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Alcohol Induced Psychosis, Hallucinations, & Delusions

Many intoxicating substances can lead to psychosis, which is a mental condition characterized by disruptions to thinking and the perception of the world.

What is Psychosis?

Psychosis involves disruptions to a person’s thoughts and perceptions in ways that can make it challenging for them to distinguish between what’s real and what’s not—making it difficult for them to interact with their daily environment. Rather than representing a distinct mental illness itself, the concept of psychosis embodies several characteristic symptoms.1 Psychosis is sometimes thought of as a break with reality because the cognitive and perceptual changes associated with certain psychotic illnesses may give rise to symptoms such as seeing, hearing, or feeling things that aren’t there, as well as unwarranted thoughts or persecutory beliefs.1

Other symptoms of psychosis may include:2

  • Disturbed thoughts or perceptions.
  • Poor executive functioning.
  • Trouble thinking clearly or concentrating.
  • Memory problems.
  • Difficulty understanding what is real.
  • Behavior that is inappropriate for the situation.
  • Incoherent speech.
  • Delusions.
  • Hallucinations.

Approximately 3 out of every 100 people will experience some form of psychosis in their lifetimes, with many first psychotic episodes appearing in their later teen years or early 20s.3 Although the causes of psychosis are not fully understood, it is likely that a combination of factors may contribute to its development; for example, genetics (e.g., a positive family history of psychosis or psychotic disorders), life experiences, certain chemical imbalances in the brain, and alcohol or drug use may all be associated with the development of psychotic disorders.4

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What is Alcohol-Induced Psychotic Disorder?

Alcohol-induced psychotic disorders, on the other hand, involve secondary psychotic episodes that may be similar in presentation to other primary psychoses, but arise due to alcohol-related conditions.5 Secondary psychoses are those in which symptoms manifest in association with known medical conditions or substance use behavior, rather than as a result of a primary condition such as schizophrenia.6 An alcohol related psychosis can occur in a setting of either acute intoxication or alcohol withdrawal, but may also arise in chronic drinkers (e.g., people with alcohol use disorders with long-term, compulsive patterns of alcohol consumption).7

alcohol induced psychotic disorders

Studies show that people with psychotic disorders are much more likely to abuse alcohol or drugs than people who do not experience psychosis.11 The Substance Abuse and Mental Health Services Administration (SAMHSA) reports that among Americans aged 18-25, approximately 15.1% had a substance use disorder (SUD) in 2016.2 Of those, about 2.1% also had a co-occurring serious mental illness.2 In that same year, 13-51% of young people for whom treatment had been initiated for a first-episode psychosis also had a co-occurring SUD.2 Research also suggests that approximately 20-53% of young adults with first-episode psychosis also met the criteria for an AUD at some point in their lives.2

Once a person develops a substance-induced psychosis, the symptoms usually appear quickly and resolve within days to weeks.4 Though symptoms resolution is usually quick, continued drinking after experiencing an alcohol-induced psychotic episode could trigger the onset of longer-lasting psychotic disorders in those predisposed for such conditions.4

Features of an alcohol-induced psychosis include alcohol hallucinosis, a rare complication of chronic alcohol abuse that occurs during or after a period of heavy drinking.8 These hallucinations are typically auditory but may manifest as visual or tactile.8 The condition is also characterized by mood disturbances and delusions which may eventually mimic schizophrenia or delirium tremens.8 Often, alcohol hallucinosis will clear up on its own if a person stops drinking alcohol all together.

Alcohol-Induced Wernicke-Korsakoff Syndrome

Wernicke-Korsakoff disease is a syndrome that encompasses both the acute and chronic phases of a vitamin B1, or thiamine deficiency-related condition, known as Wernicke’s encephalopathy and Korsakoff psychosis, respectively.9 A depletion of thiamine is a common complication of chronic alcoholism.5,10

The symptoms of Wernicke’s encephalopathy may include confusion, ataxia (or loss of muscular coordination), abnormal eye movements (e.g., nystagmus), vision changes, and eyelid drooping; left unmanaged, the associated diminished level of consciousness could progress to coma or death.10 Korsakoff syndrome involves hallucinations, confabulation (i.e., making up stories), minor to severe loss of memory, inability to form new memories, and replacing old memories with false ones.10

