GuidelinesPrimary Care STG
Substance-Induced Psychosis
Description General Measures Medicine Treatment Referral ICD-10 code: F10.0-F19.9 + (R40-R46/Z65.0-5/Z65.8-9/Z81.0-4/Z81.8) Description Psychosis secondary to a substance use or withdrawal such as abuse of alcohol, drugs, e.g. cannabis and methamphetamines. General Measures Most patients with substance-induced psychosis can be managed without medication. Ensure the safety of the patie
ICD-10 code: F10.0-F19.9 + (R40-R46/Z65.0-5/Z65.8-9/Z81.0-4/Z81.8)
Description
Psychosis secondary to a substance use or withdrawal such as abuse of alcohol, drugs, e.g. cannabis and methamphetamines.
General Measures
- Most patients with substance-induced psychosis can be managed without medication.
- Ensure the safety of the patient and those caring for them.
- Minimise stress and stimulation (do not argue with psychotic thinking).
- Avoid confrontation or criticism, unless it is necessary to prevent harmful or disruptive behaviour.
Medicine Treatment
See: Aggressive disruptive behaviour in adults and Aggressive disruptive behaviour in children and adolescents.
Referral
- All patients to hospital for inpatient management of psychosis.
- All patients to social worker for referral to substance rehabilitation centres.
Standard Treatment Guidelines and Essential Medicines List for South Africa Primary Healthcare Level_Chapter 16: Mental Health Conditions_NEMLC Recommendations for Medicine Amendments 2020_2023
ICD-10 codes
- F10.0Mental and behavioural disorders due to use of alcohol, acute intoxication
- F10.1Mental and behavioural disorders due to use of alcohol, harmful use
- F10.2Mental and behavioural disorders due to use of alcohol, dependence syndrome
- F10.3Mental and behavioural disorders due to use of alcohol, withdrawal state
- F10.4Mental and behavioural disorders due to use of alcohol, withdrawal state with delirium
- F10.5Mental and behavioural disorders due to use of alcohol, psychotic disorder
- F10.6Mental and behavioural disorders due to use of alcohol, amnesic syndrome
- F10.7Mental and behavioural disorders due to use of alcohol, residual and late-onset psychotic disorder
- F10.8Mental and behavioural disorders due to use of alcohol, other mental and behavioural disorders
- F10.9Mental and behavioural disorders due to use of alcohol, unspecified mental and behavioural disorder
- F11.0Mental and behavioural disorders due to use of opioids, acute intoxication
- F11.1Mental and behavioural disorders due to use of opioids, harmful use
- F11.2Mental and behavioural disorders due to use of opioids, dependence syndrome
- F11.3Mental and behavioural disorders due to use of opioids, withdrawal state
- F11.4Mental and behavioural disorders due to use of opioids, withdrawal state with delirium
- F11.5Mental and behavioural disorders due to use of opioids, psychotic disorder
- F11.6Mental and behavioural disorders due to use of opioids, amnesic syndrome
- F11.7Mental and behavioural disorders due to use of opioids, residual and late-onset psychotic disorder
- F11.8Mental and behavioural disorders due to use of opioids, other mental and behavioural disorders
- F11.9Mental and behavioural disorders due to use of opioids, unspecified mental and behavioural disorder
- F12.0Mental and behavioural disorders due to use of cannabinoids, acute intoxication
- F12.1Mental and behavioural disorders due to use of cannabinoids, harmful use
- F12.2Mental and behavioural disorders due to use of cannabinoids, dependence syndrome
- F12.3Mental and behavioural disorders due to use of cannabinoids, withdrawal state
- F12.4Mental and behavioural disorders due to use of cannabinoids, withdrawal state with delirium
- F12.5Mental and behavioural disorders due to use of cannabinoids, psychotic disorder
- F12.6Mental and behavioural disorders due to use of cannabionoids, amnesic syndrome
- F12.7Mental and behavioural disorders due to use of cannabinoids, residual and late-onset psychotic disorder
- F12.8Mental and behavioural disorders due to use of cannabinoids, other mental and behavioural disorders
- F12.9Mental and behavioural disorders due to use of cannabinoids, unspecified mental and behavioural disorder
- F13.0Mental and behavioural disorders due to use of sedatives or hypnotics, acute intoxication
- F13.1Mental and behavioural disorders due to use of sedatives or hypnotics, harmful use
- F13.2Mental and behavioural disorders due to use of sedatives or hypnotics, dependence syndrome
