Alcohol-Induced Psychosis: The Connection With Alcohol Use Disorder

Alcohol-Induced Psychosis

What Is Alcohol-Induced Psychosis?

Alcohol-induced psychosis is used to describe the psychotic conditions that can occur after alcohol intoxication, alcohol withdrawal, or chronic alcoholism. When these symptoms occur frequently enough, it can be diagnosed as an alcohol-induced psychotic disorder.

Psychosis itself is a broad term to describe a mental state where a person loses contact with reality. This can result in delusions, hallucinations, or disorganized thinking or behaviors.

In the case of alcohol-related psychosis, such symptoms usually occur after excessive alcohol consumption or withdrawal from chronic alcohol abuse.

Can Drinking Alcohol Cause Psychosis?

Yes, drinking alcohol can cause psychosis, according to a recent systematic review. It’s most common in people who are struggling with alcohol addiction or chronic alcohol use disorder (AUD), as they are more likely to engage in alcohol misuse or intoxication. Alcohol-induced psychosis occurs during acute alcohol intoxication, poisoning, or withdrawal.

What Causes Alcohol-Induced Psychosis?

Alcohol-induced psychosis is caused by heavy, prolonged alcohol use or acute withdrawal. Heavy drinking can affect the brain’s neurotransmitters, which are chemical messengers that transmit signals between neurons and other cells. Alcohol, in particular, affects the neurotransmitters dopamine and serotonin, which are critical for brain communication. During intoxication or withdrawal, the changes in these neurotransmitters can lead to symptoms of psychosis.

Some risk factors can influence the likelihood of someone experiencing alcohol-induced psychosis, such as lifestyle factors, environment, levels of stress, and even diet. People with a family history of alcohol dependence or mental health disorders like schizophrenia or bipolar disorder may have a predisposition to developing alcohol-induced psychosis.

Types of Alcohol-Induced Psychosis

What Are the Types of Alcohol-Induced Psychosis?

There are currently four known types of conditions that are classified as alcohol-induced psychotic disorders.

Alcohol Withdrawal Psychosis: This condition typically occurs during alcohol withdrawal and causes symptoms such as alcohol withdrawal delirium, delusions, high blood pressure, and intense fear. The most serious form of this condition is known as Delirium Tremens (DTs). 

Alcohol Poisoning (Acute Intoxication) Psychosis: This condition occurs in those with a prevalence of heavy drinking and most often occurs after heavy alcohol consumption. A person may experience severe aggressive or psychotic reactions for hours after heavy drinking and may not remember what happened after the episode is over.

Chronic Alcoholic Hallucinosis: This alcohol-induced psychotic disorder can occur after years of chronic alcoholism or misuse. It shares many of the same symptoms of delirium tremens psychosis, such as visual hallucinations, paranoia, or persecutory delusions. Sometimes, alcoholic hallucinosis can be mistaken for paranoid schizophrenia.

Alcohol-Induced Wernicke-Korsakoff Syndrome (WKS): This condition is the result of a thiamine (vitamin B1) deficiency caused by long-term alcohol consumption and misuse. Thiamine deficiency causes brain damage, leading to hallucinations and memory loss. Two syndromes are part of WKS, which are Wernicke encephalopathy (Acute) and Korsakoff syndrome (Chronic).

Can These Types Manifest Differently in Each Individual?

The form of psychosis a person may experience due to alcohol-induced psychosis will vary. For example, a person with chronic alcoholic hallucinosis may only experience visual hallucinations instead of the typical auditory ones.

A psychiatrist or other mental health care professional will examine an individual’s symptoms and alcohol intake to determine if they are experiencing alcohol-induced psychosis because of alcohol withdrawal symptoms or because of an alcohol-induced psychotic disorder.

Are There Subtypes Based on Severity or Duration?

Alcohol-induced Wernicke-Korsakoff Syndrome has two stages that are based on the severity and length of alcohol misuse and addiction.

