Alcoholism and Schizophrenia

Estimated reading time: 31 minute(s)

Schizophrenia, also known as a schizophrenia spectrum disorder, is a serious mental health issue affecting more than 24 million people worldwide. People with this mental illness have a significantly impaired ability to relate to reality, which can be highly distressing for them and their loved ones. Both disorders often occur together and can bring serious health ramifications for the sufferer.

Alcohol also intensifies the positive symptoms of schizophrenia, such as delusions and hallucinations. At the same time, it also fuels negative symptoms, such as loss of motivation and joy in life. People who suffer from alcohol abuse and schizophrenia are at a very high risk of experiencing natural deterioration of their life quality and require professional help to manage both issues.

Schizophrenia and Alcohol Addiction: Why is there a Connection?

People who consume alcohol heavily to the extent that they lose control over how much they drink despite acknowledging its harmful effects on life usually suffer from an alcohol use disorder. When this disorder co-exists with a mental health disorder, such as schizophrenia, experts use the term “co-occurring disorders” or “dual diagnosis” to define this situation. [1] Research suggests that individuals with schizophrenia are up to three times more likely to develop an alcohol use disorder than those who do not have this mental illness. There are multiple possible reasons for this, such as:


People with schizophrenia may try to use alcohol to relieve their symptoms along with the side effects of the medications prescribed to them.

Socioeconomic Reasons

Schizophrenia has been found to correlate with various factors that eventually lead to heavier use of alcohol, such as cognitive problems, impaired social functioning, and poverty.

Trauma or Genetics

Certain issues with the brain, such as an injury or a dysfunctional reward system, may put certain people at risk of developing alcohol use disorder and schizophrenia.

How to Know if Someone with Schizophrenia is Misusing Alcohol?

Do you suspect that someone around you who is a known schizophrenic is also misusing alcohol at the same time? Look out for the following signs:

  • Inability to control how much they drink
  • Experiencing frequent cravings for alcohol
  • Preferring to drink over all other activities
  • Continuing to engage in drinking despite acknowledging its harmful effects on like
  • Drinking in risky situations
  • Past attempts to quit alcohol but with no success
  • Spending a lot of time in recovering from alcohol-related side effects
  • Experiencing negative withdrawal symptoms, like nausea, sweating, vomiting, shaking, and hallucinations, when alcohol is not available.
  • Drinking higher amounts of alcohol over time experiences the same effects
  • Continuing to practice healthy drinking habits even though alcohol worsens mood and memory
  • Facing trouble in personal and professional lives due to excessive alcohol use

If your loved one displays the signs mentioned above and is diagnosed case of schizophrenia, referring them to a professional dual-diagnosis treatment center is essential.

Can Alcohol Cause Schizophrenia or Make it Worse?

Contrary to the widespread belief, there is no such thing as alcohol-induced schizophrenia. While alcohol cannot directly cause schizophrenia, it can influence the disease’s progression.[2] The symptoms of either disorder may exacerbate the others, leading to a worse outcome for both disorders. Many people start relying on alcohol to self-medicate against schizophrenia symptoms but only end up worsening it. In particular, drinking alcohol can exacerbate the following schizophrenia symptoms:

  • Violent behavior
  • Non-compliance to treatment
  • Skipping treatment
  • Increased impulsiveness
  • Depression
  • Aggression
  • Difficulty in attaining and maintaining employment
  • Increased risk of hospitalization, homelessness, or legal issues
  • Inability to think clearly
  • Poor judgment
  • Delusions and hallucinations

Experts also suggest that misusing alcohol can sometimes trigger psychosis in some people. Psychosis refers to a group of symptoms that make it difficult for a person to distinguish what’s real and what’s not. Considered a hallmark of psychosis, its symptoms include hallucinations, thought disorganization, delusions, lack of expression, and disorganized behavior. When psychosis occurs due to alcohol, experts call it alcohol-related psychosis. Different types of alcohol misuse can trigger this psychosis, such as chronic alcohol use disorder, alcohol withdrawal, and alcohol poisoning. Even though alcohol-related psychosis and schizophrenia may appear similar, remember that both are separate conditions. Compared to schizophrenia, alcohol-related psychosis can lead to the following in people:

  • More intense anxiety and depression
  • Less formal education
  • Onset at a much older age
  • Fewer disorganized behaviors and thoughts

Researchers are yet to determine what causes alcohol-associated psychosis; most of them believe it to be a cause of neurotransmitter imbalance, mainly seen in serotonin and dopamine levels. Alcohol seems to mess with these neurotransmitters, which potentially leads to psychotic symptoms. While this type of psychosis can be extremely uncomfortable, it is possible to reduce its risk in the future by abstaining from alcohol.

Treating Alcoholism and Schizophrenia: What are the Recovery Needs?

