Alcoholic Hallucinosis Explained [Signs & Concerns]

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Alcoholic hallucinosis is a condition that occurs in people with AUD (alcohol use disorder) and heavy drinkers when they try to quit drinking.

They start experiencing hallucinations that can be extremely vivid and realistic, which is why the condition is also known as alcohol-related psychosis.

Hallucinations are part of alcohol withdrawal symptoms that can occur when you suddenly stop drinking after experiencing alcohol dependence. These symptoms can be so severe that you relapse within hours to days.

In other cases, people who consume excessive amounts of alcohol in one go might become too intoxicated and experience these hallucinations. This type of alcoholic hallucinosis happens when the body fails to process excess alcohol efficiently.

What Causes Hallucinations in Alcoholics?

Alcoholic hallucinosis is considered an alcohol-induced psychotic disorder, meaning alcohol is the main culprit.

  1. Alcohol Withdrawal Syndrome: When you try to cut back after chronic alcohol abuse, you’ll experience withdrawal symptoms, which include alcohol hallucinosis
  2. Acute Alcohol Intoxication: Acute intoxication is also known as alcohol poisoning. This is when you drink a large amount of alcohol that can damage all of your organs and lead to hallucinations or even death.

Certain medical conditions can also contribute to hallucinations in people with chronic alcoholism, such as:

  • Pre-existing mental health conditions (post-traumatic stress disorder, bipolar disorder, schizophrenia, and depression)
  • Neurodegenerative conditions such as Alzheimer’s and Parkinson’s
  • Kidney or liver failure
  • Dementia  

The Science of Alcoholic Hallucinations

The main reason alcohol can cause hallucinations is that it disrupts the chemical and neural networks of the brain.

An alcoholic brain is vastly different from a normal brain, even before alcohol withdrawal or toxicity. However, once you’ve consumed enough alcohol to experience hallucinations, your brain chemistry becomes severely altered.

Two of your brain’s neurotransmitters, GABA (gamma-aminobutyric acid) and glutamate are thrown off balance. This causes you to be hyper-excitable and extremely sensitive to alcohol withdrawal.

Moreover, your brain’s dopamine levels spike while serotonin levels dip, and that’s when you start developing hallucinations.

Your brain becomes in a state of hyperarousal where the slightest stimulus gets grossly exaggerated. It starts seeing, feeling, and hearing things that aren’t there.

Symptoms of Alcoholic Hallucinosis

Delusions

Before you start hallucinating, you might experience some delusions which differ from one person to another. You might believe that you’re being watched or followed, while another person might believe that they’re in some kind of danger when none of this is true.

You might also have delusions of power where you believe you can read minds, have special powers, or that you’re famous.

Some of these delusions are harmless, but some, such as believing you can fly, can lead to terrible accidents or even death.

Exaggerated Feelings

Alcoholic hallucinosis can amplify your feelings, making them much stronger and more impactful than normal. Some people might feel extreme ecstasy, while others might feel intense fear or horror.

Much like delusions, these powerful feelings can lead to dangerous actions and consequences.  

Sensory Hallucinations

There are three main types of sensory hallucinations you might encounter: auditory, visual, and tactile.

Auditory

Auditory hallucinations are the most common type out of all the psychotic symptoms. When you experience this kind of hallucination, you might report hearing noises or words that no one else can hear.

You might hear someone’s footsteps, music playing, or people talking when you’re alone.

Research has shown that this type of hallucination is usually ominous or trauma-related. This is why most people who hear things that aren’t there feel stressed or threatened, so much so that it can affect their work and social life.  

Visual

Visual hallucinations are also quite common in people with chronic alcohol use disorder. You might see colors, lights, or even people in your surroundings that no one else can see.  

These types of hallucinations are usually linked to your creativity. They’re also extremely vivid, which can make it hard for you to believe you’re hallucinating.  

Tactile Hallucinations

When you experience tactile hallucinations, you physically feel things that aren’t there. You might feel like there are insects crawling on your skin, or you might have an itching sensation all over.

Some people also experience burning or numbness throughout their body, although this can be explained by alcoholic neuropathy.

Less Common Hallucinations

Olfactory and gustatory hallucinations aren’t as common as the other types. The former happens when you smell things in your environment that no one else can smell because they’re non-existent.

The latter occurs when you taste something you haven’t physically ingested.

