Alcohol psychosis stories

SAMHSA’s National Helpline | SAMHSA

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  • SAMHSA’s National Helpline is a free, confidential, 24/7, 365-day-a-year treatment referral and information service (in English and Spanish) for individuals and families facing mental and/or substance use disorders.

    Also visit the online treatment locator.

SAMHSA’s National Helpline, 1-800-662-HELP (4357) (also known as the Treatment Referral Routing Service), or TTY: 1-800-487-4889 is a confidential, free, 24-hour-a-day, 365-day-a-year, information service, in English and Spanish, for individuals and family members facing mental and/or substance use disorders. This service provides referrals to local treatment facilities, support groups, and community-based organizations.

Also visit the online treatment locator, or send your zip code via text message: 435748 (HELP4U) to find help near you. Read more about the HELP4U text messaging service.

The service is open 24/7, 365 days a year.

English and Spanish are available if you select the option to speak with a national representative. Currently, the 435748 (HELP4U) text messaging service is only available in English.

In 2020, the Helpline received 833,598 calls. This is a 27 percent increase from 2019, when the Helpline received a total of 656,953 calls for the year.

The referral service is free of charge. If you have no insurance or are underinsured, we will refer you to your state office, which is responsible for state-funded treatment programs. In addition, we can often refer you to facilities that charge on a sliding fee scale or accept Medicare or Medicaid. If you have health insurance, you are encouraged to contact your insurer for a list of participating health care providers and facilities.

The service is confidential. We will not ask you for any personal information. We may ask for your zip code or other pertinent geographic information in order to track calls being routed to other offices or to accurately identify the local resources appropriate to your needs.

No, we do not provide counseling. Trained information specialists answer calls, transfer callers to state services or other appropriate intake centers in their states, and connect them with local assistance and support.

  • Suggested Resources

    What Is Substance Abuse Treatment? A Booklet for Families
    Created for family members of people with alcohol abuse or drug abuse problems. Answers questions about substance abuse, its symptoms, different types of treatment, and recovery. Addresses concerns of children of parents with substance use/abuse problems.

    It's Not Your Fault (NACoA) (PDF | 12 KB)
    Assures teens with parents who abuse alcohol or drugs that, "It's not your fault!" and that they are not alone. Encourages teens to seek emotional support from other adults, school counselors, and youth support groups such as Alateen, and provides a resource list.

    After an Attempt: A Guide for Taking Care of Your Family Member After Treatment in the Emergency Department
    Aids family members in coping with the aftermath of a relative's suicide attempt. Describes the emergency department treatment process, lists questions to ask about follow-up treatment, and describes how to reduce risk and ensure safety at home.

    Family Therapy Can Help: For People in Recovery From Mental Illness or Addiction
    Explores the role of family therapy in recovery from mental illness or substance abuse. Explains how family therapy sessions are run and who conducts them, describes a typical session, and provides information on its effectiveness in recovery.

    For additional resources, please visit the SAMHSA Store.

Last Updated: 08/30/2022

Alcohol, Tobacco, and Other Drugs

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Misusing alcohol, tobacco, and other drugs can have both immediate and long-term health effects.

The misuse and abuse of alcohol, tobacco, illicit drugs, and prescription medications affect the health and well-being of millions of Americans. SAMHSA’s 2020 National Survey on Drug Use and Health reports that approximately 19.3 million people aged 18 or older had a substance use disorder in the past year.



  • In 2020, 50.0% of people aged 12 or older (or 138.5 million people) used alcohol in the past month (i.e., current alcohol users) (2020 NSDUH)
  • Among the 138.5 million people who were current alcohol users, 61. 6 million people (or 44.4%) were classified as binge drinkers and 17.7 million people (28.8% of current binge drinkers and 12.8% of current alcohol users) were classified as heavy drinkers (2020 NSDUH)
  • The percentage of people who were past month binge alcohol users was highest among young adults aged 18 to 25 (31.4%) compared with 22.9% of adults aged 26 or older and 4.1% of adolescents aged 12 to 17 (2020 NSDUH)
  • The 2019 National Survey on Drug Use and Health reports that 139.7 million Americans age 12 or older were past month alcohol users, 65.8 million people were binge drinkers in the past month, and 16 million were heavy drinkers in the past month
  • About 2.3 million adolescents aged 12 to 17 in 2019 drank alcohol in the past month, and 1.2 million of these adolescents binge drank in that period (2019 NSDUH)
  • Approximately 14.5 million people age 12 or older had an alcohol use disorder (2019 NSDUH)
  • Excessive alcohol use can increase a person’s risk of stroke, liver cirrhosis, alcoholic hepatitis, cancer, and other serious health conditions
  • Excessive alcohol use can also lead to risk-taking behavior, including driving while impaired. The Centers for Disease Control and Prevention reports that 29 people in the United States die in motor vehicle crashes that involve an alcohol-impaired driver daily