Wernicke encephalopathy (WE) is an acute syndrome that requires immediate treatment to prevent permanent damage and death. It causes symptoms such as general confusion, tremors, double vision, and loss of muscle coordination. If treated right away and alcohol use stops, this condition can be managed without progressing to Korsakoff syndrome.

Korsakoff syndrome (KS) is a chronic memory disorder that occurs due to prolonged alcohol misuse. It causes memory loss and makes it difficult for those with it to form new memories or recall past events. Those with KS may create false memories to fill in the gaps that are missing due to memory loss.

Signs & Symptoms

What Are the Early Warning Signs of Psychosis?

Some early warning signs can be the precursor to a psychotic episode or psychosis symptoms, with common signs including:

• Depression or anxiety
• Withdrawing socially
• Difficulty communicating thoughts
• Self-isolation
• Sleep disturbances
• Difficulty concentrating
• Mood swings
• Indifference to personal hygiene
• Difficulty managing stress
• Decline in daily functioning
• Lack of motivation
• Fatigue
• Strong inappropriate emotions or a lack of emotions entirely
• Feeling uneasy around others
• Odd beliefs or expressing magical thinking
• Suspicion or paranoia
• Odd speech patterns (talking to self, talking in circles, going off into tangents)
• Perceptual incongruence (When your perceived stimulus does not match the brain’s expectations)

What Are the Symptoms of Alcoholic Psychosis?

The exact symptoms of alcohol-induced psychosis vary depending on the individual and whether they have alcohol-induced psychotic disorder.

There are three main psychotic symptoms that a person may experience, which are:

• Delusions: Firmly held false beliefs that cannot be swayed by reason or contradictory evidence
• Hallucinations: Sensory perceptions that occur without any external stimulus, such as feeling someone touch your skin while you are alone (tactile hallucinations )
• Disorganized Thinking or Behavior: Engaging in self-contradictory or inconsistent thoughts or behaviors, such as experiencing unprovoked anger or movements that have no clear purpose or cause

How Long Can Alcohol-Induced Psychosis Symptoms Last?

Alcohol-induced psychosis symptoms can last for hours, days, or weeks, depending on the severity of alcohol abuse and individual health. Heavy alcohol use will often result in longer-lasting psychotic episodes. Some symptoms may reduce or go away entirely after an individual stops drinking alcohol. However, some symptoms may require more time to fully recover from.

Short-Term Effects of Alcohol-Induced Psychosis

What Are the Short-Term Effects of Alcohol-Induced Psychosis?

Examples of short-term effects of alcohol-induced psychosis include:

• An escalation of binges and general alcohol use
• Increased alcohol tolerance
• Changes, often very subtle, in thoughts or perceptions. Examples include seeing shadowy figures or believing your loved ones are talking behind your back
• Increased injury risk
• Medical emergencies, such as dehydration or arrhythmias
• Increased paranoia, mood swings, or irritability while intoxicated or withdrawing from alcohol

How Quickly Do Symptoms Appear?

Symptoms can appear rapidly during acute intoxication or withdrawal, often within hours or days of use or cessation.

Are Short-Term Effects Reversible?

The short-term effects of alcohol-induced psychosis are reversible, especially after alcohol use has ceased and withdrawal symptoms are managed.

Long-Term Effects of Alcohol-Induced Psychosis

What Are the Long-Term Effects of Alcohol-Induced Psychosis?

When alcohol misuse continues or alcohol intake increases, the individual may begin to experience the full effects of psychosis. These include the common symptoms of psychosis, such as:

• Auditory hallucinations
• Visual hallucinations
• Tactile hallucinations
• Delusional Thinking
• Disorganized Speech or Behavior
• Cognitive Dysfunction

In some cases, psychosis can progress into self-harm or violence due to impulsive behavior. This puts individuals at risk for:

• Violent outbursts
• Urges to self-harm
• Accidental injuries

What Other Problems Can Long-Term Alcohol Abuse Cause?

Chronic and long-term alcohol abuse can severely impact your health and cause conditions such as:

• Liver disease
• Heart disease
• Gastrointestinal disease
• Cancer
• Weakened immune system
• Neurological damage
• Cognitive function impairment
• Development of co-occurring mental health disorders
• Social and occupational decline
• Legal Issues

How Does Long-Term Psychosis Affect Overall Mental Health?

