosyncratic, and many participants even reported increasing their use. Our findings add depth and nuance to our understanding of the relationship between psychosis and methamphetamine and may inform future clinical intervention research.