  • STOP Underage Drinking interagency portal - Interagency Coordinating Committee on the Prevention of Underage Drinking
  • Interagency Coordinating Committee on the Prevention of Underage Drinking
  • Talk. They Hear You.
  • Underage Drinking: Myths vs. Facts
  • Talking with your College-Bound Young Adult About Alcohol

Relevant links:

  • National Association of State Alcohol and Drug Abuse Directors
  • Department of Transportation Office of Drug & Alcohol Policy & Compliance
  • Alcohol Policy Information Systems Database (APIS)
  • National Institute on Alcohol Abuse and Alcoholism



  • In 2020, 20.7% of people aged 12 or older (or 57. 3 million people) used nicotine products (i.e., used tobacco products or vaped nicotine) in the past month (2020 NSDUH)
  • Among past month users of nicotine products, nearly two thirds of adolescents aged 12 to 17 (63.1%) vaped nicotine but did not use tobacco products. In contrast, 88.9% of past month nicotine product users aged 26 or older used only tobacco products (2020 NSDUH)
  • Data from the 2019 NSDUH reports that 58.1 million people were current (i.e., past month) tobacco users. Specifically, 45.9 million people aged 12 or older in 2019 were past month cigarette smokers (2019 NSDUH)
  • Tobacco use is the leading cause of preventable death, often leading to lung cancer, respiratory disorders, heart disease, stroke, and other serious illnesses. The CDC reports that cigarette smoking causes more than 480,000 deaths each year in the United States
  • The CDC’s Office on Smoking and Health reports that more than 16 million Americans are living with a disease caused by smoking cigarettes

Electronic cigarette (e-cigarette) use data:

  • Data from the Centers for Disease Control and Prevention’s 2020 National Youth Tobacco Survey.  Among both middle and high school students, current use of e-cigarettes declined from 2019 to 2020, reversing previous trends and returning current e-cigarette use to levels similar to those observed in 2018
  • E-cigarettes are not safe for youth, young adults, or pregnant women, especially because they contain nicotine and other chemicals


  • Tips for Teens: Tobacco
  • Tips for Teens: E-cigarettes
  • Implementing Tobacco Cessation Programs in Substance Use Disorder Treatment Settings
  • Synar Amendment Program


  • Truth Initiative
  • FDA Center for Tobacco Products
  • CDC Office on Smoking and Health
  • National Institute on Drug Abuse: Tobacco, Nicotine, and E-Cigarettes
  • National Institute on Drug Abuse: E-Cigarettes



  • Among people aged 12 or older in 2020, 3.4% (or 9.5 million people) misused opioids in the past year. Among the 9.5 million people who misused opioids in the past year, 9.3 million people misused prescription pain relievers and 902,000 people used heroin (2020 NSDUH)
  • An estimated 745,000 people had used heroin in the past year, based on 2019 NSDUH data
  • In 2019, there were 10.1 million people age 12 or older who misused opioids in the past year. The vast majority of people misused prescription pain relievers (2019 NSDUH)
  • An estimated 1.6 million people aged 12 or older had an opioid use disorder based on 2019 NSDUH data
  • Opioid use, specifically injection drug use, is a risk factor for contracting HIV, Hepatitis B, and Hepatitis C. The CDC reports that people who inject drugs accounted for 9 percent of HIV diagnoses in the United States in 2016
  • According to the Centers for Disease Control and Prevention’s Understanding the Epidemic, an average of 128 Americans die every day from an opioid overdose