Untreated psychosis can cause neurological damage. This damage can progress into the development of a mental health condition, such as depression or anxiety, or drastically reduce cognitive functioning. Some delusions or hallucinations can be traumatizing and frightening, which further impacts mental health.

Effects on Relationships

How Can Alcohol-Induced Psychosis Impact Your Loved Ones?

Alcohol-induced psychosis is difficult to watch a loved one go through. The inability to help can cause sadness, stress, and frustration in your loved ones. Without professional guidance, it’s difficult for families to cope.

How Does It Impact Romantic or Family Relationships?

People who struggle with psychosis often experience impaired social functioning. This makes it difficult to establish and maintain healthy relationships with others. The more disorganized and delusional thinking associated with psychosis can strain relationships and cause conflict.

How Can It Affect Work and Social Life?

Psychosis may lead to individuals withdrawing from social life completely. This makes them unable to participate in daily responsibilities, such as going to work or maintaining a home. Individuals struggling with alcohol-induced psychosis may lose a job, flunk out of school, or completely self-isolate from others.

Early Intervention for Alcohol-Induced Psychosis

What Do I Do if a Loved One Experiences Alcohol-Induced Psychosis?

It can be scary to witness a loved one have a psychotic episode, but there are things you can do to help. The goal is to calm the situation down and make sure your loved one is safe before calling a professional.

1. Stay calm. Don’t argue with your loved one, even if they are wrong.

2. Listen. This helps your loved one feel less isolated and builds trust.

3. Remember that your loved one’s thoughts and experiences are real to them, so be empathetic.

4. Focus on your loved one, not the delusion. Be supportive without validating their delusions.

5. Offer practical assistance, such as getting them a drink of water or a chair to sit down.

6. Reach out for professional help.

How Can I Get My Loved One to Realize They Need Help?

Talk to your loved one without judgment and explain that you love them and need help. An intervention is another way, with the assistance of a mental health care professional, to express to your loved one that they need help.

What Kinds of Health Professionals Should I Contact?

For alcohol-induced psychosis, the best mental health care professionals to contact are those with experience in psychiatric disorders and alcohol addiction. Contacting addiction treatment centers that treat alcohol addiction, like Infinite Recovery, is a great way to get in touch with professionals who can treat alcohol-induced psychosis.

When Is the Best Time to Seek Help?

The best time to seek help for substance abuse and psychotic symptoms is today. Alcohol-induced psychosis can be deadly to the individual struggling with it. Getting immediate help is a life-saving measure.

Diagnosis & Assessment

How Is Alcohol-Induced Psychosis Diagnosed?

A diagnosis is determined by examining data, such as the timeline of symptoms, how symptoms persist, and collecting collateral Information. This is to determine if the psychosis is caused by substance abuse or by a possible comorbid condition.

What Screening Tools Are Used?

A healthcare professional can use tools such as the CIWA-Ar for alcohol withdrawal severity and a thorough psychiatric evaluation/medical assessment to rule out other causes of psychosis.

How Do Clinicians Differentiate It From Other Psychotic Disorders?

The difference between alcohol-induced psychosis and other psychotic disorders is the presence of alcohol misuse. If symptoms emerge exclusively during or after heavy drinking, or during alcohol withdrawal, it’s likely alcohol-induced psychosis. This is because other psychotic disorders will have psychotic episodes regardless of the presence of substances.

Treatment for Alcohol-Induced Psychosis

How Is Alcohol-Induced Psychosis Treated?

Alcohol-induced psychosis is treated with a combination of psychotherapy and psychiatry. To fully heal, they must get professional treatment for alcohol addiction. This usually involves detox, inpatient treatment, outpatient treatment, and aftercare support.

What Medical Treatments Are Typically Used?

Close medical supervision is used during treatment to ensure the safety and comfort of the individual. Medications are often used during the process, such as benzodiazepines to manage acute withdrawal psychosis and antipsychotic medications to manage long-term symptoms of psychosis.

