Schizophrenia is a mental health condition. Alcohol itself cannot cause schizophrenia. However, some people might experience symptoms of schizophrenia due to alcohol-induced psychosis.

Alcohol-induced psychosis disorder (AIPD) can arise when someone drinks too much or withdraws from heavy alcohol use. Individuals who can bring their drinking under control have a good chance of not experiencing this form of psychosis again.

This article explores the relationships that alcohol has with psychosis and schizophrenia. It also discusses the causes, symptoms, treatment, and complications of AIPD, as well as the outlook for people with this condition.

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Schizophrenia is a psychotic disorder, which means that it involves hallucinations or delusions. People with schizophrenia may also experience thought, behavior, and speech disturbances. Schizophrenia affects roughly 1% of adults worldwide.

Alcohol cannot cause schizophrenia. However, some forms of alcohol use can lead to AIPD, a condition sometimes known as alcohol-related psychosis or alcohol hallucinosis.

Learn more about psychosis.

Acute alcohol intoxication, alcohol withdrawal, and long-standing alcohol misuse all have the potential to lead to alcohol-induced psychosis. However, this complication of alcohol use is relatively rare.

Research also suggests that people with schizophrenia may be three times more likely than those without this condition to develop alcohol use disorder (AUD). There are several possible reasons for this:

  • Self-medication: Some people with schizophrenia might use alcohol to try to get relief from their symptoms or the side effects of prescribed medications.
  • Socioeconomic reasons: The study suggests that having schizophrenia correlates with factors that can lead to heavier alcohol consumption, such as poverty, cognitive problems, and impaired social functioning.
  • Genetics or trauma: Some problems with the brain, such as injury or dysfunction of the brain’s reward system, could predispose some people toward developing schizophrenia and AUD.

Schizophrenia and AIPD are both psychotic disorders, and they have some symptoms in common.

Alcohol-induced psychosis symptoms

AIPD refers to psychosis that develops as a result of alcohol consumption. According to a 2022 review, the symptoms of AIPD arise either during or just after a period of heavy alcohol consumption. They include:

Schizophrenia symptoms

The Diagnostic and Statistical Manual of Mental Disorders, 5th edition (DSM-5) states that a person has schizophrenia if they experience at least two of the following symptoms for at least 1 month:

At least one of these symptoms must be delusions, hallucinations, or disorganized speech.

Learn about the stages of schizophrenia.

There are some important differences between schizophrenia and AIPD. People with the latter condition tend to have more severe anxiety or depression symptoms than people with schizophrenia. Conversely, people with schizophrenia tend to have more disorganization symptoms than people with AIPD.

Scientists remain uncertain regarding how AIPD arises. As a 2022 review explains, some scientists consider changes to dopamine activity to be a crucial factor, while others draw attention to serotonin activity.

Another theory is that abnormal amino acids could alter brain neurotransmitter activity, causing hallucinations.

More research is necessary before scientists can be confident in understanding alcohol’s potential to cause psychosis.

Learn more about dopamine and serotonin.

Treatment should begin shortly after a person receives a diagnosis of AIPD. Experts emphasize that healthcare professionals must first ascertain whether alcohol consumption has caused life threatening physiological changes and then react accordingly.

Acute alcohol intoxication has reportedly led to several serious complications, including:

If the individual has the tendency to become aggressive or violent, they may require sedation. Doctors can provide this using medications, such as benzodiazepines, antipsychotics, or a mixture of both. Although the dosage may change, the use of these medications may persist into the medium or long term.

Scientists consider abstinence from alcohol an essential component of the treatment plan. Several treatment options exist for people with AUD.

The United Kingdom’s National Health Service (NHS) lists these as follows:

  • Talk therapy: This is when a specially trained therapist helps the individual understand how and why their thoughts or feelings might affect their alcohol consumption. The therapist may provide tips for dealing with those thoughts or feelings to minimize the risk of drinking alcohol.
  • Alcohol detox: This is when someone with an alcohol addiction stops drinking completely for an extended time in a safe and controlled environment. Specialist staff will be around to help the individual manage any alcohol withdrawal symptoms.
  • Support groups: Support groups such as Alcoholics Anonymous can help people with alcohol addiction. They allow for open, nonjudgmental discussions about addiction and give a person access to a network of supportive and understanding people.

Support from addiction and mental health services might give someone the best chance of recovering from addiction.

The Substance Abuse and Mental Health Services Administration offers resources for people in the United States seeking help for alcohol addiction.

The National Institute on Drug Abuse also has many helpful resources on seeking help for substance misuse and related mental health problems, such as suicidal ideation. The organization also links to websites that can help people search for nearby addiction and mental health services.

Providing accurate diagnoses can be difficult when different conditions produce similar symptoms. Conditions that can appear similar to AIPD include:

Medical records can help doctors rule out conditions such as those above. However, this may not always be possible.

There are possible severe complications of AIPD, including an elevated risk of depression, anxiety, and suicide.

Additionally, people with AIPD may be unpredictable or resort to violence.

Here are some answers to common questions about AIPD.

How long does alcohol-induced psychosis last?

Scientists estimate that AIPD lasts 18–35 days, provided an individual receives appropriate treatment. However, a minority of people could experience symptoms for more than 6 months.

The minimum duration for AIPD is 48 hours. If behavioral and mental symptoms do not last this long, healthcare professionals may not consider AIPD the cause of the episode.

What is alcohol paranoia?

Alcohol paranoia is a paranoid episode resulting from alcohol use. People with AIPD can also experience intense paranoia.

The outlook for people with AIPD will vary. For instance, acute alcohol intoxication can be a life threatening condition, which means that people whose psychosis originates from this condition could need urgent medical attention.

A person’s outlook can depend on whether they abstain from alcohol. Those who do not are likely to experience ongoing mental health problems. People with AIPD have a 5–30% chance of developing a chronic condition that is schizophrenia-like.

However, by abstaining from alcohol, individuals can lower their risk of experiencing another alcohol-induced psychotic episode.

AIPD is a rare but serious complication of alcohol use. Although it is not a form of schizophrenia, these conditions have several characteristic symptoms in common.

Experiencing psychosis can be scary, but support from healthcare professionals and mental health and addiction services can help people with AIPD. People who abstain from alcohol have the best chance of not experiencing psychosis again.