Recently, the concept of harm reduction has become widespread in the field of dependence treatment. The idea is not to seek abstinence from alcohol and/or drugs by the dependency patient, but rather to support the suppression of the substance abuse to the extent that the health hazard is reduced as much as possible. According to the self-treatment hypothesis, those who become addicted abuse drugs to escape trauma, such as abuse in early childhood, encountering poor social situations, and mental distress arising from discrimination due to ethnic or sexual status. There is no problem with recommending support without stigma for drug-dependent patients, who often face social stigma. However, this should not lead to an attitude that blames strict regulation on minority discrimination and tries to advance sudden structural reform for the tolerization of illicit drug abuse. Stimulants cause psychosis due to long-term abuse, sometimes leading to serious crimes, and psychotic symptoms may become chronic and serious. The perspective on toxic psychosis is missing from the discussion on harm reduction. In this paper, the case of a stimulant psychosis patient who continued treatment at this hospital for more than 10 years is reported. We wish to provide a reference for considering what kind of countermeasures are appropriate considering the drug abuse situation in our country.
Authors' abstract
The Long-term Course of Methamphetamine-Related Psychiatric Disorders: A Cautionary Tale for Careless Harm Reduction
Shimofusa Psychiatric Medical Center
Psychiatria et Neurologia Japonica
124: 763-770, 2022
Accepted in revised form: 20 June 2022.
Accepted in revised form: 20 June 2022.
<Keywords:methamphetamine psychosis, harm reduction, self-medication hypothesis>