What Is Alcohol-Induced Psychosis?

As per a recent survey, around 62.5 million people in India, that is close to 1/3rd of the country’s population, consume alcohol and 17.4% of this population (10.6 million) struggles with alcohol use disorder (AUD). This blog takes a dive into understanding alcohol-induced psychosis and will cover the following:

• What is psychosis?
• What is alcohol-induced psychosis?
• What is the cause of alcohol-induced psychosis?
• What are the different types of alcohol-induced psychosis?
• Who is at risk of alcohol-induced psychosis?
• What are the early warning signs of alcohol-induced psychosis?
• What are the symptoms of alcohol-induced psychosis?
• What is the diagnosis process of alcohol-induced psychosis?
• What can be the complications of alcohol-induced psychosis?
• How long does alcohol-induced psychosis last?
• What is the treatment for alcohol-induced psychosis?
• How to get help for alcohol addiction?

What Is Psychosis?

Psychosis is a state-of-mind or a set of symptoms that cause a disruption in the thoughts and perceptions of a person in a way that makes it difficult for him to differentiate between what’s real and what’s not. This impacts his ability to interact with his real-time or present circumstances. Drug or alcohol use, trauma, or over-stress may induce psychosis. The symptoms of psychosis occur in certain medical illnesses such as schizophrenia and alcohol-induced psychosis. 

Symptoms of Psychosis

• Hallucinations – Seeing, hearing, feeling or perceiving things that are not real and the person hallucinating believes that they are real.
• Delusions – Falsely believing something to be true despite having the proof or evidence of it being untrue. Paranoia, for instance, is an example of delusion in which the person might have a fear that someone is after him or is lying to him.
• Dissociation/ depersonalisation – The person experiences detachment from the rest of the world or self. For instance, the person feeling dissociated might feel that other people around him are not real.

What Is Alcohol-Induced Psychosis?

Alcohol-induced psychosis disorder is a medical condition causing the person to experience episodes of psychosis, such as hallucination and delusion, triggered by alcohol intoxication or alcohol withdrawal.

Alcohol-induced psychosis may arise due to

• Heavy alcohol consumption
• The compulsive pattern of alcohol consumption

People experiencing alcohol-induced psychosis should undergo medical consultation and treatment. The symptoms of psychosis leave after the consumption of alcohol is stopped or its withdrawal symptoms get subsided. 

What Is the Cause of Alcohol-Induced Psychosis?

The aetiology of alcohol-induced psychosis is unknown. According to some, it is caused by the effects of alcohol on dopamine levels inside the body, or perhaps changes to neural receptors.

Below are the prime causes that may lead to alcohol-induced psychosis episodes:

• Prolonged consumption of alcohol
• Consumption of alcohol in heavy quantity
• Consumption of alcohol in a compulsive pattern

What Are the Different Types of Alcohol-Induced Psychosis?

Alcohol-induced psychosis exists in three types:

Acute Intoxication

Acute intoxication is the type of alcohol-induced psychosis that may occur when a person consumes large quantities of alcohol in one sitting. Since acute intoxication may lead to alcohol-induced psychosis, if gone out of control, it may also lead to alcohol poisoning. Hence anyone who is experiencing alcohol-poisoning must get the required medical attention at the earliest; delaying can be fatal.

Chronic Alcoholic Hallucinosis

Chronic alcoholic hallucinosis is the type of alcohol-induced psychosis caused by chronic, severe and constant alcohol abuse. It involves seeing, hearing or perceiving what’s not real. This causes a delusion and mood disturbance in the mind of the person under its influence and impacts their ability to interact with their environment. Usually, Chronic Alcoholic Hallucinosis lasts for hours, days, weeks or months at length in which case it closely mimics schizophrenia.

Alcohol Withdrawal Psychosis

Alcohol withdrawal psychosis is an amplified form of hallucination over a prolonged period. In the case of hallucinations taking a full-blown form on alcohol withdrawal, it’s called alcohol withdrawal delirium (AWD). It may be caused if someone who consumes high-volumes of alcohol over an extended period suddenly stops its consumption and suffers severe withdrawal. Long-term alcohol consumption leads to the structural and chemical makeup of the brain, and when alcohol is cut down or removed, it may trigger psychosis.

Symptoms of Alcohol Withdrawal Delirium (AWD)

• Extreme sensitivity to light, sound or touch
• Mood swings
• Increased heart and breathing rates
• Delusions
• Hallucinations
• Formication, or the feeling that tiny insects are crawling on or under the skin
• Body tremors

Delirium tremens is one of the most serious withdrawal symptoms of alcohol withdrawal delirium (AWD).

The above types of alcohol-induced psychosis can have serious effects and can be life-threatening. This is why it’s important for anyone facing them to reach out for medical attention. If they are experiencing them due to alcohol withdrawal, it’s highly recommended to stop alcohol under medical supervision under a medical detox program.

Who Is at Risk of Alcohol-Induced Psychosis?

Although alcohol-induced psychosis is rare, there are certain types of people who have a greater risk for the condition:

• Anyone going through alcohol withdrawal
• Chronic alcoholics
• People who are acutely intoxicated

Non-drinker or occasional drinkers are at little to no risk of having psychosis due to alcohol.

