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Alcohol Hallucinosis

Alcohol hallucinosis is a side effect of chronic alcohol abuse. People with alcohol hallucinosis have vivid hallucinations, delusions, intense feelings of anxiety or fear. 

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Sometimes, the problem fades with appropriate treatment. However, some people have symptoms for six months or longer, even with treatment.[1]

Understanding what alcohol hallucinosis looks like is critical. If someone you love drinks excessively, they may develop the condition and need your help. Learning more about the condition may also prompt you to limit how much alcohol you consume. 

What Is Alcohol Hallucinosis?

Alcohol hallucinosis is a set of symptoms that develop when heavy drinkers stop consuming alcohol abruptly or cut back on how much they drink. Common signs include the following:[1]

  •  Hallucinations: People hear things others can’t hear, and those sounds can be vivid. They may believe people are talking about them or threatening them.
  •  Delusions: People may believe that they’re in danger, even if no one else can spot the threat.
  •  Powerful feelings: Some people feel intense ecstasy, but others experience fear or terror.

Research suggests that symptoms typically resolve with 18 to 35 days of medication treatment. However, some people have persistent symptoms that last six months or more, even with medications.[1]

Causes of Alcohol Hallucinations 

Researchers say alcohol hallucinosis typically affects people who have used alcohol for more than 10 years. It’s more common in men than in women.[6]

Known risk factors associated with alcohol hallucinosis include the following:[1]

  • Younger age when alcohol dependence developed
  • Low socioeconomic status
  • Repeated hospital visits due to alcohol use disorder

Issues that could cause alcohol hallucinosis include the following:

  • Dopamine: Some researchers say alcohol changes dopamine receptors in the brain. When cells are flooded with this powerful chemical, they can’t communicate effectively, and hallucinations develop.[2]
  • Amino acids: Other researchers blame amino acid abnormalities or elevated levels of beta-carbolines for hallucinations.[2]
  • Mild brain damage: Some researchers say auditory and sensory pathways in the brain are damaged by heavy drinking, which could cause visual or auditory hallucinations.[1]

Alcohol Hallucinosis Risk Factors

Drinking a large amount of alcohol is the largest risk factor for alcohol hallucinosis, experts say. Some people develop the problem as a side effect of alcohol addiction. But anyone who drinks too much can experience this altered state of consciousness.[3]

Other risk factors include the following:[1]

  • Beginning a drinking habit at a young age 
  • Repeated admissions to a hospital due to alcohol abuse 
  • Low economic status 
  • Other mental health issues 

Researchers haven’t identified a specific amount of alcohol that always causes hallucinosis. Everyone digests and metabolizes alcohol differently. An amount that’s safe for you may be too powerful for someone else. 

But in general, drinking a lot of alcohol and doing so regularly can significantly increase your risk of developing alcohol hallucinosis.[1]

Alcohol Hallucinosis vs. Delirium Tremens vs. Alcohol Psychosis 

Doctors use many terms to describe brain changes caused by alcohol. They’re very rarely interchangeable. Understanding which one applies can help you talk openly with your medical team. 

Alcohol hallucinosis and alcohol psychosis (predominantly hallucinatory type) are synonyms.[7] People with these conditions have auditory hallucinations that seem very real to them.

Delirium tremens is a separate medical diagnosis. It is also caused by alcohol abuse, but the symptoms are different and slightly more severe. People with delirium tremens often have visual (not auditory) hallucinations. And they can develop seizures as the problem progresses.[1]

Delirium tremens can also cause heart-related symptoms that don’t appear with alcohol hallucinosis. For example, people with delirium tremens may have a fast heartbeat. Since they’re typically breathing quickly, they can hyperventilate too. These problems just aren’t seen in alcohol hallucinosis.[4]

How Is Alcohol Hallucinosis Treated?

People with alcohol hallucinosis are incredibly uncomfortable. And since the problems can last for so long, treatment can be critical. 

Some doctors use antipsychotic medication to rebalance brain chemistry.[3] Medications like this can reduce hallucinations and anxiety, helping people to feel much more relaxed and comfortable. 

People can also benefit from alcohol withdrawal treatments.[3] If hallucinations develop due to long-term alcohol abuse and an attempt to quit, doctors might use medications like benzodiazepines to ease withdrawal symptoms and help people recover more comfortably. 

A more tapered approach to alcohol withdrawal can also help, allowing the body to ease into sobriety rather than suddenly stopping drinking.

Treatment Options for Alcohol Abuse 

Anyone who develops alcohol hallucinosis needs to stop drinking. Regular alcohol abusers will need help to do so. 

Chronic alcohol abuse can alter brain chemistry in persistent ways. When long-time drinkers try to quit abruptly, they can develop seizures during withdrawal.[5] 

A treatment program with medications can help you to get sober without experiencing life-threatening problems. You’ll also have medical supervision throughout the process to ensure you stay safe and supported the entire time. 

Withdrawal management can help you get sober, but it can’t help you stay that way. A rehab program can help you identify drinking triggers, and you can learn new ways of dealing with them. With a program like this, you can stop drinking for good, as you’ll acquire the skills to deal with life’s stressors without turning to alcohol.

Frequently Asked Questions

These are the questions we often hear about alcohol hallucinosis:

Can alcohol cause hallucinations?

Yes. When long-time drinkers quit abruptly or dramatically reduce their intake, they can develop hallucinations.

Are alcohol hallucinations the same as DTs?

Not always. Alcoholic hallucinosis refers to alcohol withdrawal hallucinations that are typically auditory. Delirium tremens ( DTs) typically refers to visual hallucinations accompanied by seizures and other life-threatening problems.

Can alcohol hallucinations be treated?

Yes. Doctors can use medications like benzodiazepines to help the brain adjust to sobriety slowly. With the proper treatment, hallucinations can be reduced or even eliminated.

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Medically Reviewed By Dr. Alison Tarlow

Dr. Alison Tarlow is a Licensed Clinical Psychologist in the States of Florida and Pennsylvania, and a Certified Addictions Professional (CAP). She has been a practicing psychologist for over 15 years. Sh... Read More

Updated March 22, 2024
  1. Acute alcoholic hallucinosis: A review Skryabin V, Martinotti G, Franck J, Zastrozhin M. Psychopathology. 2023;56(5):383–390
  2. Alcohol-related psychosis Stankewicz H, Richards J, Salen P. StatPearls. Published July 10, 2023. Accessed September 25, 2023.
  3. Treatment of alcohol-induced psychotic disorder (alcoholic hallucinosis)—A systematic review Masood B, Lepping P, Romanov D, Poole R. Alcohol and Alcoholism. 2018;53(3):259–267
  4. Management of moderate and severe alcohol withdrawal syndromes Hoffman R, Weinhouse G. Up to Date. Published September 15, 2023. Accessed September 25, 2023.
  5. Clinical management of alcohol withdrawal: A systematic review. Kattimani S, Bharadwaj B. Ind Psychiatry J. 2013;22(2):100-108. doi:10.4103/0972-6748.132914
  6. Alcoholic hallucinosis. Psychiatry and Clinical Psychopharmacology. 2014;24(1):S194.
  7. Alcoholic hallucinosis. Bhat P, Ryali V. Srivastava K, et al. Industrial Psychiatry Journal. 2012;21(2):155-157
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