What Is Alcohol-Induced Psychosis?

Reviewed by Aaron Horn, LMFT

Published 07/25/2022

Alcohol use disorder (alcoholism) is one of the most common addictions affecting more than 15 million people in the United States. In addition, those who drink, also run the risk of having alcohol-induced psychosis. This condition is not an official disorder, per se, but it is a group of symptoms that happen to someone that causes them to lose touch with reality.

What Is Psychosis?

According to the National Institute of Mental Health (NIMH), psychosis is a group of conditions that cause your brain to lose contact with reality. During an episode, your thoughts are jumbled, and you have trouble understanding what is real. It is often accompanied by another mental health condition like anxiety or depression and is commonly found in those who often drink to extremes.

Signs Of Psychosis

Alcoholic psychosis may start with just minor signs like avoiding people, trouble sleeping, or talking to people who are not there. Alcohol psychosis can cause serious issues that can be frightening and serious, resulting in what is referred to as a psychotic break. Those who suffer from a psychotic break may show these signs:

  • Changes in sleeping pattern
  • Avoiding friends and family
  • Seeing things that are not there
  • Hearing voices or other sounds that nobody else hears
  • Not being able to focus or concentrate
  • Believing you are being followed or stalked
  • Thinking the internet, radio, or television is sending you secret messages
  • Feeling strange or experiencing weird smells
  • Acting out of the ordinary
  • Not being able to speak clearly
  • Having trouble understanding things
  • Lack of self-control
  • Frightening thoughts and perceptions
  • Forgetting things
  • Alcohol-induced schizophrenia(hearing voices)

How Does Alcohol Cause Psychosis?

Because alcohol affects your brain, it can cause you to have periods of losing touch with reality if you drink too much. Those who are sensitive to alcohol may exhibit symptoms the first time they drink, while others may not have any psychotic issues until they stop drinking. Others may never have a psychotic episode at all. 

Experts believe that it has something to do with the brain's chemicals, underlying mental health conditions, and physical problems like brain injuries. The neurol receptors in your brain help you recognize what is real and what is fake, and for those with alcohol-induced psychosis, the alcohol may be damaging or affecting those neurons. You may not know if you have a problem with alcohol-induced psychosis, but you can take an online test that may give you an idea of whether or not you may need treatment.

What Is Alcohol Use Disorder?

Any type of problem drinking is grouped into a medical diagnosis as an alcohol use disorder. This may include those who drink every day for years, those who binge drink on weekends, or those who rarely drink but drink heavily when they do. Here are some of the signs you may have alcohol use disorder:

  • You have withdrawal symptoms when you do not drink, such as insomnia, nausea, restlessness, anxiety, and shakiness.
  • Have had to drink a lot more alcohol to get the effect you want.
  • Continue to drink even after it caused a health problem or made you feel depressed or anxious.
  • Frequently get into bad situations during your drinking episodes, such as having unsafe sex, acting reckless, or driving while intoxicated.
  • Have tried to quit drinking but cannot.
  • Stopped doing certain things you like to do if you cannot drink while doing them.
  • Keep drinking even after it caused problems with friends or family.
  • Drinking or hangovers are interfering with your work or taking care of your family.
  • Craved drinking when you stop.
  • Spend a lot of time drinking or getting over hangovers.
  • Have legal trouble because of drinking.

Different Types Of Alcohol-Induced Psychosis

Even though many people just use the term alcohol-induced psychosis as a term covering a group of symptoms, there are several types of alcohol psychosis. These include acute intoxication, alcohol withdrawal psychosis, and chronic alcoholic hallucinations.


The type of psychosis caused by acute intoxication happens when you drink a large amount of alcohol at one time. Even though it is rare for someone to have a psychotic episode after one heavy drinking period, it does happen in some people. This is an especially dangerous type of psychosis because the amount of alcohol you need to consume to have a psychotic break is the same as alcohol poisoning. Therefore, acute intoxication psychosis can be considered a symptom of alcohol poisoning, which can be lethal.


