Alcoholic Psychosis Symptoms

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Alcoholic Psychosis Symptoms

When we hear the word “psychosis” we might first think of mental illness. In fact, psychotic disorder is a severe class of mental health disorders such as schizophrenia. 

Although rare, it is possible for someone with a chronic alcohol use disorder to experience psychotic symptoms. Here we will explore the condition called alcoholic psychosis, and see how it differs from psychotic disorder.

What is Alcohol Hallucinosis?

Alcohol hallucinosis is an alcohol-induced form of psychosis. The terms alcoholic psychosis and alcohol hallucinosis are interchangeable. Both terms denote a condition related to alcohol intoxication or withdrawal from it, where a person experiences symptoms of psychosis. The symptoms of psychosis can also occur in those who have a history of severe alcohol use disorder, or who engage in binge drinking.

At present, there is no known cause for the development of alcohol-induced psychosis. It is thought to be due to the affect of alcohol on neurotransmitters, such as serotonin and dopamine. It is considered a rare condition, affecting about 4% of those with severe alcohol use disorder. Among those with alcohol-induced psychosis there is a 5%-30% risk of acquiring a chronic schizophrenia-like syndrome later.

A study out of South Africa noted several findings about this condition. In the alcoholic subjects, the onset of alcoholism was between the ages of 21-29. The average age of the onset of alcoholic psychosis was age 35. It was also noted that a higher number of Caucasian men were diagnosed with the condition, versus non-Caucasian men.

Alcoholic Hallucinosis vs. Psychotic Disorders

Although those with alcoholic psychosis experience hallucinations or delusions, it is not the same as psychotic disorder. Psychotic disorder is a severe form of mental illness. Examples of psychotic disorders include schizophrenia, schizoaffective disorder, and brief psychotic disorder.

The main distinction is that psychotic disorders are forms of mental illness that do not originate with alcoholism. One way to distinguish alcoholic psychosis from psychotic disorder is through drug trials. Someone with alcoholic psychosis will not respond to anti-psychotic drug therapy.

Can Alcoholism Cause Schizophrenia?

Again, because schizophrenia is a type of psychotic disorder, or a mental illness, it cannot be caused by alcohol abuse or addiction. However, alcohol abuse can trigger alcoholic psychosis, which features many of the same symptoms of schizophrenia.

There is, however, a strong link between those who suffer from schizophrenia going on to develop alcohol use disorder. Studies show that these individuals are three times more likely to become alcoholics.

Symptoms of Alcohol-Induced Psychosis

Symptoms of alcohol-induced psychosis are associated solely with the use of alcohol, and not related to a mental illness. For this reason, it is called a secondary psychosis, secondary to the alcohol use disorder. 

Alcoholic psychosis may surface while the person is acutely intoxicated, or it may emerge as a withdrawal symptom later in the form of delirium tremens.

To qualify as alcoholic psychosis, the symptoms must persist for a minimum of 48 hours after onset. Some cases of alcohol-induced psychosis have lasted up to six months in duration.

Symptoms of alcoholic psychosis include:

  • Visual hallucinations, or seeing things or people that are not really there.
  • Auditory hallucinations, or hearing things or voices that are not real.
  • Severe disorientation.
  • Delusions, or false beliefs about reality.
  • Confused or jumbled speech.
  • Paranoid thoughts.
  • Violent or aggressive outbursts.
  • Suicidal actions or thoughts.

When someone is in the midst of experiencing symptoms of alcoholic psychosis, they will not be able to seek help. Therefore, if someone you care about is displaying these symptoms, you can assist them in obtaining the help they need.

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Setting up a doctor’s appointment so the person can receive an exam is a good first step. The doctor will conduct a physical exam and order blood work to rule out a health condition. If a medical problem is not found, the attending doctor will will recommend the person to an inpatient alcohol treatment program.

Medical Detox for Alcohol Use Disorder


The most important factor in overcoming alcoholic psychosis is getting and staying sober. Getting treatment and following the on-going treatment plan, it key to staying sober over the long term. Survival depends entirely on sustained abstinence from alcohol. Without sobriety, the outcome could be an early death.

Someone seeking help for alcohol dependency begins treatment by completing a medically supervised alcohol detox. Whether the person has a history of alcoholic psychosis or not, the medical detox team will be on alert. 

Even more so for someone with alcoholic psychosis, who has a much higher risk of a severe withdrawal condition called delirium tremens (DTs). However, the person may develop symptoms of psychosis (DTs) for the first time during withdrawal.

Alcohol Withdrawal Symptoms

Alcohol withdrawal symptoms will emerge within hours of the last drink. There are three distinct phases during alcohol detox. These include:

Early symptoms: In the early phase of detox, about 24 hours, the person will experience nausea, abdominal pain, insomnia, sweating, and anxiety, and headache.

Peak symptoms: The withdrawal symptoms reach their peak on days 2-4. Likely symptoms will include tremors, high blood pressure, increased body temperature, irregular heart rate, agitation, irritability, and mental confusion. The DTs may surface on about day 3 of detox. Should it arise, symptoms of DTs would include severe confusion, loss of coordination, seizures, terrors, delusions, and hallucinations.

Subsiding symptoms: Days 5-7 feature a gradual decline of most symptoms. It is common for psychological symptoms, such as depression, anxiety, and sleep disturbance to linger.

Treatment Options After Detox

Once detox has been safely completed, it is time to enter the treatment program. This is a carefully curated program designed to assist the person in establishing new healthy thought and behavior patterns.

  • Psychotherapy. CBT and other evidence-based therapies help individuals in recovery change how they respond to cravings and stressors.
  • Group therapy. Peers meet up for group sessions led by a counselor.
  • Medication. Naltrexone can help reduce cravings for alcohol, as well as the risk of relapse.
  • Education. Relapse prevention strategies are taught along with coping skills.
  • 12-step program. The 12-step program is part of the weekly schedule. 
  • Holistic methods. Rehab includes holistic therapies to reduce stress and enhance overall treatment success.

If you or a loved one has experienced symptoms of alcoholic psychosis, please reach out for help today.

Annandale Behavioral Health Provides Evidence-Based Treatment for Alcoholism

Annandale Behavioral Health offers the full spectrum of recovery services, including medical detox, stabilization, residential treatment, and aftercare. To learn more about our program, please reach out today at (855) 778-8668