  • Medication-Assisted Treatment
  • Opioid Overdose Prevention Toolkit
  • TIP 63: Medications for Opioid Use Disorder
  • Use of Medication-Assisted Treatment for Opioid Use Disorder in Criminal Justice Settings
  • Opioid Use Disorder and Pregnancy
  • Clinical Guidance for Treating Pregnant and Parenting Women With Opioid Use Disorder and Their Infants
  • The Facts about Buprenorphine for Treatment of Opioid Addiction
  • Pregnancy Planning for Women Being Treated for Opioid Use Disorder
  • Tips for Teens: Opioids
  • Rural Opioid Technical Assistance Grants
  • Tribal Opioid Response Grants
  • Provider’s Clinical Support System - Medication Assisted Treatment Grant Program


  • National Institute on Drug Abuse: Opioids
  • National Institute on Drug Abuse: Heroin
  • HHS Prevent Opioid Abuse
  • Community Anti-Drug Coalitions of America
  • Addiction Technology Transfer Center (ATTC) Network
  • Prevention Technology Transfer Center (PTTC) Network



  • The percentage of people who used marijuana in the past year was highest among young adults aged 18 to 25 (34. 5%) compared with 16.3% of adults aged 26 or older and 10.1% of adolescents aged 12 to 17 (2020 NSDUH)
  • 2019 NSDUH data indicates that 48.2 million Americans aged 12 or older, 17.5 percent of the population, used marijuana in the past year
  • Approximately 4.8 million people aged 12 or older in 2019 had a marijuana use disorder in the past year (2019 NSDUH)
  • Marijuana can impair judgment and distort perception in the short term and can lead to memory impairment in the long term
  • Marijuana can have significant health effects on youth and pregnant women.


  • Know the Risks of Marijuana
  • Marijuana and Pregnancy
  • Tips for Teens: Marijuana

Relevant links:

  • National Institute on Drug Abuse: Marijuana
  • Addiction Technology Transfer Centers on Marijuana
  • CDC Marijuana and Public Health

Emerging Trends in Substance Misuse:

  • Methamphetamine—In 2019, NSDUH data show that approximately 2 million people used methamphetamine in the past year. Approximately 1 million people had a methamphetamine use disorder, which was higher than the percentage in 2016, but similar to the percentages in 2015 and 2018. The National Institute on Drug Abuse Data shows that overdose death rates involving methamphetamine have quadrupled from 2011 to 2017. Frequent meth use is associated with mood disturbances, hallucinations, and paranoia.
  • Cocaine—In 2019, NSDUH data show an estimated 5.5 million people aged 12 or older were past users of cocaine, including about 778,000 users of crack. The CDC reports that overdose deaths involving have increased by one-third from 2016 to 2017. In the short term, cocaine use can result in increased blood pressure, restlessness, and irritability. In the long term, severe medical complications of cocaine use include heart attacks, seizures, and abdominal pain.
  • Kratom—In 2019, NSDUH data show that about 825,000 people had used Kratom in the past month. Kratom is a tropical plant that grows naturally in Southeast Asia with leaves that can have psychotropic effects by affecting opioid brain receptors. It is currently unregulated and has risk of abuse and dependence. The National Institute on Drug Abuse reports that health effects of Kratom can include nausea, itching, seizures, and hallucinations.


  • Tips for Teens: Methamphetamine
  • Tips for Teens: Cocaine
  • National Institute on Drug Abuse

More SAMHSA publications on substance use prevention and treatment.

Last Updated: 04/27/2022

"I hid for ten years that I was suffering from psychosis." The story of a man with hallucinations

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Photo copyright, Luke Watkin

Photo caption,

Luke Watkin first experienced hallucinations at the age of 12

Luke Watkin was in high school when it happened. He was walking along an empty school corridor and suddenly heard a strange sound.

"It seemed to me that there was a screech of train brakes, and then a metallic clang. For me it was a complete surprise, I just did not understand what happened. And then I got scared," he says.

This was his first encounter with mental illness. He was then 12 years old.

  • "We were taught not to whine": how to accept and overcome depression
  • Euthanasia due to mental illness. Was there an alternative?
  • Skunk cannabis increases the risk of psychosis

The auditory hallucinations grew - he heard single words, his own name, and at the end - whole phrases, as if someone was trying to talk to him.

This is one of the main signs of psychosis - hallucinations and delusions, and they can be caused by a specific disease - schizophrenia, bipolar disorder or acute depression.

