Substance Use

What Is Alcohol-Induced Psychosis? Symptoms & Treatment

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The symptoms of alcohol-induced psychosis are complex and dangerous. Alcohol-induced psychosis is a serious condition that results in hallucinations and delusions following substance use. It is a condition that contributes to the current alcohol-related issues plaguing the United States and can become dangerous if not treated. Those experiencing alcohol-related psychosis can harm themselves and others — particularly when they lose touch with reality. 

If you or your loved one are experiencing potential symptoms associated with alcohol intoxication or substance use disorders, you must seek help.

Psychosis is a serious collection of symptoms that can hinder your ability to live a fulfilling life. Since heavy alcohol use is often involved, your health, relationships, and finances are also at risk. 

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What is Alcohol-Induced Psychosis?

While you may assume alcohol-induced psychosis would occur following long-term alcohol abuse, this condition can develop during various situations, including acute intoxication, better known as alcohol poisoning, chronic heavy drinking, and alcohol withdrawal. This rare phenomenon is often a complication of alcohol use disorder (AUD). (1)

Alcohol-related psychosis is also referred to as alcohol hallucinosis because of the hallucinations that often present themselves. However, it differs from schizophrenia — although there are several overlapping symptoms. (2) Most commonly, patients experience auditory hallucinations and paranoid delusions. 

In most cases, alcohol-induced psychosis is first recognized when a patient is hospitalized and develops alcohol withdrawal psychosis. This condition signals something very serious that requires immediate treatment.

Not only do patients pose a risk to themselves, but they can often act in unpredictable ways. Those affected may resort to violence and harm others if their hallucinations and delusions cause a significant disconnect from reality. 

Symptoms of Alcohol-Induced Psychosis

The symptoms of alcohol-induced psychosis surface during or shortly after a heavy intake of alcohol. Although it is clinically similar to schizophrenia, it is a unique, independent condition. 

Since many patients experiencing alcohol-induced psychosis have a history of alcohol abuse, it can be challenging to determine whether symptoms are related to substance abuse, mental health disorders, or both. This diagnostic difficulty is especially true during emergencies that lack patient history. (2)

When compared to schizophrenia, patients suffering from alcohol-related psychosis tend to: (3)

  • Experience the onset of psychosis at an older age 
  • Have more intense depressive and anxiety symptoms
  • Have fewer negative/disorganized symptoms
  • Showcase better judgment and insight 

Like any form of psychosis, many symptoms can be present and often depend on the individual’s mental health and history of alcohol abuse. However, for alcohol-induced psychosis, two symptoms must be evident.

They include the following psychotic symptoms:

  • Hallucinations 
  • Delusions

As discussed, symptoms of psychosis are often present during the alcohol withdrawal period. During this time, individuals can experience delirium tremens (DT). (4)

Although over 50% of those with a history of alcohol abuse experience alcohol withdrawal symptoms, only 3% to 5% develop DT.

This condition causes the following:

  • Immense confusion 
  • Heart dysfunction 
  • Visual hallucinations 
  • Heightened nervous system activity, resulting in fear and anxiety

DT can develop as early as 48 hours following the abrupt discontinuation of alcohol in those with a history of chronic abuse. Symptoms can last up to five days. (4)

Since it can be a medical emergency, recognizing signs of this condition is imperative to positive outcomes. The longer you wait to seek help, the higher the chance of brain damage, loss of vital signs, etc. 

