Alcohol Psychosis: How Alcohol Can Cause Paranoia & Hallucinations

Contrary to popular belief, psychosis is not a mental health condition. Psychosis is a state that can either exist as a symptom of a psychotic disorder, like schizophrenia or be brought on by certain substances, including alcohol. In most instances, alcohol-induced psychosis ends when the symptoms of alcohol consumption or withdrawal subside. However, in cases of prolonged use, psychosis can be long-lasting or life-threatening. Because of this, it’s crucial that anyone experiencing alcohol-induced psychosis or exhibiting the early signs of an alcohol use disorder receive professional treatment.

Alcoholism With Psychosis
Alcohol-induced psychosis describes any delusions and hallucinations tied to heavy alcohol consumption that cannot be attributed to a pre-existing mental health condition. Generally, alcohol-induced psychosis exists in three forms: acute intoxication, chronic alcohol hallucinosis and alcohol withdrawal psychosis.
While uncommon, acute intoxication describes the acute alcoholic psychosis that occurs after a person consumes a large amount of alcohol in a single sitting. In most cases, alcohol psychosis symptoms end once the body is clear of alcohol. However, because consuming alcohol in large enough quantities to trigger psychosis often also leads to alcohol poisoning, it’s crucial that anyone experiencing acute intoxication receive medical attention as soon as possible. In many cases, alcohol poisoning can be fatal.

Alcoholic hallucinosis is a rare condition that usually arises after years of chronic, severe alcohol abuse. While other forms of alcohol-induced psychosis may involve visual and tactile hallucinations, those associated with alcoholic hallucinosis are primarily auditory and usually occur during or shortly after periods of heavy alcohol consumption. Alcoholic hallucinosis may also involve delusions and mood disturbances. The periods of psychosis characteristic of alcoholic hallucinosis may last for a matter of hours, days or weeks, or progress to a chronic, long-lasting form that mimics schizophrenia.  

Hallucinations are a possible side effect of alcohol withdrawal. In some cases, these hallucinations can escalate to a full-blown state of temporary psychosis called alcohol withdrawal delirium (AWD). Individuals who stop drinking after consuming high-volumes of alcohol over an extended period are at particularly high risk of developing AWD. Long-term alcoholism can change the structure and chemical makeup of the brain, triggering temporary psychosis when alcohol is removed from the system.

Also referred to as delirium tremens, symptoms of AWD may include any of the following:

  • Extreme sensitivity to light, sound or touch
  • Sudden changes in mood
  • Increased heart and breathing rates
  • Delusions
  • Hallucinations
  • Formication, or the feeling that tiny insects are crawling on or under the skin
  • Body tremors

  • Delirium tremens is one of the most potentially dangerous side effects of alcohol withdrawal. These symptoms tend to be life-threatening and require professional medical attention. Because of this, it’s crucial that any individual undergoing alcohol withdrawal do so under the supervision of a medical detox program.

    The exact cause of alcohol-induced psychosis is unclear. Some studies suggest that alcohol-induced psychosis is the result of alcohol’s effects on the levels of certain neurotransmitters in the brain, namely, dopamine. Others speculate that the way alcohol disrupts certain neural receptors plays a role. What is certain is that prolonged alcohol use has profound, far-reaching effects on both the brain and body. Alcohol-induced psychosis is thought to be a result of these effects.
    Alcohol use can trigger short-term psychosis, including acute alcoholic psychosis, alcoholic hallucinosis and AWD. In most cases, these episodes of psychosis will end once alcohol consumption has ceased and withdrawal symptoms have subsided. If long-term psychosis persists, it is typically caused by a separate, co-occurring mental health disorder that pre-dated or developed alongside the alcohol use disorder, like schizophrenia.

    Telling the difference between alcohol-related psychosis and schizophrenia can be difficult, as they share many of the same symptoms. Fortunately, alcohol-induced psychosis has characteristics that distinguish it from schizophrenia, including:

  • Later onset of symptoms
  • More depressive and anxiety symptoms
  • Fewer negative and disorganized symptoms
  • Less functional impairment
  • While alcohol assessments and quizzes can help determine if an individual is addicted to alcohol, experiencing any form of alcohol-related psychosis is often a sign of an alcohol use disorder. Therefore, it’s important to discontinue alcohol consumption as soon as possible in the event of an alcohol-induced episode of psychosis. In most cases, stopping alcohol consumption is the first step in alcohol-induced psychosis treatment, as the symptoms of psychosis tend to subside once alcohol is out of a person’s system. However, because alcohol-induced psychosis tends only to arise when individuals consume quantities of alcohol that lend themselves to dependence and withdrawal, it’s crucial that people stop drinking under medical supervision as part of a professional medical detox program.

    Individuals with an alcohol-use disorder tend to have more success when medical detox is undergone as part of a continuum of care because they can gradually develop the skills needed to maintain lifelong recovery.

    A continuum of care includes:

  • Medical detox
  • Inpatient programs
  • Partial hospitalization
  • Intensive outpatient
  • Outpatient programs
  • Aftercare

  • While psychosis can develop temporarily as the result of excessive alcohol consumption, it may also be a symptom of a co-occurring psychotic disorder, like schizophrenia, schizoid personality disorder or schizotypal personality disorder. In these cases, a dual diagnosis alcohol treatment program that addresses both the alcohol use disorder and psychological condition is crucial to long-term recovery.

    When it comes to alcohol-induced psychosis, it’s best to seek medical help during or shortly after an episode of alcohol-induced psychosis. If you or a loved one have an alcohol use disorder or experienced substance-induced psychosis, it’s important to keep the following points in mind:

  • Prolonged or excessive alcohol use can lead to temporary psychosis
  • Alcohol-induced psychosis typically manifests as acute intoxication, alcohol hallucinosis or AWD
  • While the exact cause of alcohol-induced psychosis is unknown, it is thought to be related to the way that excessive alcohol consumption affects the brain and body
  • While alcohol can cause temporary psychosis, it typically does not cause long-term psychosis
  • When psychosis persists for an extended period after alcohol use has stopped, it is often a sign of a co-occurring mental health condition
  • Professional care is crucial for any individual experiencing alcohol-induced psychosis, as this is usually a sign of an alcohol use disorder

  • With treatment centers across the country, The Recovery Village provides high-quality medical and clinical support to individuals struggling with an alcohol use disorder and co-occurring psychosis. If you or a loved one are ready to take the first step toward recovery, reach out to a representative today for more information.

    Alcohol Psychosis: How Alcohol Can Cause Paranoia and Hallucinations
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