Alcohol Induced Psychosis: Signs, Symptoms And Causes

About 4% of people who develop AUD will possibly experience alcohol-induced psychosis, according to a May 2018 review in the journal entitled Alcohol and Alcoholism. 

The more we educate people about the extent of the dangers of any heavy form of alcohol consumption, the more we can lower that number altogether. That’s why in this blog, we will talk about alcohol-induced psychosis and how to spot the signs, symptoms and causes. 

What is Alcohol Induced Psychosis?

Alcohol Induced Psychosis is a condition that develops because of excessive alcohol consumption. It is also referred to as alcohol-induced psychotic disorder, and it is characterised by difficulty perceiving the environment around them and social interactions. The symptoms will carry on even after the intoxicating effects of alcohol wear off. 

Alcohol causes changes in the function of the cells, cell membranes, and organs. As a result, people who are suffering from alcohol use disorder might develop hallucinations and delusions. The person may also have their auditory system affected, which can cause those symptoms. 

This condition happens to people who experience acute intoxication or alcohol poisoning, alcohol withdrawal, and chronic alcohol use disorder. 

What are the Symptoms of Alcohol-Induced Psychosis?

It can be difficult to differentiate the symptoms associated with alcohol-induced psychosis and intoxication. However, one important thing to remember is the symptoms of alcohol-induced psychosis will last longer than the usual alcohol intoxication. There will also be more severe disorientation and lower inhibitions that are normally connected to alcohol intoxication.

Common Symptoms of Alcohol Psychosis

The common symptoms of alcohol-related psychosis include: 

• Visual, auditory, or tactile hallucinations
• Delusional thinking
• Severe confusion or disorientation
• Agitation or restlessness
• Paranoia
• Fear

4 Types of Alcohol-Induced Psychosis

There are four types of alcohol-induced psychosis:

Delirium Tremens Psychosis

Delirium Tremens Psychosis happens during the duration of alcohol withdrawal syndrome. People may experience delirium in 4-7 days after stopping the alcohol intake. If this condition is left untreated, there is a possibility that it can become fatal. 

Examples of the symptoms will include:

• Disorientation
• Persecutory delusions of the feeling of being chased
• High blood pressure, temperature and pulse
• Mood swings
• Sensitivity to sensory inputs
• Visual and auditory hallucinations
• Severe confusion, fear, or agitation

 Acute Alcohol Intoxication

This is also known as Alcohol Poisoning Psychosis. It happens after a person has consumed an excessive amount of alcohol. There are instances when the onset of the symptoms starts while the person is intoxicated, but there are also instances where the symptoms appear when the body has been cleared of alcohol. 

The person might experience severe aggression or psychotic symptoms that can last for several hours. After the episode, the person will not remember anything about the episode. 

Chronic Alcoholic Hallucinosis

Alcoholic hallucinosis happens after several years of chronic alcohol abuse. It has some similar symptoms with delirium tremens psychosis. Examples of psychotic symptoms include: 

• Vivid auditory hallucinations
• Visual hallucinations 
• Paranoia
• Persecutory delusions
• Fear 
• Mood swings

The hallucinations that come with chronic alcoholic hallucinosis are often classified as auditory. Mood disturbances are also considered normal.

Psychosis also lasts longer among alcoholics, which can be anywhere between hours, days or weeks. The longer duration makes it seem like it is paranoid schizophrenia. However, studies have shown no genetic connection between the two conditions. 

Alcohol-Induced Wernicke-Korsakoff Syndrome

The alcohol-induced Wernicke-Korsakoff Syndrome happens because of the lack of thiamine or vitamin B1. Excessive long-term alcohol intake can result in a loss of thiamine in the body. This can lead to significant brain damage that can cause hallucinations and memory loss.