For those who have been drinking a lot of alcohol for a long period, chronic alcoholic hallucinosis can begin and continue for a longer time than the other types of alcohol-induced psychosis. The symptoms are much more severe in this type as well, with frequent hallucinations and delusions. In fact, those with chronic alcoholic hallucinosis can easily become combative and aggressive, sometimes hurting others or themselves. The symptoms may last for hours or even weeks at a time.


Those who have been struggling with alcohol use disorder for a long period (years) may have hallucinations and delusions when they quit drinking. It may even cause an increase in breathing rates, heart rate, and higher blood pressure. These symptoms may be life-threatening in severe cases, so if you have been drinking for a long time and want to quit, it is best to talk to a professional about getting treatment.

Who Is Most At Risk Of Alcohol-Induced Psychosis?

Although there is no way to know exactly who will develop alcohol-induced psychosis, some risk factors are common. First of all, if you do not drink, you do not have to worry about having a psychotic episode from drinking alcohol. If you have signs of psychosis, you should talk to a mental health care professional. However, if you do drink alcohol, here are some risk factors that may trigger a psychotic break:

  • Chronic heavy drinking
  • Binge drinking
  • Abruptly quitting drinking after a long history of alcoholism
  • Imbalance in the chemicals in the brain like dopamine or serotonin
  • Having any kind of mental health disorder such as anxiety or depression
  • Vitamin deficiency such as B1 deficiency
  • Family history of psychosis or mental illness
  • Not getting enough sleep
  • Experiencing a traumatic event such as death, a serious accident, physical or sexual abuse, or combat

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  • Having a physical illness that can affect your brains, such as HIV, Parkinson’s disease, Alzheimer’s disease, brain tumor, or a traumatic brain injury
  • Using other kinds of drugs such as amphetamines or hallucinogens

Treatments For Alcohol-Induced Psychosis

The obvious treatment for alcohol-induced psychosis may be to quit drinking, but it is not that simple. Often, quitting is what causes the psychosis, so it makes quitting even more difficult. There are plenty of alcohol use disorder treatment programs such as Alcoholics Anonymous and other group therapies.

You can also benefit from an inpatient alcohol withdrawal treatment plan if your psychosis is extreme. This type of detox program may be done in a hospital or another health facility equipped to care for someone if they have any life-threatening withdrawal effects. After detox, you are usually required to stay for a certain number of days and participate in preventative treatments.

Types Of Psychotherapy For Alcohol-Induced Psychosis

There are many kinds of psychotherapy, but not all of them are best for alcohol-induced psychosis. However, they are all talk therapy, which is very important in healing after a psychotic break. Group therapy and one-on-one talk therapy with a professional therapist are excellent therapies. Others that may help include:


Also known as CBT, this type of psychotherapy is a short-term talk therapy that focuses on problem-solving and changing your thinking patterns. The main idea is that those with alcohol-induced psychosis have negative thoughts and feelings that govern their actions.

Man in Black Jacket Lying on Bed

Emphasizing feelings and thoughts being linked, the therapist will often help you learn new and more productive ways of dealing with your negative thoughts. They also introduce you to cognitive distortions that are likely to be affecting your mental health. The most common cognitive distortions are:

  • Filteringis a way of filtering out the good things that happen in your life and only focusing on the negative things.
  • Catastrophizing, in which you would always be expecting a disaster to happen, or you may magnify situations to make them worse than they are.
  • Personalizationis the distortion that everything is about you.
  • Jumping to conclusions where you constantly believe you know what is going to happen before it does.
  • Emotional reasoningcauses you to believe that what you think is always true no matter what others think.


Dialectical Behavioral Therapy is also known as DBT. This therapy is like CBT, but it concentrates more on learning how to handle the bad things that happen to you rather than ignoring or avoiding them. You will learn to find a way to accept that things are not going your way and discover other ways to handle them instead of drinking. 

The main focus of DBT is learning what your strengths are and finding ways to use them rather than just seeing your faults. Some of the most important things your therapist will do that can help include teaching you coping mechanisms, helping you learn better social skills, and finding ways to get your life back on track.

If you feel that you may have symptoms of psychosis, take this online test to find out more.