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What is Alcohol Induced Psychosis? Symptoms & Treatment

Alcohol is the most frequently abused psychoactive substance and may lead to various clinical conditions like intoxication, withdrawal, delirium tremens, and alcohol induced psychosis. Read more about the treatment options for you or your loved ones struggling with alcohol addiction.


What is Alcohol Induced Psychosis?

Alcohol induced psychosis is used to describe any number of psychotic conditions that can occur due to alcohol abuse. This psychosis often manifests itself in the form of delusions and hallucinations. It can occur during various stages of alcohol abuse, including acute intoxication, withdrawal, and chronic alcoholism. Psychosis refers to a condition that makes it difficult for an individual to differentiate between what is real and what is not.

Can alcohol induce psychosis? Alcohol has the potential to cause psychosis, especially when it is abused. Long-term alcohol abuse changes the way the neural receptors in the brain work. The exact cause of alcohol-related psychosis is still unknown. However, it is likely related to serotonin, dopamine, and other neurotransmitters. These neurotransmitters help the brain recognize the reality in front of you and are often affected when you hallucinate. Most people who experience psychosis for the first time have some substance abuse issues.

Alcohol Induced Psychosis Symptoms

Alcohol induced psychosis symptoms are characterized by hallucinations and delusions as their main symptoms. Alcohol induced psychosis can make it difficult for the person to distinguish between what’s real and what isn’t. Secondary symptoms including anger, fear, and disorientation are usually brought on by this. Some of the more noticeable alcohol induced psychosis symptoms may include:

  • Seeing, tasting, hearing, smelling, or feeling things that aren’t there
  • Disorganized thoughts and disorientation
  • Holding false beliefs about yourself, others, or the world around you
  • A belief that someone is after you or persecutory delusions
  • The sensation that insects are crawling on or under the skin (also known as parasitic hallucinations)
  • Intrusive thoughts
  • Paranoia (alcohol induced paranoia)
  • Outbursts and inappropriate behavior
  • Difficulty holding a conversation
  • Trouble performing daily tasks and routines

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, any individual undergoing alcohol withdrawal must do so under the supervision of a medical detox program.

How Long Does Alcohol-Induced Psychosis Last?

The duration of alcohol induced psychosis symptoms can range from a few hours to a few weeks. For example, alcohol induced psychosis may only last a short period of time the first time you experience it. However, each occurrence raises the likelihood of having more. You run the danger of experiencing many back-to-back, long-term episodes or acquiring a chronic version of the disorder if you continue to frequently drink alcohol.

Every alcohol induced psychosis incidence poses a risk to life. In addition to producing psychosis, alcohol poisoning can cause the body’s essential systems to completely shut down. After years of heavy drinking, quitting cold turkey might overstimulate your nervous system and affect your vital signs in a harmful way, and may lead to alcohol withdrawal.

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Alcohol Induced Psychosis Facts

History of Alcohol Induced Psychosis

The association between alcohol use and psychosis was doc[1]umented as early as 1847 by Marcel. He was credited for differentiating the disorder from delirium tremens. Kraepelin and other authors also reported a distinct psychotic syndrome associated with alcoholism that differed from delirium tremens (alcohol withdrawal with delirium), Wernicke’s encephalopathy, Korsakoff’s psychosis, and alcohol-induced dementia (Glass 1989a). Psychotic manifestations may also occur in other general medical or neurological disorders associated with alcohol dependence.


Epidemiology

A 2015 Dutch literature review on alcohol-related psychotic disorders found that there is a 0.4% lifetime prevalence in the general population and a 4% prevalence in patients with alcohol dependence. The incidence is highest in working-age men. There is also a higher prevalence of alcohol-related psychosis in patients who became dependent on alcohol at a younger age, those with low socioeconomic status, individuals who are unemployed or living on their pension, and those who live alone.  In patients with alcohol use disorder, paternal alcohol and mental health problems were found to be associated with a higher incidence of alcohol-related psychosis.


Pathophysiology

The pathophysiology of alcohol-related psychosis is unclear. Several hypotheses exist. Some studies suggest that an increase in central dopaminergic activity and dopamine receptor alterations may be associated with hallucinations in patients with alcohol use disorder. However, serotonin may also be involved. Other studies imply that amino acid abnormalities may lead to decreased brain serotonin and increased dopamine activity leading to hallucinations. Elevated levels of beta-carbolines and an impaired auditory system have also been associated with alcohol-related psychosis. Neuro-imaging studies have suggested that perfusion abnormalities to various regions in the brain may be associated with hallucinations in alcohol dependence.