Different Forms of Alcohol-Induced Psychosis

  1. Acute Alcohol Intoxication: Acute alcohol intoxication is a form of alcohol-induced psychosis characterized by the immediate and temporary effects of consuming a large amount of alcohol. In this state, individuals may experience hallucinations, confusion, and impaired judgment. (5) Delirium, a severe disturbance in mental abilities, can also occur. Symptoms often dissipate as the alcohol is metabolized, but acute intoxication poses risks such as accidents, injuries, and dangerous behaviors.
  2. Chronic Alcoholic Hallucinosis: Chronic alcoholic hallucinosis is a more persistent form of alcohol-induced psychosis that typically emerges after years of heavy drinking. Unlike acute intoxication, the hallucinations associated with this condition persist even when the individual is not under the influence of alcohol. (6) These hallucinations are often auditory, involving hearing voices or sounds that are not present. Chronic alcoholic hallucinosis may also be accompanied by mood disturbances and paranoia.
  3. Alcohol Withdrawal Psychosis: Alcohol withdrawal psychosis manifests during the period of alcohol withdrawal when an individual suddenly stops or significantly reduces their alcohol intake. Symptoms may include severe confusion, hallucinations, agitation, and delirium. This form of psychosis is a result of the brain’s struggle to adapt to the absence of alcohol. It is a serious condition that requires medical attention to manage withdrawal symptoms and prevent complications.
  4. Alcohol-Induced Delirium (Delirium Tremens): Delirium tremens is a severe and potentially life-threatening form of alcohol-induced psychosis that occurs during alcohol withdrawal. It is characterized by profound confusion, hallucinations, severe tremors, and autonomic nervous system hyperactivity. Delirium tremens typically occur in 48 to 72 hours after the last drink and require immediate medical intervention. Without proper treatment, delirium tremens can lead to cardiovascular collapse and other complications.
  5. Wernicke-Korsakoff Syndrome: While not a form of psychosis in the traditional sense, Wernicke-Korsakoff syndrome is a neurological disorder associated with chronic alcohol abuse. It results from thiamine (vitamin B1) deficiency, leading to significant cognitive impairments, including psychosis. (7)  Wernicke-Korsakoff syndrome often presents with symptoms such as confusion, memory loss, and hallucinations. Timely thiamine supplementation is crucial for managing and preventing this syndrome. (8)
  6. Alcohol-Induced Mood Disorder: Prolonged alcohol abuse can contribute to mood disorders, including depression and anxiety. While not always characterized by psychosis, severe cases may involve psychotic features such as delusions or hallucinations. (9) Alcohol-induced mood disorders underscore the complex interplay between alcohol and mental health, requiring comprehensive treatment approaches.
  7. Alcohol-Induced Paranoid Disorder: Some individuals who misuse alcohol may develop paranoid thoughts and behaviors. Alcohol-induced paranoid disorder involves unfounded suspicions, mistrust, and a heightened sense of threat. These paranoid features may persist even when the individual is not actively drinking, emphasizing the lasting impact of alcohol on mental health.

Causes and Risk Factors of Alcohol Psychosis

The prevalence of this condition depends on the source. A Dutch review found a 0.4% lifetime prevalence in the general population. However, among patients with alcohol dependence, this figure jumps to 4%. (10)

The risk of alcohol-induced psychosis increases based on the following:

  • Becoming dependent on alcohol at a young age and ongoing excessive alcohol consumption
  • A low socioeconomic status
  • Being unemployed 
  • Living alone 
  • Co-occurring disorders and mental illness symptoms
  • A potential genetic predisposition based on twin studies 

Those with alcohol-related psychosis have a 5% to 30% risk of developing a chronic schizophrenia-like syndrome. (11)

Treatment is required to avoid worsening symptoms or a more severe condition, especially if you have a family history of alcoholism or schizophrenia. 

The Dangers and Long-Term Impacts

Alcohol-induced psychosis poses severe dangers and can lead to enduring consequences, impacting both mental and physical well-being. Understanding the risks associated with this condition is crucial for individuals and their support networks.

Here’s an in-depth exploration of the dangers and long-term impacts:

  1. Potential for Violence: Alcohol-induced psychosis heightens the risk of aggressive and violent behavior. Individuals experiencing psychosis may lose touch with reality, leading to unpredictable actions. This escalation in aggression can result in harm to oneself or others, jeopardizing personal safety and causing strained relationships.
  2. Risk of Self-Harm and Suicide: The altered perceptions and distorted thinking associated with alcohol-induced psychosis may contribute to an increased risk of self-harm and suicidal ideation. Individuals in this state may engage in impulsive and harmful behaviors, necessitating immediate intervention to prevent tragic outcomes.
  3. Long-Term Mental Health Consequences: Persistent alcohol-induced psychosis can have enduring effects on mental health. Chronic psychosis may contribute to the development or exacerbation of mental health disorders, including anxiety, depression, and schizophrenia. These conditions often require ongoing treatment and support.
  4. Physical Health Complications: Prolonged alcohol abuse and psychosis can lead to significant physical health complications. Chronic alcohol consumption may result in liver disease, cardiovascular issues, and weakened immune function. Neglecting physical health during episodes of psychosis can exacerbate these risks.
  5. Impaired Cognitive Function: Repeated episodes of alcohol-induced psychosis can contribute to cognitive impairment, affecting memory, attention, and overall cognitive function. The persistence of cognitive deficits may hinder daily functioning and reduce one’s ability to engage in meaningful activities.
  6. Strained Relationships: The unpredictable and erratic behavior associated with alcohol-induced psychosis can strain relationships with family, friends, and colleagues. The strain on interpersonal connections may persist even after the acute phase of psychosis, impacting social support networks and hindering recovery.
  7. Legal Consequences: Engaging in aggressive or unlawful behavior during episodes of alcohol-induced psychosis may lead to legal consequences. Legal repercussions can include arrests, charges, and potential incarceration, adding additional challenges to the individual’s life.
  8. Social Isolation: The impact of alcohol-induced psychosis on behavior and mental health may contribute to social isolation. Individuals experiencing psychosis may withdraw from social interactions, leading to feelings of loneliness and further exacerbating mental health challenges.
  9. Reduced Quality of Life: The cumulative effects of dangers and long-term impacts can significantly reduce an individual’s overall quality of life. Persistent mental health struggles, physical health complications, and strained relationships contribute to a diminished sense of well-being.
  10. Recovery Challenges: Overcoming the dangers and long-term impacts of alcohol-induced psychosis requires comprehensive treatment and ongoing support. The recovery journey may be challenging, involving therapeutic interventions, lifestyle changes, and ongoing commitment to sobriety.

