Alcohol-induced psychosis can happen after intoxication, during withdrawal, or it can be chronic among people living with alcohol use disorder (AUD). Here’s what it looks like.

Alcohol is a mind-altering substance. It depresses the function of your central nervous system, affecting processes related to memory, judgment, speech, and mood, among many others.

Psychosis is the term used to describe a set of symptoms that indicate altered reality perception in your brain. Psychotic symptoms include hallucinations, delusions, disorganized thinking and movement, and what is known as “negative symptoms,” which involve withdrawal and a lack of interest.

Psychosis can occur for many different reasons and is a symptom seen in a variety of mental health conditions. Alcohol-induced psychosis, also known as alcoholic hallucinosis, is directly linked to alcohol use or misuse.

Psychosis is a rare complication of drinking alcohol for some people.

When this happens, it’s known as “secondary psychosis,” meaning it’s psychosis occurring secondary to another condition. In this case, psychosis is secondary to intoxication, withdrawal, or alcohol use disorder (AUD).

Alcohol affects how your brain works. It alters chemical messengers and compounds like dopamine, serotonin, and beta-carbolines, which are essential to how your neurons work and communicate.

While the exact mechanisms behind alcohol-induced psychosis aren’t well understood, changes involving these brain chemicals, and abnormal blood flow to certain regions of your brain from chronic alcohol misuse, are thought to play major roles.

As you become intoxicated, alcohol can distort your senses, which may also contribute to the experience of psychosis.

Can alcohol cause schizophrenia?

Schizophrenia is a psychotic disorder featuring symptoms of hallucinations, delusions, and other experiences of reality distortion.

It’s not caused by alcohol use, though research suggests people living with schizophrenia are nearly three times more likely to develop AUD or another substance use disorder (SUD).

The reason for this relationship isn’t clear. Schizophrenia and AUD may share underlying causes or genetic factors that increase the chances of experiencing both conditions.

Living with an AUD dual diagnosis can make the symptoms of schizophrenia more challenging to manage and can increase the likelihood of low treatment adherence, hospitalization, and mood instability.

Alcohol-induced psychosis can be used to describe different alcohol-related experiences of psychotic symptoms.

Alcohol-induced psychotic disorder

Alcohol-induced psychotic disorder is a mental health condition classified in the Diagnostic and Statistical Manual of Mental Disorder, 5th edition, text revision (DSM-5-TR), as a form of substance/medication-induced psychotic disorder.

According to the DSM, alcohol-induced psychotic disorder is the experience of alcohol-related delusions and/or hallucinations developing during or after intoxication, or occurring from withdrawal of alcohol.

Alcohol-induced psychotic disorder is a rare condition typically associated with chronic alcohol misuse and AUD, but it is theoretically possible to experience alcohol-induced psychosis after one night of heavy drinking.

Delirium tremens

Alcohol-withdrawal delirium, also known as delirium tremens, is a medical condition seen among people who chronically misuse alcohol and abruptly stop drinking.

It’s known as the most severe form of alcohol withdrawal, presenting with a sudden onset of intense confusion, agitation, and cognitive impairment, known as delirium.

Alcohol-induced psychosis in the form of hallucinations is common in delirium tremens, occurring approximately 12 hours after stopping alcohol intake. The hallucinations may be primarily visual but can also include auditory and tactile, or touch, hallucinations.

In delirium tremens, delirium is the primary condition and alcohol-induced psychosis occurs as a symptom.

Alcohol-induced psychosis involves experiencing hallucinations, delusions, or both while consuming alcohol or during withdrawal periods.

Hallucinations are incorrect sensory experiences, like seeing things that aren’t there or hearing voices when you’re alone. Delusions, conversely, are false beliefs that you stand firm in, even with ample evidence to the contrary.

Psychotic symptoms in alcohol-induced psychosis are directly linked to alcohol use. They can’t be attributed to any other cause, like another underlying mental health condition.

According to a systematic review from 2017, antipsychotic medications and alcohol use cessation are the most effective treatment options for alcohol-induced psychotic disorder.

In many cases of substance-induced psychosis, symptoms resolve after the substance is gone from your body and you’ve gone through withdrawal.

A variety of other symptoms can accompany alcohol-induced psychosis. These may arise from the other effects of alcohol on your body or from withdrawal.

Your doctor can prescribe medications to help with secondary symptoms like headaches, nausea, mood disturbance, or cravings. In some cases, emergency medical care or a stay in a care facility may be necessary to help with extreme discomfort or to treat delirium.

Because alcohol-induced psychosis is typically associated with chronic alcohol misuse, long-term treatment often involves psychotherapy. A mental health professional can help you discover the underlying causes of problematic drinking and can help you develop more beneficial coping strategies.

Speaking with a therapist can also help you connect to groups and local organizations that support your efforts of sobriety.

Alcohol-induced psychosis is defined by symptoms of hallucinations, delusions, or both when drinking or going through withdrawal. In the absence of delirium, it’s known as alcohol-induced psychotic disorder.

Stopping alcohol use and treating psychotic symptoms with antipsychotic medications can successfully treat alcohol-use psychosis. Other medications to help with withdrawal or the effects of alcohol may also help.

Long-term guidance from a mental health professional can help address the factors that underlie problematic drinking.