Can Alcohol Cause Psychosis?
By The Recovery Village
Medical Reviewer Benjamin Caleb Williams, RN | Editor Jonathan Strum
Last Updated: May 16, 2023
Editorial Policy | Research Policy
Psychosis can occur due to heavy and prolonged alcohol use, withdrawal or brain damage caused by alcohol-related thiamine deficiencies.
Psychosis1, a state of being detached from reality in some way, can occur2 due to alcohol abuse. A person may experience temporary psychosis as a symptom of alcohol withdrawal, but heavy, long-term alcohol use can lead to psychosis that is more severe and longer-lasting. In addition, brain damage caused by alcohol misuse can lead to permanent psychosis.
Alcohol-induced psychosis can damage your mental health and negatively impact your life in many ways. If you or someone you love struggles with alcohol use, it’s important to understand the risks of alcohol-induced psychosis and learn where to turn for help.
What Is Psychosis?
Psychosis3 is a condition of the mind that causes someone to perceive reality differently than others. These perceptions can range from more dramatic situations, such as having hallucinations of aliens, to more subtle changes, such as believing everyone is out to get you.
Psychosis is usually related to one of two things: a mental illness or use of a mind-altering substance. Those who have a mental illness and also use mind-altering substances are at higher risk of psychosis than others.
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Symptoms of Psychosis
Symptoms of psychosis can include any symptom that is related to a detachment from reality. Symptoms of psychosis will usually fall into one of two categories: hallucinations or delusions. Some of these symptoms can include:
- Hearing voices or other things that are not explainable
- Seeing things that others cannot
- Strange sensations or feelings of things being present that are not
- Belief that you have special powers
- Belief that others are conspiring against you
- Belief that ordinary events have hidden significance
- Belief that external forces are controlling your actions or thoughts
What Is Alcohol-Induced Psychosis?
Alcohol-induced psychosis, also called alcohol-related psychosis4, is psychosis that is caused by alcohol use or withdrawal. This informal term is used to describe different types of psychosis with different alcohol-related causes. Some types of alcohol-induced psychosis may be temporary, while others may potentially be permanent.
What Causes Alcohol-Induced Psychosis?
Medical scientists do not fully understand psychosis5 and how it is caused, but they do know that it often occurs due to chemical imbalances in the brain. Alcohol can cause these imbalances in three different ways.
Alcohol can cause chemical imbalances by how it reacts with brain receptors6 when someone drinks. This is referred to as alcoholic hallucinosis and is uncommon, as it typically only occurs in people who drink heavily over a long period of time.
Alcohol can also cause psychosis during withdrawal. During withdrawal, receptors in the brain are readjusting to the absence of alcohol in the bloodstream. This period causes many changes in the brain that can lead to psychosis.
Finally, alcohol can lead to psychosis by causing brain damage. While alcohol itself can be damaging to the brain, alcohol-related brain damage typically occurs because alcohol affects how vitamin B1 is absorbed. A deficiency in this vitamin can lead to brain damage that is permanent if not treated.
Delirium tremens7 is a severe form of alcohol withdrawal that can be deadly, especially when left untreated. People experiencing delirium tremens will often suffer from psychosis, leading to hallucinations that cause them to see and hear things that are not there. This is often coupled with agitation, and it may cause someone to become aggressive.
Alcoholic hallucinosis8 is a rare condition that is connected with heavy alcohol use. Someone who uses alcohol heavily over a prolonged period of time may experience these hallucinations while drinking or after an episode of heavy drinking. These hallucinations are usually auditory and cause people to hear things that are not there, such as the sound of someone speaking.
Alcohol Withdrawal Psychosis
Psychosis can also occur during alcohol withdrawal9 when delirium tremens is not present. Psychosis during alcohol withdrawal is uncommon and often occurs in the form of hallucinations.
Alcohol-Induced Wernicke-Korsakoff Syndrome
Wernicke-Korsakoff syndrome10 is a brain disease caused by a lack of vitamin B1 (thiamine). In Westernized countries, heavy, prolonged alcohol use is the main cause of this condition, as alcohol affects the body’s ability to absorb thiamine. In its early stages, Wernicke-Korsakoff syndrome can be reversed by providing thiamine, but it becomes permanent as it advances.
When Wernicke-Korsakoff syndrome becomes permanent, it is because it has caused irreversible brain damage. This leads to long-term neurological symptoms, such as the inability to make new memories, memory loss and hallucinations. Hallucinations are a form of psychosis, and psychosis caused by Wernicke-Korsakoff syndrome will likely be permanent.
Can Alcohol Cause Schizophrenia?
Alcoholism and schizophrenia are connected11, but most medical scientists agree that alcohol use does not appear to cause schizophrenia. Instead, it appears that those with schizophrenia are more prone to misusing alcohol and developing an alcohol addiction.