Evaluation

The Diagnostic and Statistical Manual of Mental Disorders (DSM-V) states that the diagnosis of substance-induced psychotic disorder requires the presence of significant hallucinations or delusions. There must be evidence that the hallucinations or delusions started during or soon after substance intoxication or withdrawal or the substance used is known to cause the disturbance. The symptoms are not better explained by a psychotic disorder unrelated to substance use. The psychosis does not occur only with delirium. The symptoms cause clinically significant distress or difficulty with normal activity such as work or social interactions.


Treatment

If the patient requires sedation due to alcohol-related psychosis, neuroleptics, such as haloperidol, have been considered the first-line medications for treatment. Benzodiazepines, such as lorazepam, are used if there is a concern for alcohol withdrawal and seizures. Certain atypical antipsychotics, such as ziprasidone and olanzpine, have also been used to help sedate patients with acute psychosis.

Patients with alcohol-related psychosis must also be evaluated for suicidality since it is associated with higher rates of suicidal behaviors. The prognosis for alcohol-related psychosis is less favorable than earlier studies had speculated. However, if the patient can abstain from alcohol, the prognosis is good. If patients are unable to abstain from alcohol, the risk of recurrence is high

Alcohol Induced Psychosis Statistics

 Alcohol-induced psychosis is caused by withdrawal from prolonged, excessive drinking. It is relatively rare among the general population, with higher rates among those struggling with alcohol dependence. Although it is dangerous, it is usually temporary, ending after a few weeks of sobriety.


3%

Approximately 3% of persons with alcoholism experience psychosis during acute intoxication or withdrawal.

Source: NIMH

10%

Roughly 10% of individuals who are dependent on alcohol and are in withdrawal experience severe withdrawal symptomatology, including psychosis.

Source: NIAAA

68%

Once diagnosed with alcohol-related psychosis, there is a 68% chance of re-admission and a 37% co-morbidity with other mental disorders. 

Source: NCBI


Signs of Alcohol Induced Psychosis

It is not uncommon for people to experience both addiction problems and mental health issues simultaneously. A heavy drinker who uses alcohol to cope with his difficulties should look for alcohol and depression treatment. A consistent drinker who starts to see or hear things that aren’t there should also seek professional help.

Heavy drinking is dangerous for many reasons,  It may lead to an alcohol induced psychosis disorder.
Heavy drinking is dangerous for many reasons, It may lead to an alcohol induced psychosis disorder.

Along with showing more common signs of alcoholism like social withdrawal, drinking alone, agitation, shakiness, and decline in personal hygiene, those with alcohol-related psychosis will start to exhibit other symptoms that can be more severe. The most common signs of this condition are hallucinations and delusions that occur immediately following heavy drinking or during the withdrawal period following consistent drinking. While hallucinations and delusions are signs of various mental health disorders like psychosis and schizophrenia, this psychosis should directly relate to the person’s alcohol abuse and consumption. Because of this minor discrepancy, alcohol-related psychosis can be difficult to diagnose and take time to differentiate from other possible mental health disorders.

Another way to differentiate between a psychotic disorder stemming from other factors and one directly related to alcohol abuse is by looking at family history. If the client has a family history of alcohol abuse but no family history of psychotic disorders, it is good to indicate that psychosis associated with alcohol is the problem. If you or your loved one is exhibiting signs of alcohol induced psychosis, get substance-induced psychosis treatment right away. Battling both an addiction problem and mental health issues is scary, but you can get help. 

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Can Alcoholism Lead To Psychosis?

Alcohol use can trigger short-term alcohol induced psychosis, including acute alcoholic psychosis, alcoholic hallucinosis, and AWD (alcohol withdrawal delirium). In most cases, these episodes of psychosis will end once alcohol consumption has ceased, and withdrawal symptoms have subsided. However, if long-term psychosis persists, it is typically caused by a separate, co-occurring mental health disorder that predated or developed alongside 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:

  • Fewer negative and disorganized symptoms
  • Less functional impairment
  • Later onset of symptoms
  • More depressive and anxiety symptoms

What Causes Alcohol Induced Psychosis?

The exact cause of alcohol induced psychosis is unclear. Some studies suggest that alcohol induced psychosis results from alcohol’s effects on the levels of certain neurotransmitters in the brain, namely dopamine. Others speculate that the way alcohol disrupts specific neural receptors plays a role. What is certain is that prolonged alcohol use has profound, far-reaching effects on both the brain and body.

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Types and Symptoms Of Alcohol Induced Psychosis

Alcohol induced psychosis describes 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.