Wernicke-Korsakoff syndrome may not be effectively managed with abstinence alone. Along with discontinuing alcohol use, treatment involves replacement of thiamine along with proper nutrition and hydration.9 The goals of treatment are to manage symptoms and to prevent the disorder from getting worse.10 Stopping alcohol use will also decrease the chances of further nerve and brain damage.9

Treatment for Alcohol-Induced Psychotic Disorder

People who experience psychosis caused by alcohol are likely to experience this condition again if they continue to drink. Therefore, abstinence from alcohol is the first step in recovering from alcohol induced psychosis. Early management through various supportive measures (e.g., guidance and education about the early warning signs of psychosis, stress and anxiety management, relaxation training, employment programs, social and living skills training and family education), rehabilitation for any underlying substance use disorder and, when needed, antipsychotic medications may also be helpful for recovery.3,4

alcohol addiction treatment

However, in those who struggle with alcoholism, stopping alcohol use may be difficult and even dangerous if they’ve developed a significant level of physical dependence. Left unmanaged, heavy alcohol users may experience uncomfortable and potentially life-threatening symptoms of withdrawal when quitting or cutting back on their drinking. Because of this, a medical detox program is essential to keeping patients as safe and comfortable as possible throughout the acute withdrawal period.

The type of detox program or level of intensity needed for effective alcohol withdrawal management will be determined by a doctor or other treatment professional. Following successful completion of detox, an inpatient or outpatient rehabilitation program will be beneficial to continue working toward recovery. Treatment may include group therapy, individual counseling, support group meetings, family counseling, medication treatments, behavioral therapies, and wellness activities as part of a comprehensive treatment plan for alcohol use disorders.

Get Help For Alcohol Addiction

If you suspect that you or a loved one might be suffering from compulsive alcohol use and any adverse health consequences of problematic drinking, medical treatment, as well as professional medical detox and rehabilitation can help start the recovery process. Calling our hotline will put you in touch with an American Addiction Centers admissions navigator who can help you evaluate your treatment options.

As a subsidiary of American Addiction Centers (AAC), a nationwide provider of substance abuse treatment facilities, offers a quick and easy form below to verify if you’re covered to receive care at one of their facilities. AAC understands that making the decision to seek treatment for addiction isn’t easy. Because of this, our admissions navigators are available to speak with you 24/7 regarding any questions you may have about treatment.

We also accept many insurance plans and can work with you on a manageable payment schedule so that finances aren’t a roadblock to your loved ones getting the help they deserve.

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[1]. National Alliance on Mental Illness. (n.d.). Early Psychosis And Psychosis.

[2]. Substance Abuse and Mental Health Services Administration. (2019). First-Episode Psychosis and Co-Occurring Substance Use Disorders.

[3]. National Institute of Mental Health. (2015). Fact Sheet: First Episode Psychosis.

[4]. National Drug and Alcohol Research Centre. (2011). Psychosis and Substance Use.

[5]. Medscape. (2017). Alcohol-Related Psychosis.

[6]. Keshavan, M. S., & Kaneko, Y. (2013). Secondary psychoses: an updateWorld psychiatry: official journal of the World Psychiatric Association (WPA), 12(1), 4–15.

[7]. U.S. National Library. (2019). Alcohol Related Psychosis.

[8]. Bhat, P. S., Ryali, V., Srivastava, K., Kumar, S. R., Prakash, J., & Singal, A. (2012). Alcoholic hallucinosisIndustrial psychiatry journal21(2), 155–157.

[9]. National Institute of Neurological Disorders and Stroke. (2019). Wernicke-Korsakoff Syndrome Information Page.

[10]. MedlinePlus. (2018). Wernicke-Korsakoff Syndrome.

[11]. National Collaborating Centre for Mental Health (UK). (2011). Psychosis with Coexisting Substance Misuse. Psychosis with Coexisting Substance Misuse: Assessment and Management in Adults and Young People.