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Alcohol-Induced Psychosis

If you’ve ever seen the original 1941 classic animated film Dumbo, you may recall a controversial scene where the titular baby elephant gets into a barrel of champagne. What follows is one of the movie’s most memorable scenes in which Dumbo has a vision of pink elephants formed out of the beverage’s bubbles. 

Pink elephants, along with blue mice, bats, and snakes in boots, were classic folkloric examples of drunken hallucinations. Through the end of the 19th century to the beginning of the 20th, writers used multiple variations of colorful animals to describe alcohol hallucinations. But is the idea of alcohol-induced visions an accurate representation of what some people with alcohol use disorders experience? 

Hallucinations are a sign of psychosis, which is associated with alcohol, especially alcohol use disorder. Learn more about alcohol-induced psychosis and why alcohol hallucinations may be more frightening and even dangerous than pink elephants on parade. 

Does Alcohol Really Cause Psychosis?

According to the 2015 National Survey on Drug Use and Health, alcohol is so ubiquitous, more than 86 percent of Americans age 18 and older reported having tried it at some point in their lives. Plus, nearly 27 percent engaged in binge drinking within a month of that survey. 

Most people drink without ever experiencing strange hallucinations or oddly colored animals. However, even though you and the people you know have never had symptoms of psychosis, some people do. A study in 2018 found that the prevalence of binge drinking among first-time psychotic episodes was relatively high. 

Psychosis is associated with alcohol intoxication, withdrawal, and chronic alcoholism. There is even a specific diagnosis called alcohol hallucinosis that refers to alcohol-related psychotic symptoms. Psychosis is often associated with recent heavy alcohol use, but it can also be seen after quitting alcohol abruptly after a period of chemical dependence. Alcohol-induced psychosis is similar to schizophrenia, but there are some clearly observed differences. Alcohol psychosis is characterized by hallucinations, paranoia, fear, and panic. 

Researchers are still unsure of alcohol’s role in causing hallucinations and psychosis. For all we know about alcohol and the brain, we don’t fully understand its effects. Certain neurotransmitters like dopamine and serotonin are affected by alcohol. But they are also affected by psychedelic drugs, which are known for their ability to alter consciousness and induce hallucinations. Alcohol likely has something to do with the levels of these chemical messengers, but the exact cause is unknown. 

What Is Delirium Tremens?

Another condition that links alcoholism and psychosis is delirium tremens (DT), which is a complication of alcohol and depressant withdrawal. Central nervous system depressants like alcohol, benzodiazepines, and barbiturates are unique in that they are in the only common recreational drug category that can cause deadly withdrawal effects. 

When you become dependent on a depressant like alcohol, your body adapts your brain chemistry around the presence of alcohol in the brain. Your brain may even increase nervous system excitability to counteract the depressant. However, when you stop drinking suddenly, your nervous system may become overstimulated, causing symptoms like anxiety, insomnia, tremors, seizures, and extreme confusion. 

One of the most dangerous symptoms of alcohol withdrawal is delirium tremens, which is characterized by the sudden onset of panic, seizures, confusion, heart palpitations, hyperthermia, coma, and death. Delirium tremens can become deadly when seizures cause fatal injuries, injuries caused by confusion, and heart-related complications caused by heart palpitations or an irregular heartbeat. Delirium tremens symptoms can last for a year or more, bringing on mood swings, fatigue, and drowsiness. Seeking medical attention before going through alcohol withdrawal can dramatically lower your risk of experiencing fatal symptoms. 

How Common Is Alcohol-Induced Psychosis? 

In 2015, a Dutch review of the prevalence of alcohol-induced psychosis found that there was a 0.4 percent prevalence of it in the general population. Among people that are dependent on alcohol, they found 4 percent experienced alcohol-induced psychosis. The highest instances of psychosis were in adult men, especially those who developed an alcohol dependence at a younger age. 

Delirium tremens is also highest among adult men with a lifetime prevalence of 36 percent. Having gone through depressant withdrawal before can also increase your risk of experiencing delirium tremens. Depressant withdrawal can cause a phenomenon called kindling, which refers to neurological changes that occur in the brain that make subsequent withdrawal periods more severe. 

Why Seek Addiction Treatment?

Addiction and alcoholism are chronic and progressive diseases that can worsen over time if left untreated. Alcoholism can take over different parts of your life, causing severe complications. It can cause long-term health problems, strained relationships, and financial instability. Though the disease is long-lasting, it can be treated effectively. Seeking treatment early in the disease can help you avoid some of these severe symptoms. However, no matter how alcoholism has affected you, treatment may be able to help. Learn more about alcoholism and how it can be treated to begin taking steps toward lasting recovery today.

Sources

Lovinger, D. M. (1997). Serotonin's role in alcohol's effects on the brain. Retrieved from https://www.ncbi.nlm.nih.gov/pubmed/15704346

Moggi, F. (2018, June 1). 1 Universitätsklinik für Psychiatrie und Psychotherapie, Universität Bern. Retrieved from https://europepmc.org/abstract/med/29909760

National Institute on Alcohol Abuse and Alcoholism. (2019, August 8). Alcohol Facts and Statistics. Retrieved from https://www.niaaa.nih.gov/alcohol-facts-and-statistics

Rahman, A. (2018, November 18). Delirium Tremens (DT). Retrieved from https://www.ncbi.nlm.nih.gov/books/NBK482134/

Tan, J. H., Shahwan, S., Satghare, P., Cetty, L., Verma, S., Sendren, J. R., … Subramaniam, M. (2018, October 21). Binge drinking: Prevalence, correlates, and expectancies of alcohol use among individuals with first‐episode psychosis. Retrieved from https://onlinelibrary.wiley.com/doi/full/10.1111/eip.12744

U.S. National Library of Medicine. (2019, October 2). Delirium tremens: MedlinePlus Medical Encyclopedia. Retrieved from https://medlineplus.gov/ency/article/000766.htm

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