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Days without sleep, very high energy, or paranoia after using

Also called: Stimulant psychosis, stimulant overuse

Going days without sleep, having very high energy, or feeling paranoid after using stimulants like methamphetamine or cocaine can be dangerous. Stimulant psychosis needs care. Help is available at 1-800-662-4357.

Common causesMethamphetamine, cocaine, other stimulants
Usually serious?Yes
Get checked ifParanoia, confusion, or chest pain
If you think it's an emergency, call 911.Thinking about suicide or in crisis? Call or text 988.Being hurt or threatened at home? National Domestic Violence Hotline: 1-800-799-7233.Help with alcohol or drug use: SAMHSA Helpline, 1-800-662-4357.

Overview

Stimulants keep you awake and can cause paranoia and hallucinations.

Heart problems and overheating can happen.

When to get medical care

Call 911Chest pain, seizures, high fever, confusion, or danger to self or others. Thoughts of harming yourself or others: call or text 988, or call 911 if you're in danger.
Get care todayParanoia or seeing or hearing things.
See a doctor soonWanting help to stop.

Causes

Caused by stimulant use.

OwieClear has pages on 2 conditions that can cause days without sleep, very high energy, or paranoia after using. Each shows how soon to get care.

Common causes

  • Stimulant use (meth or cocaine)See a doctor if it doesn't get better

    Regular use of meth, cocaine, or other stimulants can cause severe tooth decay and dry mouth, picking sores from feeling bugs under the skin, weight loss, days…

Less likely causes

  • Psychosis or schizophreniaOften needs care today

    Psychosis means losing touch with what's real, such as hearing voices, seeing things others don't, or having strong beliefs others say aren't true, like being…

What you can do at home

  • Stop using.
  • Rest and drink water.
  • Be with someone safe.

Medicines

Treatment includes counseling and support.

At the doctor

The provider will check safety.

Questions you may be asked

  • Use
  • Symptoms

The exam

A physical exam.

Tests

  • Drug screen

Prevention

Get help.

  • Call 1-800-662-4357

Check your symptoms

Most symptoms have more than one possible cause. The symptom checker looks at all of your symptoms together, plus your age, and shows how soon to get care.

Start the symptom checker

Sources

Last updated 2026-11-13.