“First you take a drink, then the drink takes a drink, then the drink takes you.”
– F. Scott Fitzgerald
Imagine seeing shadows move across the wall when no one is there. Or hearing voices whisper your name in an empty room. These aren’t scenes from a horror movie—this is the terrifying reality of alcoholic hallucinations.
If you or someone you love is struggling with alcohol use, this is something you need to know. These hallucinations aren’t just vivid dreams or a bad hangover. They’re signs of alcohol-induced psychosis, a serious condition that could lead to permanent brain damage—or worse.
According to the National Institute on Alcohol Abuse and Alcoholism, more than 29 million people in the U.S. suffer from alcohol use disorder. Yet few realize how dangerous long-term drinking can become. Beyond liver disease and broken relationships, chronic alcohol use can actually change the way your brain works—causing you to see, hear, and feel things that aren’t real.
Let’s break down the scary truth, what it feels like, and how to get help before it’s too late.
What Are Alcoholic Hallucinations?
Alcoholic hallucinations are false sights, sounds, or sensations that happen after heavy drinking or during withdrawal. They usually occur 12 to 24 hours after the last drink, and may last up to 48 hours.
Unlike delirium tremens (DTs), which include confusion and full-body tremors, alcoholic hallucinosis usually doesn’t cause disorientation. People know what’s happening, but they can’t stop the terrifying things they’re seeing or hearing.
Some examples include:
- Seeing bugs crawling on the skin
- Hearing threatening voices
- Feeling someone is watching or following you
- Visual distortions (walls bending, colors changing)
Alcohol-Induced Psychosis vs. Hangover: What’s the Difference?
It’s easy to confuse alcohol-induced psychosis with a severe hangover or anxiety, especially if you don’t know what to look for.
| Symptom | Hangover | Alcoholic Hallucinations |
|---|---|---|
| Headache & Nausea | ✅ | ✅ |
| Anxiety | ✅ | ✅ |
| Seeing or hearing things | ❌ | ✅ |
| Risk of seizure | ❌ | ✅ |
| Confusion | Sometimes | Rare (unless DTs) |
| Requires medical care | Usually not | Always |
If hallucinations are involved, it’s a medical emergency. Alcohol-induced psychosis means the brain is no longer processing reality correctly—and that’s dangerous for everyone involved.
What Causes Alcoholic Hallucinations?
These hallucinations are caused by chemical changes in the brain due to long-term alcohol abuse or sudden withdrawal. Alcohol affects dopamine and serotonin levels—two chemicals that regulate mood, thought, and perception.
When alcohol is removed suddenly after chronic use, the brain goes into overdrive. This can lead to seizures, delirium tremens, and hallucinations.
Risk factors include:
- Heavy alcohol use for 10+ years
- History of withdrawal seizures or DTs
- Lack of sleep and poor nutrition
- Mental health conditions like schizophrenia or bipolar disorder
How Common Are Alcoholic Hallucinations?
They’re more common than you think—especially in people who try to detox at home. Here are some eye-opening stats:
- Up to 25% of chronic alcohol users experience hallucinations during withdrawal (source: NIH)
- Around 5% of people with alcohol use disorder will develop alcohol-induced psychosis
- Delirium tremens, which includes hallucinations, affects 1 in 20 people going through alcohol withdrawal
That’s why medical detox is so important.
What Do Alcoholic Hallucinations Feel Like?
Here’s what people often report:
- “I thought someone was breaking into my house.”
- “I saw my dead brother standing in the corner.”
- “I heard whispers all night long. I couldn’t sleep.”
- “It felt like bugs were crawling all over me, but there was nothing there.”
These aren’t just bad dreams. They feel real—and they’re terrifying.
How Is Alcoholic Hallucinosis Treated?
Treatment starts with safe detox in a medical setting. Doctors may use:
- Benzodiazepines to calm the nervous system
- Antipsychotic medications to manage hallucinations
- IV fluids and vitamins (especially thiamine) to support brain function
- Close monitoring to prevent seizures and heart issues
After detox, long-term treatment is essential:
- Inpatient rehab for structure and support
- Therapy to address trauma and triggers
- 12-step programs or smart recovery for connection
- Medication-assisted treatment if needed
Understanding Hallucinations in Alcoholism
Types of Hallucinations
- Auditory Hallucinations: The most common type, where individuals hear voices that are non-existent.
- Visual Hallucinations: Seeing objects, patterns, lights, or people that aren’t there.
- Tactile Hallucinations: The false sensation of things happening on or under the skin, often described as crawling insects.
Associated Conditions
- Alcohol Withdrawal Hallucinations: Occur during acute withdrawal from alcohol, typically manifesting within 12 to 24 hours after the last drink.
- Alcoholic Hallucinosis: A condition that can occur during or after prolonged periods of heavy drinking, even after alcohol withdrawal symptoms subside.
You’re Not Crazy—You’re Sick, and You Can Get Better
If you’ve experienced alcoholic hallucinations, don’t be ashamed. You’re not alone, and you’re not “crazy.” You’re dealing with something real—and very serious. But help is available, and recovery is absolutely possible.
The scariest part is thinking no one understands. But we do.
And if no one else has told you this today:
You matter. You deserve to get better. And you can.