- F13.3Mental and behavioural disorders due to use of sedatives or hypnotics, withdrawal state
- F13.4Mental and behavioural disorders due to use of sedatives or hypnotics, withdrawal state with delirium
- F13.5Mental and behavioural disorders due to use of sedatives or hypnotics, psychotic disorder
- F13.6Mental and behavioural disorders due to use of sedatives or hypnotics, amnesic syndrome
- F13.7Mental and behavioural disorders due to use of sedatives or hypnotics, residual and late-onset psychotic disorder
- F13.8Mental and behavioural disorders due to use of sedatives or hypnotics, other mental and behavioural disorders
- F13.9Mental and behavioural disorders due to use of sedatives or hypnotics, unspecified mental and behavioural disorder
- F14.0Mental and behavioural disorders due to use of cocaine, acute intoxication
- F14.1Mental and behavioural disorders due to use of cocaine, harmful use
- F14.2Mental and behavioural disorders due to use of cocaine, dependence syndrome
- F14.3Mental and behavioural disorders due to use of cocaine, withdrawal state
- F14.4Mental and behavioural disorders due to use of cocaine, withdrawal state with delirium
- F14.5Mental and behavioural disorders due to use of cocaine, psychotic disorder
- F14.6Mental and behavioural disorders due to use of cocaine, amnesic syndrome
- F14.7Mental and behavioural disorders due to use of cocaine, residual and late-onset psychotic disorder
- F14.8Mental and behavioural disorders due to use of cocaine, other mental and behavioural disorders
- F14.9Mental and behavioural disorders due to use of cocaine, unspecified mental and behavioural disorder
- F15.0Mental and behavioural disorders due to use of other stimulants, including caffeine, acute intoxication
- F15.1Mental and behavioural disorders due to use of other stimulants, including caffeine, harmful use
- F15.2Mental and behavioural disorders due to use of other stimulants, including caffeine, dependence syndrome
- F15.3Mental and behavioural disorders due to use of other stimulants, including caffeine, withdrawal state
- F15.4Mental and behavioural disorders due to use of other stimulants, including caffeine, withdrawal state with delirium
- F15.5Mental and behavioural disorders due to use of other stimulants, including caffeine, psychotic disorder
- F15.6Mental and behavioural disorders due to use of other stimulants, including caffeine, amnesic syndrome
- F15.7Mental and behavioural disorders due to use of other stimulants, including caffeine, residual and late-onset psychotic disorder
- F15.8Mental and behavioural disorders due to use of other stimulants, including caffeine, other mental and behavioural disorders
- F15.9Mental and behavioural disorders due to use of other stimulants, including caffeine, unspecified mental and behavioural disorder
- F16.0Mental and behavioural disorders due to use of hallucinogens, acute intoxication
- F16.1Mental and behavioural disorders due to use of hallucinogens, harmful use
- F16.2Mental and behavioural disorders due to use of hallucinogens, dependence syndrome
- F16.3Mental and behavioural disorders due to use of hallucinogens, withdrawal state
- F16.4Mental and behavioural disorders due to use of hallucinogens, withdrawal state with delirium
- F16.5Mental and behavioural disorders due to use of hallucinogens, psychotic disorder
- F16.6Mental and behavioural disorders due to use of hallucinogens, amnesic syndrome
- F16.7Mental and behavioural disorders due to use of hallucinogens, residual and late-onset psychotic disorder
- F16.8Mental and behavioural disorders due to use of hallucinogens, other mental and behavioural disorders
- F16.9Mental and behavioural disorders due to use of hallucinogens, unspecified mental and behavioural disorder
- F17.0Mental and behavioural disorders due to use of tobacco, acute intoxication
- F17.1Mental and behavioural disorders due to use of tobacco, harmful use
- F17.2Mental and behavioural disorders due to use of tobacco, dependence syndrome
- F17.3Mental and behavioural disorders due to use of tobacco, withdrawal state
- F17.4Mental and behavioural disorders due to use of tobacco, withdrawal state with delirium
- F17.5Mental and behavioural disorders due to use of tobacco, psychotic disorder
- F17.6Mental and behavioural disorders due to use of tobacco, amnesic syndrome
- F17.7Mental and behavioural disorders due to use of tobacco, residual and late-onset psychotic disorder
- F17.8Mental and behavioural disorders due to use of tobacco, other mental and behavioural disorders