The acute version of this condition is called Wernicke encephalopathy. Some of the symptoms are:

• General confusion 
• Loss of mental activity 
• Loss of muscle coordination
• Tremors
• Strange eye moments
• Vision changes (double vision)

The chronic or long-lasting version is Korsakoff syndrome, and examples of symptoms are:

• Memory loss
• Difficulty in forming new memories
• Hallucinations
• Delusions

How to Identify Acute Psychosis Due to Alcohol

Acute psychosis has two different kinds, which are primary and secondary psychosis. The most common reasons for acute secondary psychosis because of alcohol are chronic alcoholism, alcohol withdrawal syndrome, and alcohol poisoning. 

The symptoms of general acute alcohol-induced psychosis include: 

• Auditory and visual hallucinations
• Paranoid delusions
• Agitation
• Difficulty to speak clearly
• A total break with reality

Understanding Alcohol Hallucinosis

Alcohol Hallucinosis is an uncommon but serious psychiatric disorder that is tied to experiencing hallucinations or delusions, or even both, while the person is consuming alcohol or during withdrawal. It develops around 12 to 24 hours after the excessive drinking suddenly stops, and it can last up to several days.

How is Alcohol Addiction Related to Psychosis?

People who heavily drink or consume excessive amounts of alcohol may develop symptoms of psychosis, such as hallucinations and or delusional thinking while undergoing withdrawal or being intoxicated.

Long-term Effects of Alcohol Dependence on Mental Health

Alcohol can change the way your brain cells communicate signals to one another. There have been instances where people have turned to alcohol to help manage the symptoms of stress, anxiety, and depression.

On the other hand, some people are drinking alcohol to self-medicate. This may feel good for a short period, but it does not last long, and once the feeling has worn off, the symptoms of depression will only become worse. 

Examples of other long-term effects are 

• Insomnia and sleep concerns
• Weakened immune system
• Mood swings
• Irritability
• Difficulty regulating emotions
• Changes in libido, sexual function, appetite and weight

What are the Treatment Options for Alcohol-Induced Psychosis?

The treatment protocol for AUD will vary depending on the severity of the case at hand and several other factors. However, the collective treatment goal is to rebuild and improve the quality of life slowly the patient is living.

Overview of Treatment for Alcohol Use Disorder

The treatment for AUD may involve a residential or outpatient stay, group or individual counselling, or interventions. 

The programme may begin with detoxification and medically managed withdrawal. Generally, this process may last 2 to 7 days and is usually conducted in an inpatient treatment centre or a hospital.

Once the process is over, the patient will follow up with an alcohol treatment specialist to create an individualised treatment plan that will fit all their goals and needs during their recovery journey. Next on the docket are counselling and different therapies for the patient to understand the why and how of the origin of their alcohol addiction. Counselling and therapy are also important for patients for them to receive the support that they need from the psychological aspects of alcohol use. 

The patient will also be prescribed the required type of medication, such as oral medicine or injected medication, based on their state to help them through the addiction recovery process. 

Medications for Managing Symptoms of Alcohol-Related Psychosis

The medical intervention for managing the symptoms associated with alcohol-related psychosis is composed of benzodiazepines and antipsychotic medications. Among the benzodiazepines are lorazepam and chlordiazepoxide to manage withdrawal symptoms and psychosis because of the sedative and anxiolytic properties the medications have. 

On the other hand, antipsychotics also play an important role in managing symptoms. First-hand antipsychotics are usually the first line of defence, and they have proven to be successful in achieving full or partial remission of the symptoms. However, second-hand antipsychotics are now being used more often because they have a better balance between efficiency and side effects. 

Mental health disorders happen to coincide often with alcohol use disorder or any other substance use disorder. It must also be treated alongside the addiction to cover all aspects of life that are affected by addiction in the first place.

Some people would find it helpful and comforting to have spiritual practices to power through the recovery process from alcohol addiction. Continuous support, such as aftercare and support groups, is also presented, and encouragement is given to avoid relapses and support the foundation built inside the treatment centre. 

Therapeutic Approaches for Patients with Alcohol Dependence

Incorporating or mixing in components from motivational interviewing, cognitive behavioural techniques such as coping or social skills training, and emotional regulation is known to be highly effective for alcohol dependence.  

