Alcohol-induced psychosis
Many mental disorders can cause psychotic symptoms such as depression, mania, and schizophrenia, but other types of psychosis are alcohol-induced and may be categorized in the following ways:
• Psychosis related to toxicity
• Psychosis related to withdrawal
• Psychosis related to intoxication
Alcohol-induced psychosis is defined roughly as a mental condition in which:
• Contact with reality is compromised by delusions and/or hallucinations, and
• These symptoms occur during or shortly after intoxication or withdrawal
Any class of substance may cause psychosis. Overall, susceptibility to a substance-induced psychosis appears to be largely an individual issue and to depend upon how innately vulnerable a person is. There are no reliable ways to predict if a person will have a substance-induced psychosis for the first time. People who have a mental illness with delusions or hallucinations are, however, particularly vulnerable to having psychotic symptoms while using substances.
Alcohol-Related Psychosis is a condition in which hallucinations occur during alcohol intoxication or during withdrawal from alcohol. This is often an indication of chronic alcoholism that affects about 3% of people with alcohol dependence. Typically these hallucinations stop and do not continue once the crisis of intoxication or withdrawal is over.
Alcohol-Related Psychosis can be indicative of conditions that are serious health concerns and could even be life-threatening. It often signals the acute stage of alcohol withdrawal in which seizures and other physiological crises occur. These could be life endangering without proper treatment. Alcohol psychosis can also indicate an excessive amount of ingested alcohol resulting in a high alcohol blood content level or alcohol poisoning. Intoxication related death by alcohol is commonly due to alcohol poisoning or overdose.
Another type of alcohol psychosis is a rare condition called idiosyncratic intoxication. This occurs when a small amount of alcohol causes severe reactions and intoxication. One might become aggressive and have hallucinations and delusions. There are usually no symptoms after intoxication has passed with the possible exception of amnesia for what occurred during the psychosis. Delirium tremens (DTs) occurs with alcohol withdrawal and has many physiological symptoms which can be life-threatening. Some of these symptoms are:
• fever
• tachycardia
• hypertension
• seizures
Delirium tremens is also characterized by hallucinations or illusions, but the serious physiological symptoms listed above distinguish it from a substance- induced psychosis that is not life-threatening. In delirium tremens hallucinations are typically visual, but may include tactile hallucinations such as the sensation of something crawling on the skin (formication).
Alcohol hallucinosis typically occurs in a later stage of alcohol withdrawal -- usually 48 hours after abruptly decreasing or stopping alcohol intake when there has been excessive alcohol use for a long period of time. Alcohol hallucinosis also causes the types of hallucinations found in other alcohol-induced psychoses; however, these persist for some time. Some individuals may have symptoms of alcohol hallucinosis for weeks or months.
Medical treatment is required for management of alcohol-induced psychoses. At times psychiatric services or even hospitalization are needed due to the severity of disorientation and agitation. Medically supervised withdrawal and detoxification protocols monitor and manage the health risks of these conditions. Medications may be used to treat symptoms such as hypertension, fever, seizures and other complications of withdrawal. Similarly, medications for sedation and psychosis may be used to manage delusions, hallucinations and agitation.