- F17.9Mental and behavioural disorders due to use of tobacco, unspecified mental and behavioural disorder
- F18.0Mental and behavioural disorders due to use of volatile solvents, acute intoxication
- F18.1Mental and behavioural disorders due to use of volatile solvents, harmful use
- F18.2Mental and behavioural disorders due to use of volatile solvents, dependence syndrome
- F18.3Mental and behavioural disorders due to use of volatile solvents, withdrawal state
- F18.4Mental and behavioural disorders due to use of volatile solvents, withdrawal state with delirium
- F18.5Mental and behavioural disorders due to use of volatile solvents, psychotic disorder
- F18.6Mental and behavioural disorders due to use of volatile solvents, amnesic syndrome
- F18.7Mental and behavioural disorders due to use of volatile solvents, residual and late-onset psychotic disorder
- F18.8Mental and behavioural disorders due to use of volatile solvents, other mental and behavioural disorders
- F18.9Mental and behavioural disorders due to use of volatile solvents, unspecified mental and behavioural disorder
- F19.0Mental and behavioural disorders due to multiple drug use and use of other psychoactive substances, acute intoxication
- F19.1Mental and behavioural disorders due to multiple drug use and use of other psychoactive substances, harmful use
- F19.2Mental and behavioural disorders due to multiple drug use and use of other psychoactive substances, dependence syndrome
- F19.3Mental and behavioural disorders due to multiple drug use and use of other psychoactive substances, withdrawal state
- F19.4Mental and behavioural disorders due to multiple drug use and use of other psychoactive substances, withdrawal state with delirium
- F19.5Mental and behavioural disorders due to multiple drug use and use of other psychoactive substances, other psychotic disorder
- F19.6Mental and behavioural disorders due to multiple drug use and use of other psychoactive substances, amnesic syndrome
- F19.7Mental and behavioural disorders due to multiple drug use and use of other psychoactive substances, residual and late-onset other psychotic disorder
- F19.8Mental and behavioural disorders due to multiple drug use and use of other psychoactive substances, other mental and behavioural disorders
- F19.9Mental and behavioural disorders due to multiple drug use and use of other psychoactive substances, unspecified mental and behavioural disorder
- R40.0Somnolence
- R40.1Stupor
- R40.2Coma, unspecified
- R41.0Disorientation, unspecified
- R41.1Anterograde amnesia
- R41.2Retrograde amnesia
- R41.3Other amnesia
- R41.8Other and unspecified symptoms and signs involving cognitive functions and awareness
- R42Dizziness and giddiness
- R43.0Anosmia
- R43.1Parosmia
- R43.2Parageusia
- R43.8Other and unspecified disturbances of smell and taste
- R44.0Auditory hallucinations
- R44.1Visual hallucinations
- R44.2Other hallucinations
- R44.3Hallucinations, unspecified
- R44.8Other and unspecified symptoms and signs involving general sensations and perceptions
- R45.0Nervousness
- R45.1Restlessness and agitation
- R45.2Unhappiness
- R45.3Demoralization and apathy
- R45.4Irritability and anger
- R45.5Hostility
- R45.6Physical violence
- R45.7State of emotional shock and stress, unspecified
- R45.8Other symptoms and signs involving emotional state
- R46.0Very low level of personal hygiene
- R46.1Bizarre personal appearance
- R46.2Strange and inexplicable behaviour
- R46.3Overactivity
- R46.4Slowness and poor responsiveness
- R46.5Suspiciousness and marked evasiveness
- R46.6Undue concern and preoccupation with stressful events
- R46.7Verbosity and circumstantial detail obscuring reason for contact
- R46.8Other symptoms and signs involving appearance and behaviour
- Z65.0Conviction in civil and criminal proceedings without imprisonment
- Z65.1Imprisonment and other incarceration
- Z65.2Problems related to release from prison
- Z65.3Problems related to other legal circumstances
- Z65.4Victim of crime and terrorism
- Z65.5Exposure to disaster, war and other hostilities
- Z65.8Other specified problems related to psychosocial circumstances
- Z65.9Problem related to unspecified psychosocial circumstances
- Z81.0Family history of mental retardation
- Z81.1Family history of alcohol abuse
- Z81.2Family history of tobacco abuse
- Z81.3Family history of other psychoactive substance abuse
- Z81.4Family history of other substance abuse
- Z81.8Family history of other mental and behavioural disorders