Alcohol-Induced Psychosis

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Alcohol use impacts many people differently. While some may find its effects relaxing, others are prone to uncomfortable mental health disturbances. Approximately 4% of those diagnosed with alcohol use disorder develop alcohol-induced psychosis. A mental state defined as losing contact with reality, psychosis can be frightening for the individual and their loved ones. Management requires alcohol cessation and immediate medical attention for symptomatic treatment.

If are at risk for developing alcohol-induced psychosis as a result of alcohol misuse, Guardian Recovery offers a multitude of services to care for your mind and body on the path to sobriety. Our stabilization programs, such as medically monitored detox and intensive therapy allow our experienced team to assess you throughout each step of recovery. We are available 24/7 to answer any questions and explain our intake process. Reach out to a treatment advisor today to learn more about our alcohol treatment programs. 

Read on to understand the relationship between drinking and psychotic disorders.

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Can Alcohol Misuse Lead to Psychosis?

Also referred to as alcohol hallucinosis, alcohol-induced psychosis is a rare but serious consequence of excessive drinking. Emotional and behavioral disruptions can occur at any point during alcohol use, from acute intoxication to withdrawal. Psychotic features most commonly develop during or after heavy alcohol use. A psychotic episode, regardless of the cause, is characterized by an impaired understanding of reality. Someone experiencing psychosis is unable to differentiate between real life and their perceptions.

Signs and Symptoms of Psychosis Include:

  • Hallucinations (seeing or hearing that are not real).
  • Delusions (false beliefs that can be readily disproven).
  • Disorganized thinking.
  • Bizarre or inappropriate thoughts.
  • Unusual, irregular speech patterns.
  • Depression and anxiety.
  • Sleep trouble.
  • Social withdrawal.
  • Decreased work or school performance.
  • Inability to care for oneself (chores, personal grooming, finances, etc.).
  • Violence or aggression.

Unlike primary psychosis in psychiatric disorders such as schizophrenia, bipolar disorder, or major depression, alcohol hallucinosis is considered a secondary psychosis. The mental disturbances are the direct result of alcohol ingestion rather than a discrete psychological condition. As a result, symptoms typically resolve with alcohol cessation.

You Are More Likely to Develop Alcohol-Induced Psychosis With These Risk Factors:

  • Alcohol dependency at an early age.
  • Low income or social class.
  • Unemployment or living on pension.
  • Living alone or socially isolated.

What Causes Alcohol-Induced Psychosis?

The exact cause of alcohol-induced psychosis is unknown; however, several theories point to a multifactorial etiology. Two brain chemicals (neurotransmitters) may play a critical role. Increased dopamine and decreased serotonin levels could be to blame for hallucinations. Medical imaging indicates a lack of adequate blood circulation to certain areas of the brain is another potential factor.

Additional risks for developing psychosis include current age, age at first drink, length of alcohol use, nutritional status, co-existing health conditions, family history, and birth complications. Older individuals with chronic malnutrition and comorbid disease are more likely to experience psychosis with long-term drinking. 

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Types of Alcohol-Induced Psychosis & Associated Symptoms

Symptoms of alcohol hallucinosis vary depending on the severity of your alcohol use, age, and overall health status. While a psychotic episode caused by drinking may seem difficult to discern from diagnoses like schizophrenia, knowing which stage of alcohol use you are in can be helpful.

Alcohol-Induced Psychosis Differs From Other Psychotic Disorders as Follows:

  • Symptom onset occurs within two weeks of alcohol misuse.
  • Symptoms must continue for at least 48 hours but must not exceed six months.
  • There are higher levels of depressive and anxious symptoms.
  • Cognition (thinking) is more organized.
  • The person may have greater insight into their illness.
  • Functional impairment is not as severe.

Acute Intoxication

Acute alcohol intoxication is the immediate onset of physical and neurological impairment following binge drinking. For men and women who have had more than five drinks on one occasion, the likelihood of manifesting psychotic symptoms is higher. This form of alcohol-induced psychosis is the rarest and is more likely to occur if you have a low alcohol tolerance. Symptoms usually resolve after the alcohol is cleared from your system. 