Miscellaneous Symptoms 

In addition to the hallucinations, you might also experience co-occurring symptoms, such as:

  • Headaches or migraines
  • Dizziness and lightheadedness
  • Paranoia or fear
  • Sweating and chills
  • Emotional flatness or alterations in mood
  • Insomnia or disturbances in your sleep patterns
  • Loss of appetite
  • Anxiety  

Hallucinations Timeline

If you’ve had too much to drink, you might experience acute hallucinosis within minutes to hours of drinking.

However, if your hallucinosis is a result of withdrawal, you might experience symptoms within 12 to 72 hours of quitting, depending on how much alcohol you generally drink.

With heavy drinking, you’ll likely experience severe withdrawal symptoms within hours of your last drink.

Some people might continue experiencing these hallucinations on and off even after they’ve quit, while others don’t experience them despite drinking.

In one study, about 20% of patients who had alcoholic hallucinosis continued to experience symptoms for about six months.

In another study, about 21% of patients who drank heavily didn’t experience alcoholic hallucinosis at all.  

Risk Factors for Alcoholic Hallucinosis

There are a few other things that can affect your chances of having hallucinations, such as:

  • Drinking Age: Those who start drinking at a younger age are much more likely to develop alcoholic hallucinosis
  • Hospital Admissions: Alcoholics who have been repeatedly admitted to hospital due to alcoholic abuse are more likely to have alcoholic hallucinations
  • Economic Status: Chronic alcoholics with lower socioeconomic status have a higher probability of developing hallucinosis
  • Genetics: People digest and metabolize alcohol differently based on their genetics. Some people might have a higher threshold for alcoholic hallucinosis than others.
  • Type of Alcoholic Beverage: Beverages with a lower alcoholic content are less likely to cause alcoholic hallucinations.  

There isn’t a specific amount of alcohol that can cause alcohol hallucinosis. It comes down to your genetics and how your body handles alcohol, so it’s better to avoid drinking excessively to avoid running the risk of developing this condition or any of its complications.

Complications of Alcoholic Hallucinosis

While alcoholic hallucinosis is often a temporary condition, it can cause permanent complications.

A 2022 study showed that people who experienced alcoholic psychosis have almost a 30% greater chance of developing schizophrenia.

They also have a much higher chance of becoming depressed.

Alcohol hallucinations can also cause psychosocial impairment. Since alcohol affects patients’ cognitive reasoning and their behaviors, they often find themselves withdrawing from society.

The final and most dangerous complication of alcoholic hallucinosis is suicide. Many people commit suicide due to the altered reality they see during their hallucinations.

Alcoholic Hallucinosis Vs. Delirium Tremens

Many people confuse alcoholic hallucinosis with delirium tremens, a life-threatening complication of alcohol abuse.

However, while they do have a few common symptoms, such as mild hallucinations, delirium tremens is a far more dangerous condition.

Delirium tremens is often associated with heart problems where your entire cardiovascular system might end up collapsing. This condition can also result in seizures, which is why it’s important to differentiate between it and alcoholic hallucinosis.

Another important factor to remember is that delirium tremens’ hallucinations are usually visual and not auditory. In other words, if an alcoholic is hearing things that aren’t there, there’s a higher chance they’re suffering from alcoholic hallucinosis.  

Alcoholic Hallucinosis Treatment

Medical assistance is crucial for the treatment of alcohol hallucinosis. 

A healthcare professional can determine if you’re experiencing alcoholic hallucinosis or delirium tremens. They’ll also help you manage the symptoms of alcohol withdrawal so you’re not tempted to relapse again.

Depending on the severity of your symptoms and hallucinations, they might also recommend alcohol addiction medication.

Benzodiazepines, such as Lorazepam, can ease your symptoms and reduce any potential chances of hyperexcitation as your body detoxifies. 

Your doctor might also prescribe neuroleptics, which are antipsychotic medications that rebalance your brain chemistry and reduce hallucinations.  

One thing that most people overlook when it comes to alcohol addiction is nutrition. Excessive alcohol consumption often causes nutritional deficiencies, which can make your hallucinations even worse.

That’s why your healthcare provider will usually give you nutritional supplements such as B vitamins, thiamine, magnesium, and zinc to replenish your body. They’ll also start you on a healthy diet plan as part of your alcoholic recovery program.

After managing your hallucinations, the next step of treatment is to join a rehab program that makes sure you don’t relapse. These addiction rehab programs provide emotional, mental, and medical support you need to stay off alcohol.

They also help ease long-term withdrawal symptoms, which can last for months after quitting alcohol.  

Your Recovery Journey Starts Today

If you’re struggling with alcohol addiction or have had any kind of hallucinations, you should seek help immediately.

Talk to your healthcare provider or book an appointment with Curednation’s telemedicine services and make sure you get the help you need.  

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