Opioid-Induced Hallucinations: A Case Report

This article presents the case of a 67-year-old African American male patient who was referred to a psychiatry clinic by his Internal Medicine Provider with a diagnosis of "schizophrenia, unspecified." The patient reported the onset of auditory and visual hallucinations (AVHs) two years ago, coinciding with his starting Norco (hydrocodone 5 mg/acetaminophen 325 mg) for chronic back pain. He noted that his AVH worsened when he increased his prescribed Norco dosage (within his prescribed recommended range) and observed that the hallucinations ceased when he discontinued the medication. This case highlights the potential for opioid-induced AVH to be misdiagnosed as schizophrenia while emphasizing the importance of careful evaluation of opioid use in psychiatric assessments.