Chronic Alcoholic Hallucinosis

Unlike acute intoxication, where an individual consumes a large quantity of alcohol once or twice per month, chronic alcohol use is long-term. Regularly having more than seven drinks a week for women or 14 drinks a week for men is often indicative of alcohol use disorder. 

People with chronic alcoholic hallucinosis are prone to auditory hallucinations, delusions, and mood changes. Long-term alcohol use is responsible for vitamin deficiencies – thiamine, folate, B6, and B12 – and mineral loss – namely, magnesium, calcium, and iron. Thiamine (B1) deficiency is implicated in Wernicke-Korsakoff syndrome, characterized by confusion, movement problems, and vision loss. Left untreated, it can advance to Korsakoff psychosis, causing amnesia, severe emotional changes, and confabulation (creating false memories or scenarios).

Alcohol Withdrawal Psychosis

Alcohol cessation after chronic use requires medical monitoring. If you suddenly stop drinking, you will likely experience uncomfortable alcohol withdrawal. In mild cases, agitation, anxiety, shaking, and irritability are common. Severe cases lead to seizures, hallucinations, high blood pressure, vomiting, excessive sweating, confusion, loss of consciousness, and a racing heart. 

Because alcohol is a nervous system depressant (or “downer”), it initially lowers your blood pressure, heart rate, and breathing. It blocks some excitatory brain chemicals while triggering some inhibitory neurotransmitters. As you develop a physical dependence to alcohol, greater levels are required to maintain depressant effects. When you stop drinking abruptly, your body has no time to readjust to its pre-alcohol levels, activating the excitatory cascade responsible for withdrawal symptoms. In the case of withdrawal psychosis, excess dopamine is responsible for hallucinations and agitation.

Treatment Options for Alcohol-Induced Psychosis

Treatment for alcohol hallucinosis depends on the duration of alcohol use, symptom severity, and individual health. With acute intoxication, symptoms should resolve once you are sober. Chronic alcohol hallucinosis and withdrawal frequently require hospitalization and medically-managed care until you are stable. 

Medications Used to Treat Alcohol-Induced Psychosis Include:

  • Benzodiazepines (e.g., Ativan, Valium, or Librium) to prevent seizures, anxiety, and agitation.
  • Antipsychotics (e.g., Haldol or Zyprexa) to treat agitation and hallucinations.
  • Vitamins and minerals (e.g., folate, thiamine, magnesium, and multivitamins – also known as a “banana bag”) to treat or prevent potentially fatal deficiencies.

After hospital discharge, you may need to continue medications until symptoms have fully cleared. Your healthcare provider may also prescribe acamprosate or naltrexone to curb alcohol cravings. 

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Alcohol has various ill effects on your body and mind; managing them all at once can be unnerving. If you believe you or a loved one has been dealing with psychosis caused by alcohol use, assistance is available with Guardian Recovery. Our talented team of providers uses best practice guidelines to diagnose and treat the mental and physical effects of alcohol use disorder.

Our straightforward admissions process takes only 15 minutes. Contact us today for information about our residential and dual diagnosis programs. We can provide you with a complimentary assessment and a free, no-obligation insurance benefit check.


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Reviewed professionally for accuracy by:

Ryan Soave


Ryan Soave brings deep experience as a Licensed Mental Health Counselor, certified trauma therapist, program developer, and research consultant for Huberman Lab at Stanford University Department of Neurobiology. Post-graduation from Wake Forest University, Ryan quickly discovered his acumen for the business world. After almost a decade of successful entrepreneurship and world traveling, he encountered a wave of personal and spiritual challenges; he felt a calling for something more. Ryan returned to school and completed his Master’s Degree in Mental Health Counseling. When he started working with those suffering from addiction and PTSD, he found his passion. He has never looked back.

Written by:

Cayla Clark

Cayla Clark

Cayla Clark grew up in Santa Barbara, CA and graduated from UCLA with a degree in playwriting. Since then she has been writing on addiction recovery and psychology full-time, and has found a home as part of the Guardian Recovery team.

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