Understanding the gravity of the dangers and long-term impacts associated with alcohol-induced psychosis emphasizes the urgency of seeking professional help. Early intervention and tailored treatment approaches are vital in mitigating the risks and fostering a path toward sustained recovery and improved well-being.

Alcohol Psychosis Treatment and Recovery

Addressing alcohol-induced psychosis necessitates a comprehensive and individualized treatment strategy to ensure optimal recovery outcomes. A holistic approach, emphasizing both the physical and mental aspects of the individual, is crucial for successful treatment. 

The following outlines the stages and approaches involved in alcohol psychosis treatment and recovery:

  1. Early Intervention and Assessment: Early intervention is key to effective treatment. Seeking professional help at the onset of alcohol-induced psychosis allows for a thorough assessment of the patient’s condition. A multidisciplinary care team, including mental health and addiction specialists, conducts a comprehensive evaluation to understand the underlying causes of psychosis.
  2. Dual-Diagnosis Treatment: Alcohol-induced psychosis often coexists with alcohol use disorder and other mental health conditions. (1) Dual-diagnosis treatment addresses both the substance abuse and mental health components simultaneously. This integrated approach recognizes the interconnected nature of alcohol abuse and psychiatric symptoms, ensuring a more holistic and targeted treatment plan.
  3. Admission to a Treatment Facility: Upon deciding to seek treatment, individuals typically connect with a treatment facility to initiate the admission process. This involves providing necessary information, and medical history, and completing assessments to tailor the treatment plan to the individual’s specific needs.
  4. Initial Needs Assessment: Following admission, patients meet with their care team to discuss immediate needs and concerns. This personalized approach allows for a focused examination of the severity of alcohol-induced psychosis and the potential risks associated with withdrawal. Immediate needs, such as alcohol withdrawal support, are identified and prioritized.
  5. Medication-Assisted Detox: Alcohol withdrawal can pose serious health risks, and medication-assisted detox programs are employed to ensure a safe and successful withdrawal process. Medical professionals closely monitor and manage the detoxification, providing medications that alleviate withdrawal symptoms and reduce the risk of complications.
  6. Individualized Treatment Plan: A holistic treatment plan is crafted based on the individual’s unique circumstances. This plan may include various therapeutic modalities, counseling, support groups, and educational components. The goal is to address not only the immediate symptoms of alcohol-induced psychosis but also the underlying factors contributing to alcohol misuse.
  7. Inpatient or Outpatient Care: Depending on the severity of the condition, individuals may receive treatment on an inpatient or outpatient basis. Inpatient care provides a more structured environment for those requiring intensive support, while outpatient care allows individuals to participate in treatment while maintaining aspects of their daily lives.
  8. Therapeutic Interventions: Therapeutic interventions play a pivotal role in alcohol psychosis treatment. Individual and group counseling, cognitive-behavioral therapy (CBT), and other evidence-based therapies address psychological aspects, contributing to sustained recovery. These interventions promote self-awareness, coping skills, and relapse prevention.

Alcohol-related psychosis is a serious condition that can have profound effects on mental health. While individual susceptibility varies, adopting proactive measures can significantly reduce the risk of developing alcohol-induced psychotic disorders.