Does Psychotherapy Play a Role in Treating Alcohol-Induced Psychosis?

Yes, psychotherapy is a critical part of treatment, as it helps client address the underlying causes of their alcohol misuse and develop healthy coping strategies.

What Lifestyle Changes Help Manage Alcohol-Induced Psychosis?

You can make several lifestyle changes to maintain sobriety and prevent relapse. Some examples include exercising, having a healthy diet, and practicing healthy stress-relieving activities, such as meditation. Support groups and sober peer communities can also help keep you sober, and as a result, prevent or manage psychotic episodes.

Is Alcohol-Induced Psychosis Reversible?

Yes, alcohol-induced psychosis can be reversed with appropriate treatment and support. However, it takes time, from months to years, depending on the severity of the initial addiction and underlying health factors.

Prevention, Education, and Support

What Are the Key Strategies to Prevent Alcohol-Induced Psychosis?

The best way to prevent alcohol-induced psychosis is to prevent alcohol addiction and misuse. Education about substance use disorders and encouraging early intervention for substance abuse is one such strategy for prevention. Encouraging the public to maintain a healthy lifestyle and reduce the stigma of receiving professional mental health care is another.

How Can Education About Alcohol Risks Reduce the Likelihood of Psychosis?

Educating the public about the risk of heavy drinking helps them avoid excessive drinking. This, along with promoting responsible drinking habits and recognizing the early signs of alcohol addiction, can prevent the development of alcohol-induced psychosis.

How Can Families Help a Loved One With Alcohol Use Disorder?

The best way to help your loved one is to be encouraging, empathetic, and non-judgmental. Understand that your loved one is struggling with a serious mental health condition, and they need compassion, not anger. Utilizing the help of a mental health care professional can help you convince them to accept care. During and after treatment, continue to encourage and support them. Their providers will have tips you can use to best support their continued sobriety.

Are There Effective Programs or Resources for Alcohol Risk Prevention?

There are several programs and resources to reduce alcohol risk. Some groups work to change laws to make alcohol harder to access. An example of this is the SAFER initiative, which works to reduce alcohol-related deaths. Mental health care and addiction treatment facilities like Infinite Recovery will have resources to prevent alcohol abuse, or be able to point you to localized community prevention groups.

FAQs About Alcohol-Induced Psychosis

Can excessive drinking cause hallucinations?

Yes. Excessive drinking can lead to acute intoxication, which can cause alcoholic hallucinosis. This condition may also occur as a withdrawal symptom after you stop drinking heavily.

Can you die from alcohol withdrawal psychosis?

Yes. Delirium Tremens, in particular, can be deadly if left untreated.

Can alcohol abuse cause schizophrenia?

No, alcohol abuse cannot cause schizophrenia. However, alcohol misuse may make the symptoms of schizophrenia worse. Chronic alcoholic hallucinosis is often mistaken for schizophrenia.

What happens if I suddenly stop drinking?

If you are a heavy drinker, you will begin to have withdrawal symptoms within 12–24 hours after your last drink. Symptoms will progress in severity, peaking after several days before gradually declining. It’s important to get the help of a healthcare professional before stopping alcohol use, as they can help you navigate withdrawal safely and as comfortably as possible.

It may feel bad, but after the detox process and withdrawal symptoms subside, your body will immediately begin to heal. You may find yourself sleeping better, having more energy, and your liver function improving.

Those who struggle with alcohol use disorder (AUD) or addiction may be aware of the dangers of alcohol abuse. However, they may not be aware of alcohol-induced psychosis, a condition that can put them in great danger. Alcohol, when misused, can be deadly, and if you or a loved one is struggling with alcohol abuse or addiction, it’s critical to get help. Infinite Recovery is a Texas mental health care and addiction treatment facility dedicated to helping people from all walks of life recover from addiction. With caring staff, quality treatment, and a full continuum of care, anyone can find safety and healing at Infinite Recovery. To learn more about our AUD and alcohol addiction treatment programs, call (844) 928-1502.