For people with alcoholism and schizophrenia, seeking treatment becomes necessary. This is true not only because alcohol withdrawal carries significant dangers but also because such people require close monitoring of their mental health symptoms throughout their recovery journey. While looking for a treatment facility to treat both conditions, choose one that offers co-occurring disorders treatment, also known as a dual diagnosis program. Such programs allow the paranoid alcoholic to address their schizophrenia while managing alcohol addiction and detox at the same time. This type of integrated treatment for co-occurring issues can take place in a variety of settings, such as:

Medically-Assisted Detoxification

This step is predominantly the initial and the most crucial stage of the recovery process, which involves several interventions to stop the physical use of alcohol. Some people prefer going through this process without pharmaceutical help, while others choose to make detox more comfortable by using expert-approved, carefully dosed medications. The program typically runs for 7 to 10 days and helps clients cleanse their bodies while kicking out all alcohol residue from the body.

Inpatient Treatment

Following a detox process, most people transition to an inpatient program which allows them to seek round-the-clock care and supervision. The program runs for a few weeks to a few months as required by a patient. During this program, all participants stay onsite in their dedicated rooms while learning the skills and tools to remain sober while addressing co-occurring issues like schizophrenia.

Outpatient Treatment

An outpatient treatment program may combine medication, psychotherapy, and substance abuse treatment to help clients who cannot participate in inpatient care due to social or work obligations. These programs run in the evening and morning slots, and clients are welcome to join any of them, depending on their routine. This level is much less intense than inpatient care and usually exists to support people transitioning to their everyday lives.

Medication and therapy form the mainstay of treatment for schizophrenia, along with alcohol abuse. Behavioral skills training, motivational enhancement, and cognitive behavioral therapy have been shown to manage alcoholism and co-occurring schizophrenia together. Medications are another essential part of treatment and now provide several options for experts to choose from. Some medications used to control the symptoms of alcoholism can also work wonders for the symptoms of schizophrenia.

Whichever level of care or type of therapy you choose for yourself, keep in mind that professional help is necessary for people suffering from alcohol misuse and schizophrenia together. At the same time, remember that many of the medications that control schizophrenic symptoms may require constant monitoring to check their efficacy while. Keeping an eye on potential side effects. Once again, find a facility that provides dual diagnosis services as it is qualified enough to simultaneously deliver integrated care for both issues.

Final Thoughts

Alcohol use disorder does not always co-exist with schizophrenia, but it does; the situation may become more challenging for an individual. If you or someone you know have been exhibiting the signs of both issues at the same time, consider seeking clinical support as soon as possible. Both alcohol use and schizophrenia keep on exacerbating each other unless the victim decides to break out of this vicious cycle and do something about it. Fortunately, many dual diagnosis programs are being offered all across the country to deal with these problems simultaneously and allow users better control over them to improve their life quality.


How long does alcohol-induced psychosis last?

Alcohol-induced psychosis may take around 18 to 35 days to resolve only if the victim seeks appropriate treatment. Some people, although rare, may continue experiencing the symptoms for six months or even more. What experts know for sure is that the effects of this type of psychosis last at least 48 hours, and in case they resolve before hitting this time limit, experts may not consider it alcohol-induced psychosis.

What do you mean by alcohol paranoia?

Alcohol paranoia refers to a paranoid episode that excessive alcohol triggers. People with the alcohol-induced psychotic disorder often experience an intense form of this paranoia.

How does alcohol affect individuals diagnosed with schizophrenia?

In people with schizophrenia, alcohol use may lead to a higher risk of:

  • Violence or aggression
  • Suicide
  • Depression
  • Chronic physical symptoms
  • Not complying with treatment
  • Hospitalization
  • Incarceration
  • Housing instability

Is schizophrenia the same as alcohol-induced psychosis?

Both schizophrenia and alcohol-induced psychotic disorder (AIPD) are psychotic disorders with many common symptoms. As indicated by the name, AIPD occurs due to alcohol consumption and may lead to delusions, hallucinations, fear, and paranoia. Schizophrenia may also have similar symptoms with some additional ones, such as disorganized speech, negative mood, and disordered behavior. These symptoms must persist for at least one month to be termed schizophrenia. Despite the similarities in symptoms, there are many significant differences between AIPD and schizophrenia. For example, people with the former condition may have more severe anxiety or depression symptoms than people with the latter. Conversely, schizophrenia may cause more symptoms of disorganization than AIPD.

Are alcoholics paranoid?

Alcohol does seem to carry the potential to trigger several psychological effects, such as insomnia, depression, anxiety, hallucinations, compulsive behaviors, and drastic personality changes. It may also trigger a condition called alcohol-induced paranoia that may closely resemble the symptoms of schizophrenia. However, keep in mind that not all alcoholics will develop paranoia and psychosis; hence, it is not right to generalize these people and label them paranoids.


1 Drake, R. E., & Mueser, K. T. (2002). Co-occurring alcohol use disorder and schizophrenia. Alcohol research & health, 26(2), 99.

2 Archibald, L., Brunette, M. F., Wallin, D. J., & Green, A. I. (2019). Alcohol Use Disorder and Schizophrenia or Schizoaffective Disorder. Alcohol research: current reviews, 40(1), arcr.v40.1.06.

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