Here are key strategies to prevent alcohol-related psychosis:

  1. Early Intervention and Treatment: Early identification of alcohol misuse and prompt intervention are crucial for preventing the progression of alcohol-related psychosis. Recognizing signs of problematic drinking, such as increased tolerance or withdrawal symptoms, allows for timely intervention through counseling, therapy, or participation in support groups. Early treatment can mitigate the impact of alcohol on mental health.
  2. Moderation and Responsible Drinking: Moderating alcohol consumption is a fundamental preventive measure for substance-induced psychosis. Setting limits on the quantity and frequency of alcohol intake helps reduce the risk of developing psychiatric symptoms.
  3. Lifestyle Changes: Adopting a healthy lifestyle can support mental health and reduce the risk of alcohol-related psychosis. Engaging in regular physical activity, maintaining a balanced diet, and ensuring sufficient sleep contribute to overall well-being. These lifestyle changes help create a foundation for mental resilience and decrease the likelihood of alcohol-related psychiatric complications.
  4. Counseling and Psychoeducation: Psychoeducation programs that focus on alcohol’s impact on mental health can enhance awareness and promote responsible drinking behaviors. Counseling sessions can provide individuals with coping strategies, stress management techniques, and insight into the connections between alcohol use and mental health. Knowledge empowers individuals to make informed decisions about their alcohol consumption.
  5. Regular Medical Check-Ups: Routine medical check-ups are essential for monitoring overall health and detecting early signs of alcohol-related issues. Regular appointments with healthcare professionals allow for the assessment of mental health, identification of risk factors, and tailored interventions. Seeking medical guidance ensures that any emerging concerns are addressed promptly, preventing the escalation of alcohol-related problems.
  6. Awareness Programs and Education: Public awareness campaigns and educational initiatives play a crucial role in preventing alcohol-related psychosis on a broader scale. Informing communities about the risks associated with excessive alcohol consumption and binge drinking, the signs of alcohol-related mental health issues, and available resources for support can contribute to a culture of responsible drinking and mental well-being.
  7. Support Systems and Peer Networks: Establishing and maintaining strong support systems is integral to preventing alcohol-related psychosis. Peer networks, family support, and connections with mental health professionals create a safety net for individuals at risk. These networks provide encouragement, understanding, and assistance in navigating challenges related to alcohol use and mental health.
  8. Mindfulness and Stress Reduction Techniques: Incorporating mindfulness practices and stress reduction techniques into daily life can be effective in preventing alcohol-related psychosis. Mindfulness-based approaches, such as meditation and yoga, contribute to emotional regulation and stress resilience, reducing the likelihood of turning to alcohol as a coping mechanism.
  9. Community Resources and Treatment Facilities: Awareness of community resources and treatment facilities is essential for individuals seeking help or support. Knowing where to access mental health services, counseling, and addiction treatment facilities ensures that those in need can readily connect with professional assistance.

Seeking Help: First Steps and Immediate Actions

Alcohol withdrawal can result in alcohol-induced psychosis and other serious health problems. However, it is not the only concern. If your body is dependent on alcohol and you quit cold turkey, fatal symptoms can result. (12)

For example, delirium tremens can cause seizures. The situation can become life-threatening if you do not effectively treat this symptom. 

Professional detoxification facilities offer medication-assisted detox treatment options to ensure you remain as safe and comfortable as possible. Once your body has successfully eliminated the alcohol, you can begin the healing process.

Whether you opt for an outpatient or inpatient treatment program, some of the types of therapies available include:

  • Individual and group therapy 
  • Family therapy 
  • Cognitive-behavioral therapy (CBT)
  • Holistic treatment 
  • Wilderness therapy 
  • Art therapy 
  • Yoga therapy 

Get Help for Alcohol Addiction Today

Receiving an individualized treatment plan helps you increase the odds of long-term recovery. These tailored programs ensure your needs are met, not just concerning your alcohol use but also your mental health.

This comprehensive approach can help you build a new life — one free from the fear of alcohol-induced psychosis or related conditions.

Ready to take the new step and enter alcohol rehab or get substance abuse treatment? Zinnia Health is here to help you overcome alcohol addiction. We urge you to contact our team or call our alcohol help hotline at (855) 430-9439 to discuss your situation so that the healing process can begin at an evidence-based treatment center. Today could be the beginning of your new life. Let us help — we’re waiting to hear from you. 


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Why call us? Why call us