Alcohol-Induced Psychosis

Man holding a cup of liquor at risk of developing alcohol induced psychosis

Psychosis is a state characterized by hallucinations, delusions and disorganized behavior. Psychosis can occur as a symptom of a mental health condition such as schizophrenia, a medical condition such as stroke or a substance use disorder such as alcohol misuse or addiction.

Alcohol-induced psychosis can be severe and life-threatening. Urgent treatment by a trained medical professional is critical to prevent severe side effects of alcohol-induced psychosis.

What is Alcohol-Induced Psychosis?

Alcohol-induced psychosis, also known as alcohol-induced psychotic disorder (AIPD), is defined as a psychotic state caused by alcohol consumption rather than a mental health condition. The current Diagnostic and Statistical Manual of Mental Disorders (DSM-V) indicates that the diagnosis of substance-induced psychotic disorders such as alcohol-induced psychosis requires the occurrence of significant hallucinations or delusions. The diagnosis specifies that the hallucinations or delusions must begin during or soon after alcohol intoxication or withdrawal.

Although psychosis can be a symptom of schizophrenia, important distinctions exist between the two terms. Schizophrenia is a chronic and severe mental health condition, while psychosis is a temporary state not always linked to a mental health condition. Schizophrenia symptoms persist long-term, while alcohol-induced psychosis symptoms generally end once alcohol use ceases.

Alcohol-induced psychosis can occur as a result of heavy alcohol consumption (acute intoxication), chronic long-term consumption or during alcohol withdrawal. Alcohol withdrawal delirium (AWD), also known as delirium tremens, is a severe and dangerous psychotic state that can occur during withdrawal. AWD is more likely to occur during withdrawal in individuals who have used very high quantities of alcohol over an extended period. In addition to hallucinations and delusions, AWD symptoms may include light sensitivity, rapid heart rate, tremors and sudden mood changes.

Alcohol-induced delusions and hallucinations occur more frequently in people addicted to alcohol or who use substantial quantities over an extended period. Studies suggest that alcohol-induced psychosis is linked to changes in the levels of brain neurotransmitters such as dopamine or serotonin. However, additional research is needed to understand the biological basis of this severe condition better.

Alcohol-Induced Psychosis Symptoms

Alcohol-induced psychosis symptoms are severe and life-threatening. Thus, immediate treated is critical. Alcohol-induced psychosis symptoms include:

  • Hallucinations: Alcohol and hallucinations are linked in those who have alcohol-induced psychosis. Hallucinations are sensory experiences that appear real but are created by one’s mind and can include sounds, visions, smells or tastes. Alcoholic hallucinosis is a rare condition involving auditory hallucinations and may arise after years of chronic, severe alcohol abuse. Alcoholic hallucinosis may also include delusions and mood instabilities.
  • Delusions: Delusions are false ideas which cannot be corrected by reason. Delusions can include the mistaken belief that one is being followed, watched, betrayed or loved. In severe cases, alcohol-induced delusions can consist of alcohol-induced paranoias, such as feeling extremely suspicious of other people or fearful of flying.
  • Dissociation: Dissociation is a rare sign of alcohol-induced psychosis and involves feelings of being disconnected from the world or one’s thoughts, memories or sense of identity.

Who is at Risk of Alcohol-Induced Psychosis?

Alcohol-induced psychosis is more likely to occur in individuals with long-term alcohol addiction, those undergoing alcohol withdrawal and those acutely intoxicated with large quantities of alcohol. Studies demonstrate an overall 0.4% prevalence of alcohol-induced psychosis and a 4% prevalence in those with alcohol dependence. Alcohol-induced psychosis is more likely in working-age males and individuals who began abusing alcohol earlier in life. Studies on twins propose a genetic component of the condition, although further research is needed to prove a hereditary link. Patients with alcohol-induced psychosis also have up to a 30% chance of developing a long-lasting schizophrenia-like condition.

Alcohol-Induced Psychosis Treatment

Although alcohol-induced psychosis is a severe condition, recovery is possible with the proper treatment. A successful recovery also limits the possibility of life-threatening or long-term complications. Treatment for alcohol-induced psychotic disorders such as alcohol-induced psychosis requires a multifactorial approach.

Stopping alcohol consumption is usually the first step in alcohol-induced psychosis and alcoholic hallucinosis treatment. Alcohol withdrawal can be dangerous, with risks including seizures, heart attack, stroke or even death. Thus, medical detox under the supervision of trained medical professionals is recommended. In many cases, individuals with alcohol-induced psychosis must be admitted to a hospital for initial treatment due to the risks of both psychotic symptoms and alcohol withdrawal. Treatment for alcohol-induced psychosis may also include such steps as:

  • Inpatient rehab
  • Outpatient rehab
  • Psychotherapy, including cognitive-behavioral therapy (CBT)
  • Medications such as benzodiazepines to control seizures and antipsychotics to treat hallucinations and delusions
  • Support groups
  • Aftercare programs

Since psychosis can be a symptom of mental health conditions such as schizophrenia, diagnosis and treatment should include a detailed psychological evaluation to rule out co-occurring conditions. If a co-occurring condition is present, a dual diagnosis treatment program that addresses both the alcohol use disorder and mental health condition is critical to long-term recovery.

If you or a loved one live with alcohol addiction, contact Orlando Recovery Center to speak with a representative who can guide you through the initial steps of getting treatment. You deserve a healthier future; call today.


Sources “Early Psychosis and Psychosis.” National Alliance on Mental Illness, 2019. Accessed August 21, 2019.

Stankewicz, Holly; Salen, Philip. “Alcohol Related Psychosis.” StatPearls Publishing, Dec 23, 2018. Accessed August 21, 2019.

Bhat, Pookala; Ryali, VSSR; Srivastava, Kalpana; Kumar, Shashi; Prakash, Jyoti; Singal, Ankit. “Alcoholic Hallucinosis.” Industrial Psychiatry Journal, July, 2012. Accessed August 21, 2019.

Medical Disclaimer: Orlando Recovery Center aims to improve the quality of life for people struggling with a substance use or mental health disorder with fact-based content about the nature of behavioral health conditions, treatment options and their related outcomes. We publish material that is researched, cited, edited and reviewed by licensed medical professionals. The information we provide is not intended to be a substitute for professional medical advice, diagnosis or treatment. It should not be used in place of the advice of your physician or other qualified healthcare provider.