Iranian psychiatrists are warning of a sharp rise in acute psychiatric emergencies linked to drug use, particularly among adolescents, raising concerns that the country may face a wave of long-term psychotic disorders if the trend continues.
Doctors working in public and private psychiatric hospitals told Tehran-based daily Etemad that they are seeing growing numbers of patients with no prior mental illness who develop severe psychotic symptoms after using narcotics and synthetic stimulants.
Many require emergency hospitalization, and some go on to develop lasting psychiatric disorders.
A senior psychiatrist at a 100-bed psychiatric hospital in southwest Tehran said that typically 15 to 20 percent of inpatient beds are occupied by patients admitted after drug-induced psychosis.
“Acute symptoms mean a crisis – self-harm, violence toward others, suicidal behavior, severe delusions and hallucinations,” the doctor said, adding that most arrive in an aggressive and disoriented state.
“These patients must often be physically restrained during transfer because they pose an immediate danger to themselves and others,” the psychiatrist said, noting that many families cannot afford private ambulances and that treatment costs are not covered by insurance.
Teens increasingly at risk
The most troubling shift is the age profile, doctors say. While hospitals previously treated mostly adult men, adolescents now make up a growing share of emergency admissions.
“More than half of pediatric psychiatric admissions are teenagers who have used heavy substances,” one psychiatrist said, adding that cannabis derivatives are now “circulating like chewing gum” among youths.
Another doctor described a rise in cases involving homemade drug mixtures and hallucinogens such as LSD and mushrooms. “Some teenagers believe they are entering a spiritual world,” he said. “Instead, they arrive with persistent hallucinations that can last for years.”
A resident psychiatrist at a public hospital said that in the past year, 10–20% of emergency psychiatric visits involved first-time psychosis triggered by drug use. “Some test negative for substances by the time they reach us, yet they are hallucinating and delusional,” he said. “Even if symptoms subside after treatment, continued drug use puts them at high risk of developing chronic disorders.”
Warnings of long-term fallout
Stimulants such as methamphetamine and cocaine sharply increase the risk of severe behavioral changes, Mohammadreza Shalbafan, head of mental health and addiction at the Iranian Ministry of Health told Etemad. “These reactions are not limited to people with a psychiatric history,” he said. “No drug user is immune.”
Toxicologist Kambiz Soltaninejad, speaking at a medical workshop in September 2025, warned that high-potency cannabis strains pose the greatest risk. “With teenage use rising, we should expect a schizophrenia tsunami in the near future,” he said.
Advocacy groups say the warnings confirm what they have long observed. Rising use of hallucinogens has already pushed hospital admissions higher, Tayebeh Dehbashizadeh, head of the Association for the Support of Schizophrenia Patients said.
“Global estimates suggest one percent of any population has schizophrenia,” she said. “In Iran, that number is climbing.”
Doctors caution that hospital data capture only the most severe cases. “We are seeing just the tip of the iceberg,” one psychiatrist said. “Many more are deteriorating quietly at home, unnoticed – until it’s too late.”
Cases that haunt clinicians
Doctors interviewed by Etemad described cases that continue to trouble them years later. One psychiatrist recalled a 27-year-old man who developed vivid, shifting hallucinations after consuming a small amount of psychedelic mushrooms. He remained trapped in a fantasy world for nearly two years before briefly regaining clarity, only to spiral into severe post-traumatic stress and later schizophrenia after renewed stress, requiring lifelong treatment.
Another case involved a 16-year-old girl from a family affected by addiction, who began injecting drugs in early adolescence. She was admitted after fearing a fatal overdose and asking for help but disappeared days after being discharged from a pediatric ward.
“No one knows what happened to her after she walked out of the hospital,” a doctor said.
Clinicians also described patients who returned repeatedly after discharge, only to die from overdoses weeks later. “Some survive the psychosis, but not the next relapse,” one psychiatrist said. “That is the most devastating part.”