  • Acute Intoxication: While uncommon, acute intoxication describes the acute alcoholic psychosis after consuming a large amount of alcohol in a single sitting. In most cases, alcohol psychosis symptoms end once the body is clear of alcohol. However, drinking alcohol in large enough quantities to trigger psychosis often also leads to alcohol poisoning. Therefore, anyone experiencing acute intoxication should receive medical attention as soon as possible. In many cases, alcohol poisoning can be fatal.
  • Chronic Alcoholic Hallucinosis: 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.
  • Alcohol Withdrawal Psychosis: 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 exceptionally high risk of developing AWD. This is because long-term alcoholism can change the structure and chemical makeup of the brain, triggering temporary psychosis when alcohol is removed from the system.
The alcohol induced psychosis is a rare complication of chronic alcohol abuse.
The alcohol induced psychosis disorder is a rare complication of chronic alcohol abuse.

Alcohol Induced Psychosis Case Study

Thirty-four patients with alcohol-induced psychotic illnesses in all were admitted over the course of three years. The majority (31 or 91%) were Indian and from lower socioeconomic backgrounds. 3, or 9%, belonged to socioeconomic class III. They were 43 years old on average. The most frequent manifestation of hallucinations was auditory, while visual hallucinations were less frequent. A total of 26 patients briefly experienced auditory hallucinations.

The only three participants who experienced visual hallucinations also experienced audio hallucinations. 16 of the subjects had delusions, and eleven of them had them only during the current hospitalization. The other five had long-lasting illusions, including three who persistently persecuted their neighbors and family and 2 who had delusions of their spouse’s adultery. These happened with obvious deliberateness. During their hospital stay, four patients had speech disorders found. By the time of discharge, though, this had cleared. Only two of the participants had depression, while the other three had demented tendencies and overall memory, cognition, and personality changes.

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Can Alcohol Induced Psychosis Be Treated?

If you’re experiencing alcohol-induced psychosis, it’s a sign that you are suffering from an alcohol use disorder. For many people, once they stop abusing alcohol, the symptoms of the psychosis will begin to fade. Due to the solid mental health component, attending addiction treatment specializing in dual-diagnosis disorders is recommended. It can treat Alcohol-induced psychosis, and the first step is breaking free from alcohol addiction. And with the right detox program, you’ll be able to minimize the symptoms of psychosis during withdrawal.

Alcohol Induced Psychosis Treatment Options

Alcohol is the most abused addictive substance in America, as more than 17 million people in the United States are considered to suffer from addiction to alcohol. To determine the most effective ways to treat individuals with moderate to severe alcohol use disorder, it’s crucial to get an accurate assessment of all the symptoms. When a mental health professional has evaluated the symptoms, it may be determined that another form of mental condition is present and needs a particular treatment.

Psychotherapy 

Several different modalities of psychotherapy have been used in the treatment of mental health disorders along with addiction, including:

  • Cognitive Behavioral Therapy (CBT) – is an effective treatment that involves changing both the patterns of negative thoughts and the behavioral routines which are affecting the daily life of the depressed person for various forms of depression.
  • Dialectical Behavioral Therapy – is a comprehensive mental health and substance abuse treatment program whose ultimate goal is to aid patients in their efforts to build a life worth living. The main goal of DBT is to help a person develop what is referred to as a “clear mind.” 
  • Solution Focused Therapy – is an approach interested in solutions that can be quickly implemented with a simple first step leading to further positive consequences.
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Dual Diagnosis Treatment

Drug abuse and mental health disorders often co-occur. In many cases, traumatic experiences can result in mental health disorders and substance abuse. Dual diagnosis rehabilitation treats both of these issues together. The best approach for the treatment of dual diagnosis is an integrated system. This strategy treats both the substance abuse problem and the mental disorder simultaneously. Regardless of which diagnosis (mental health or substance abuse problem) came first, long-term recovery will depend mainly on the treatment for both diseases done by the same team or provider.

Medication-Assisted Treatments

Medication-Assisted Treatments (MAT) for substance use and mental health disorders are commonly used in conjunction with one another. This includes the use of medications and other medical procedures. During your rehab, the staff from your treatment facility will help you identify what caused your addiction and teach you skills that will help you change your behavior patterns and challenge the negative thoughts that led to your addiction. Sometimes, the pressures and problems in your life lead you to rely on substances to help you forget about them momentarily.

If an alcoholic decides to stop drinking, they may alcohol experience withdrawal effects such as anxiety, restlessness, insomnia, and tremors. The development of tolerance and withdrawal are indications of addiction. Contact one of our helpful treatment specialists today if you or a loved one are struggling with long-term drug abuse and a co-occurring mental health condition such as depression. Sobriety starts here at We Level Up, which can provide information on dual diagnosis and detox programs that may fit your specific needs.

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