Schizophrenia is a mental illness that primarily causes psychosis. This psychosis can be treated12 with medications; however, people with this health problem often try to self-medicate with alcohol. If alcohol provides any relief, they may use it repeatedly and develop an addiction. This means that although alcohol is not thought to cause schizophrenia, it does tend to be used by those who have it.
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Warning Signs of Alcohol-Induced Psychosis
Psychosis is something that usually cannot be anticipated, and the warning signs typically only occur when psychosis is already beginning. Someone who has psychosis is detached from reality in some way and will be very unlikely to recognize that they actually have a problem. Typically, the warning signs of psychosis will only be recognizable to those around them.
According to the National Alliance on Mental Illness13 (NAMI), early signs of psychosis can include:
- A decline in grades or work performance
- Problems concentrating or thinking clearly
- Becoming suspicious or paranoid
- Decreased attention to hygiene and appearance
- Becoming more withdrawn
- Decreased emotional response to life
- Strong emotions that may not fit the situation
Some of these signs can also be signs that an alcohol addiction is developing, making it more difficult to distinguish between early signs of psychosis and alcoholism. Anyone who is experiencing these signs should be seen by a doctor as soon as possible.
Is Alcohol-Induced Psychosis Permanent?
Alcohol-related psychosis is not normally permanent when it is related to psychosis that occurs while drinking or during withdrawal. However, it can be permanent when caused by Wernicke-Korsakoff syndrome, as this form of brain damage can become irreversible and lead to permanent changes.
How Long Does Alcohol-Induced Psychosis Last?
The length of alcohol-related psychosis depends entirely on what is causing it. Alcoholic hallucinosis, caused by actively drinking alcohol, will usually not last more than 24 to 48 hours after drinking. However, repeated drinking could prolong alcoholic hallucinosis.
Withdrawal-related psychosis will often resolve when withdrawal symptoms subside, even if these symptoms include delirium tremens. However, psychosis related to Wernicke-Korsakoff syndrome may be permanent. Psychosis during Wernicke-Korsakoff syndrome is often an indicator that the condition has advanced beyond a temporary state and cannot be fully treated.
Treatment for Alcohol Psychosis
Treatment for alcohol-related psychosis depends on14 the type of psychosis that is occurring. However, the best way to improve alcohol-related psychosis is to stop using alcohol.
Because psychosis is commonly connected with alcohol withdrawal, people with a history of psychosis should be supervised in a medical facility during detox, called medical detox. This allows their psychosis to be quickly recognized and correctly treated before it becomes severe. Those withdrawing from alcohol will be given thiamine during detox to avoid or reduce potential brain damage from Wernicke-Korsakoff syndrome.
The Recovery Village Cherry Hill at Cooper uses state-of-the-art-facilities and expert medical staff to monitor and treat psychosis related to alcohol use. We are dedicated to keeping you safe during withdrawal and helping you to avoid the problems that psychosis can cause, then addressing the root causes of addiction so you can stop your alcohol use for good. Contact us today to learn how we can help you or your loved one safely recover from an alcohol addiction.
Our Recovery Advocates are ready to answer your questions about addiction treatment and help you start your recovery.
- National Institute of Mental Health. “What is Psychosis?” Accessed May 10, 2022.
- U.S. National Library of Medicine. “Alcohol.” MedlinePlus, March 22, 2022. Accessed May 10, 2022.
- Mind. “Psychosis.” January 2020. Accessed May 10, 2022.
- Yang, Zhongshu. “Alcohol-Related Psychosis.” Medscape, December 1, 2017. Accessed May 10, 2022.
- U.K. National Health Service. “Causes – Psychosis.” December 10, 2019. Accessed May 10, 2022.
- Davies, Martin. “The role of GABA receptors in mediating […]ntral nervous system.” Journal of Psychiatry and Neuroscience, July 2003. Accessed May 10, 2022.
- Toohey, Shannon. “Delirium Tremens (DTs).” Medscape, August 4, 2021. Accessed May 10, 2022.
- Bhat, Pookala S.; Ryali, V.S.S.R.; et al. “Alcoholic hallucinosis.” Industrial Psychiatry, December 2012. Accessed May 10, 2022.
- Trevisan, Louis A.; Boutros, Nashaat; et al. “Complications of Alcohol Withdrawal.” Alcohol Health and Research World, 1998. Accessed May 10, 2022.
- U.S. National Library of Medicine. “Wernicke-Korsakoff syndrome.” MedlinePlus, February 4, 2020. Accessed May 10, 2022.
- Archibald, Luke; Brunette, Mary F.; et al. “Alcohol Use Disorder and Schizophrenia o[…]zoaffective Disorder.” Alcohol Research, December 20, 2019. Accessed May 10, 2022.
- National Institute of Mental Health. “Schizophrenia.” Accessed May 10, 2022.
- National Alliance on Mental Illness. “Psychosis.” Accessed May 10, 2022.
- U.K. National Health Service. “Treatment – Psychosis.” December 10, 2019. Accessed May 10, 2022.