Some scientific evidence also suggests that genetics might also play a role in triggering psychosis due to alcohol consumption.

What Are the Early Warning Signs of Alcohol-Induced Psychosis?

People struggling with psychosis experience difficulty in speaking smoothly or face hallucinations, delusions or not being able to relate to reality. Confusion and agitation are common symptoms of alcohol-induced psychosis, which if not managed, might worsen over time.

Here are some symptoms to detect the early stages of psychosis:

• Irrational fears or unfounded suspicions
• Trouble concentrating
• Detachment from family and friends
• Significant changes in sleep—too much or too little
• Obsessive thoughts
• Anxious behaviour

It’s important to recognise the early warning signs of alcohol-induced psychosis to control severe and serious damage that may result in loss of work, home or family and relationships. Also, if the person has surpassed the initial stages of psychosis, they must undergo medical interventions.

What Are the Symptoms of Alcohol-Induced Psychosis?

Below are some of the prime symptoms of alcohol-induced psychosis:

• Disturbed thoughts or perceptions
• Poor executive functioning
• Trouble thinking clearly or concentrating
• Memory problems
• Difficulty understanding what is real
• Behavior that is inappropriate for the situation
• Incoherent speech
• Delusions
• Hallucinations

What Is the Diagnosis Process of Alcohol-Induced Psychosis?

The diagnosis process of alcohol-induced psychosis includes the evidence-based presence of symptoms of psychosis-like hallucinations and delusions—triggered by alcohol intoxication or withdrawal. A few points that are examined during the diagnosis process may include the following:

• A detailed physical exam
• Stress levels
• Ease or problems performing normal activities such as work or chores
• Social interactions
• Medical conditions of the patient like airway, breathing and vital signs
• Observation of the patient’s general appearance as if the patient is unkempt, smells of alcohol or appear to be responding to internal stimuli
• Any history of factors that may influence psychosis signs of trauma (especially head injury) or any metabolic causes such as liver disease and electrolyte abnormalities
• Family history of psychotic disorder

Also, it may include certain medical tests like CT scan, urine analysis, urine drug screen test, lab evaluation including electrolyte, liver function tests, ammonia and toxicology screening, etc.

What Can Be the Complications of Alcohol-Induced Psychosis?

Below are the three complications that may be caused by alcohol-induced psychosis:

• Depression
• Suicide
• Major psychosocial impairment

How Long Does Alcohol-Induced Psychosis Last?

The episodes of psychosis usually last for a few hours to a few days, weeks or can sometimes even process to long-lasting forms that mimic schizophrenia. Though the symptoms of alcoholic-induced psychosis usually get resolved quickly, they can get triggered by quick and continued drinking. Also, people who are predisposed to a longer-lasting psychotic disorder are at greater risk to experience an alcohol-induced psychotic episode.

What Is the Treatment for Alcohol-Induced Psychosis?

Often, simply stopping the consumption of alcohol completely can be the treatment of alcohol-induced psychosis. It is best done in a detox center. Early management through various supportive measures (like guidance and education about early warning signs, stress and anxiety management, relaxation techniques, social and living skills, etc.), rehabilitation for any co-occurring substance abuse and medication, when needed, might also be helpful.

In some cases, immediate medical intervention for stabilization and safety is required to ensure normal body functioning and prevent any suspected severe withdrawal symptoms like seizures.

Below are some of the proven methods of successful treatment and recovery of alcohol use (and thus, alcohol-induced psychosis):

• Cognitive-behavioral therapy
• Stabilizing medication
• Long-term or short-term rehabilitation
• Continuing care through clinical psychiatry: 
  • Medical detox
  • Inpatient programs
  • Partial hospitalization
  • Intensive outpatient
  • Outpatient programs
  • Aftercare

How to Get Help for Alcohol-induced Psychosis?

It’s tough to fight alcohol-induced psychosis alone and can be a frightening experience for everyone involved. Also, stopping or cutting back on alcohol right away may lead to psychosis as a severe withdrawal symptom as opposed to a gradual tapering of the intake. While it should not hold you back from fighting back, if you or your loved one suffered from excessive compulsive alcohol consumption that leads to psychosis and is causing adverse health conditions, then it’s advisable to seek medical guidance immediately. Visiting a professional medical detox and rehabilitation centre can also help in the recovery process.

What Are Some Precautions and Points to Be Kept in Mind If You or a Loved One Is Suffering from Alcohol-Induced Psychosis?

Below are some of the precautions to be kept in mind if you or a loved one is suffering from alcohol-induced psychosis:

• Chronic or excessive consumption of alcohol can cause alcohol-induced psychosis.
• Alcohol-induced psychosis is a temporary psychosis, usually lasting for a few hours or days.
• Although the exact cause of alcohol-induced psychosis is unknown, it is observed that it usually gets triggered on the overconsumption of alcohol.
• If psychosis continues to persist long after the last alcohol intake or after the alcohol consumption is stopped, then the patient might have a co-occurring mental health condition, such as schizophrenia.
• It is important to reach out for professional help at the earliest if you notice the symptoms of alcohol-induced psychosis.