What are the Dangers of Alcohol-Induced Psychosis?

Alcohol-induced psychosis can be both tedious and dangerous. The dangers associated with alcohol-induced psychosis do not stop at hallucinations and delusions. These may cause dangerous incidents such as suddenly wandering off alone, aggressively reacting, or driving while being disoriented. These kinds of behaviour are hard to control without the proper support. In the long run, this could also cause serious health problems. 

Risks of Alcohol Withdrawal Leading to Psychosis

People who already experienced one incident of alcohol-induced psychosis are more likely to experience another one soon after. If this is not treated right away, it can become chronic. 

Examples of problems that can contribute to the development of psychosis are: 

• Untreated chronic abuse of alcohol
• Vitamin B1 or Thiamine deficiency
• Early-stage or late-stage alcohol withdrawal
• Abusing other substances along with alcohol
• Lack of social support while going through withdrawal
• Impulse control disorder
• Early-onset alcohol use during the adolescent period

Consequences of Excessive Alcohol Consumption

Excessive alcohol intake can affect people in different ways and at different severity levels. Here are some of the consequences of excessive alcohol consumption: 

• Alcohol poisoning
• Alcohol overdose
• Injuries 
• High blood pressure
• Unplanned pregnancies
• Miscarriages, stillbirth

Long-Term Mental Health Effects of Chronic Alcohol Use Disorder

Chronic AUD can cause significant long-term mental health effects. Once alcohol is consumed in excessive amounts over long periods, it can alter brain chemistry and function and cause several mental health challenges. 

Some of the possible mental health challenges are cognitive impairment problems such as memory problems, difficulty focusing or concentrating, and reduced executive functioning. 

Several disorders and conditions could also arise alongside chronic AUD, such as depression, anxiety disorders like general anxiety disorder, bipolar disorder, schizophrenia, post-traumatic stress disorder, and mood swings.

Excessive alcohol can also cause brain damage, particularly in areas such as decision-making, emotion regulation, and memory. It can also cause neurochemical imbalances, which alter the balance of neurotransmitters such as dopamine, serotonin, and gamma-aminobutyric acid (GABA). 

Some other known long-term effects on mental health are isolation, loneliness, increased risk of suicide, relationship problems, and several more. 

How Can One Manage Alcohol Consumption to Prevent Psychosis?

Everyone handles their alcohol intake, and everybody experiences different effects and symptoms. However, it is important to be reminded that an important factor is the amount of consumption. Like the slogan always says, “drink moderately.” Do not push your body over its limit because the problems associated with heavy alcohol consumption can be rough. 

Strategies to Abstain from Alcohol

It is important to set significant limits and boundaries to limit your alcohol intake successfully. You need to constantly remind yourself that the days of binge drinking are over, and you are going to decrease your alcohol intake slowly. However, it is recommended that you seek the guidance of a professional to ensure that you will complete the transition accurately and avoid further damage. 

The excessive amounts of alcohol in your system call for a need to be aware that you need to be properly hydrated because alcohol is a known diuretic that can cause dehydration. Practising a balanced diet and taking the vitamins you need is also advised to avoid vitamin deficiencies. 

Support Systems for Reducing Alcohol Misuse

There are several support systems that you can engage with to reduce alcohol misuse, such as groups like Alcoholics Anonymous, SMART Recovery, and Moderation Management. In these groups, you will be surrounded by people struggling with similar problems who will not judge you and help you through it. 

Family support, education, and awareness are also important. That’s why there are programmes such as Al-Anon or family therapy, wherein everyone can engage and learn about addiction and what can be done as a family to heal and avoid this problem in the future. There are also several more that can be discovered easily through the internet. 

Where To Find Help

Here at Kembali, we understand the struggles and challenges of alcohol use disorder and the range of symptoms it brings. If you feel you need to talk to us about the onset of psychosis through heavy drinking or want further information on our addiction treatment programmes, we invite you to contact us, and we will gladly provide additional details and offer advice.