Alcoholic Hallucinosis: Do Alcoholics Hallucinate?

Alcoholic hallucinosis is a serious but relatively uncommon psychiatric condition that can develop as a result of heavy, prolonged alcohol use. Unlike other alcohol-related mental health complications, alcoholic hallucinosis is characterized by vivid hallucinations, most commonly auditory, meaning a person hears sounds or voices that are not there. Visual hallucinations can also occur. These episodes typically arise during or shortly after a period of heavy drinking and can be distressing for both the person experiencing them and those around them.

Recognizing the signs of alcoholic hallucinosis early is important, as it is often an indicator of a serious underlying alcohol use disorder that requires professional attention. While the hallucinations themselves may subside with time, the alcohol abuse driving them will not resolve on its own.

Signs And Symptoms Of Alcoholic Hallucinosis

Auditory hallucinations are a common symptom of alcohol hallucinations. One may hear something that isn’t actually there. Other case reports list delusions and visual hallucinations as symptoms. People may experience sudden mood disturbances without other alcohol withdrawal symptoms. This is also known as a clear-consciousness symptom.

In long-lasting cases, a person may be misdiagnosed with schizophrenia. The two conditions share several symptoms, especially hallucinations and delusions. However, the causes of schizophrenia are still unknown, while alcoholic hallucinosis is a well-known result of alcohol abuse. If you know someone who drinks heavily and claims to hear or see abnormalities that you don’t, this may be a sign of alcohol hallucinosis.

Causes Of Alcoholic Hallucinosis

As its name suggests, alcoholic hallucinosis is seen in alcoholics (those with alcohol use disorder). Heavy alcohol consumption increases a person’s risk of alcoholism and all of the problems that come with it.

Alcohol hallucinosis can happen during a heavy drinking session or during alcohol withdrawal. The longer a person struggles with alcohol abuse, the more likely they are to suffer serious health effects. The same is true for people who drink heavily.

Long-Term Alcohol Abuse

If a person abuses alcohol for a long time, their body will become used to having alcohol in its system. Alcohol is a depressant that slows brain activity, floods the brain with dopamine, and offers a sedation effect. The brain will respond by producing chemicals (excess dopamine), and this new balance will become “normal” brain chemistry over time.

Long-term drinkers may struggle with physical and emotional alcohol dependence. They may feel a craving for alcohol when they are not drinking. The longer this goes on, the more severe the eventual withdrawal symptoms will be. Alcohol hallucinosis is one of the most severe symptoms of withdrawal. It is often accompanied by other symptoms, such as irritability and nausea.

Alcohol Use Disorder (Alcoholism)

Alcohol Use Disorder, or AUD, is characterized by a dependence on alcohol. People with AUD may drink often and in large amounts. They may also feel at a loss if they are not drinking.

Alcoholism and alcohol dependence are severe versions of AUD. Alcoholic hallucinosis is a potential side effect of alcoholism, which means that those with AUD have a higher chance to hallucinate.

Alcohol Withdrawal

If a person’s tolerance for alcohol is high, they may experience withdrawal symptoms once the alcohol wears off. In severe cases, they may have auditory or visual hallucinations.

Other symptoms of alcohol withdrawal include:

• trouble sleeping
• nausea
• sweating
• irritability
• fever
• seizures

Together, these symptoms are signs of alcohol withdrawal syndrome.

Who Is At Risk For Alcoholic Hallucinosis Or Alcoholic Psychosis?

Alcohol is one of the most common targets for substance abuse in the United States. Long-term alcohol abuse can lead to a decline in mental health. Hallucinosis and psychosis are two of the most severe examples of this.

An alcoholic who is attempting to quit drinking may also experience severe withdrawal symptoms. It’s best to refer a recovering alcoholic to professional health care. Quitting alcohol cold turkey may cause more problems than it solves.

Alcoholic Hallucinosis VS. Delirium Tremens

Alcoholic hallucinosis and delirium tremens are both extreme conditions caused by alcohol abuse. They share common symptoms, such as disorientation.

However, delirium tremens has many physical symptoms separate from alcoholic hallucinosis. These symptoms may occur if an alcoholic’s body goes without alcohol for several days at a time.

Symptoms Of Delirium Tremens

Delirium tremens is a rare complication of chronic alcohol abuse. It’s a serious form of alcohol withdrawal. After a few days without drinking, the body will experience violent reactions.

Symptoms of delirium tremens (alcohol withdrawal delirium) include:

• disorientation
• loss of consciousness
• excessive sweating
• hallucinations
• hypertension

While hallucinations are a part of both alcoholic hallucinosis and delirium tremens, these serious physical symptoms are a clear sign of delirium tremens.

Alcohol Withdrawal Seizures

Seizures are another severe side effect of alcohol withdrawal. Since the body cannot readjust quickly to a lack of alcohol, the resulting imbalance may cause seizures. Sometimes, a person going through withdrawal may suffer through several seizures in a short time.

Alcoholic Hallucinosis Treatment Options

Treatment of alcohol hallucinosis varies. Options in psychiatry and therapy offer different methods of treating hallucinosis and other severe forms of alcoholism. Any or all of these options can help get your mental health back on track.

Medication

Antipsychotic medication, also known as neuroleptics, can effectively treat psychotic disorders like alcoholic hallucinosis. Other medications such as naltrexone (brand name Vivitrol) block receptors that contribute to alcohol dependence. Many other benzodiazepines, such as diazepam (Valium), and opioids exist that treat either alcoholic hallucinosis or general alcoholism. Alcohol withdrawal in severe forms may be treated with barbiturate drugs.

Contact a treatment provider to start exploring the best treatment options for you and your loved ones.

Behavioral Therapy

Counseling and support groups can help you establish support networks. Behavioral therapy can increase motivation for quitting and inspire new coping skills. Emotional support and new healthy habits can go a long way in treating alcoholism and reducing hallucinations.

Intensive Treatment

If you or a loved one are struggling with severe alcohol abuse, intensive care may be necessary. Inpatient treatment may be required to treat serious withdrawal symptoms, delirium tremens, or alcoholic hallucinosis.

Inpatient programs may include:

• drug detox
• medication-assisted treatment
• therapy services
• prescribed medication
• follow-up care (aftercare)

Any or all of these treatment services can help a person recover in a safe environment.

Find Treatment For Alcohol Abuse Today

Alcohol abuse can have serious consequences for both the individual and the people around them. If you or a loved one are experiencing any of the following, it may be time to seek professional help.

Symptoms to look for include:

• hallucinations or other signs of severe alcohol withdrawal
• inability to cut back or stop drinking despite wanting to
• physical dependence on alcohol
• negative impacts on work, relationships, or personal health
• withdrawal symptoms when alcohol use is reduced or stopped

Treatment options for alcohol abuse and dependence include medically supervised detox, inpatient rehab programs, outpatient programs, medication-assisted treatment, and aftercare support. Browsing our directory, reaching out to a healthcare provider, or contacting SAMHSA’s National Helpline is a good place to start.

Written by the Addiction Resource Editorial Staff