Stress, trauma, drugs, alcohol, drug exposure, or a brain tumor can also cause these phenomena.

The invisible enemy

Psychosis is not as common as depression - it affects less than one person in a hundred. Experts say that for the successful treatment of psychosis, it is important to recognize and diagnose it as soon as possible.

Psychotic people are much more likely to commit suicide or cause physical injury to themselves.

According to psychiatrists, more than half of the patients admit that it was difficult for them to notice the initial symptoms of psychosis.

Most often, these symptoms appear in the age group of 18-24 years, and psychiatrists believe that a lack of knowledge in this area leads to the fact that young people do not receive timely help.

There are also more hidden signs that indicate mental ill-being and the approach of a psychotic state - growing self-isolation, a tendency to strange views and ideas, sharp mood swings and confusion in thoughts.

Symptoms of psychosis:

  • Hallucinations, when it seems to a person that he sees, hears, feels something that does not exist in reality
  • Rapid continuous speech
  • Confused speech - for example, a quick transition from one topic to another in one phrase prevails
  • 0022
  • Sudden loss of train of thought, resulting in a sudden pause in conversation

Luke tried to talk about anxiety symptoms with the teacher, but he said he was given to understand that this should not be shared with everyone.

So he decided to stand firm and keep the secret to himself. Luke kept quiet about his illness until he had to drop out of his third year at university.

He admits now that even members of his family would find it difficult to notice that something was wrong with him.

"They thought I was quiet because that's how I dealt with problems. I rarely left my room and preferred not to talk to anyone. And my parents used to consider me a quiet and calm child," says Luke.

But when he became a student, it was difficult for him - it turned out to be impossible to hide his psychosis in the conditions of student life.

He dropped out of school without telling his parents, who didn't suspect anything.

image copyrightFamily photo

Image caption,

When Luke's father Steve found out about his son's illness, he was understanding and caring.

"When my illness got to the point, I just disappeared," says Luke. "I stopped keeping in touch with my parents."

"When the university told them that I had dropped out, they realized that something was happening to me, and this was the first step towards a cure. They showed complete understanding and care."

In Britain, psychiatrists advise anyone who shows signs of psychosis to contact their doctor immediately.

Psychosis is usually treated with a combination of medication, psychotherapy, and social and family support.

Attitudes of society are changing

Luke was treated - he was prescribed antipsychotic medication and was connected to an early intervention service.

"Now, when I remember my past, it seems incredible to me. I refused to complain about my condition - the very thought of it did not occur to me. Now I complain constantly, but then I was simply afraid to think about my illness without talking about talking about it with the doctor," recalls Luke.

Luke is now 26 years old. He became a volunteer and helps other young people cope with similar problems.

According to him, he sees how psychosis is transformed from a shameful topic into a subject of research and public attention.

"It seems to me that in the future people will not hide such a disease, because it is much easier to talk about it than to treat it as a taboo subject and hide it," he concludes.

Delirium tremens (alcoholic delirium): symptoms, signs, treatment

Therapist, gastroenterologist, general practitioner


Olga Olegovna

Experience 24 years

Therapist, Doctor of Medical Sciences, Professor of the Department of Therapy, General Medical Practice and Nuclear Medicine of the Russian National Research University. N.I. Pirogova of the Ministry of Health, Member of the European Professional Association for Liver Disease, Member of the Russian Gastroenterological Association, Member of the Scientific Society of Gastroenterologists of Russia

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Alcoholic delirium (delirium tremens) is a psychosis that occurs against the background of excessive alcohol consumption. Often, narcologists fix pathology in people with the second and third stages of alcoholism. The state of psychosis develops a few days after the abrupt withdrawal of alcohol. Patients experience visual, auditory and tactile hallucinations, and remain unconscious for a long time. Harbingers of delirium are insomnia, growing anxiety, sharp jumps in blood pressure, tremor of the limbs. The patient requires urgent medical attention.


Delirium is the most common alcoholic psychosis. The first attack appears 7-10 years after the onset of systematic alcohol consumption. In most cases, fever occurs in persons suffering from alcoholism of the second and third degrees. Under certain circumstances, delirium can develop in men and women without alcohol dependence. Symptoms of the pathology develop after the patient abruptly refuses to drink alcohol-containing liquids (voluntary or involuntary).


The causes of delirium tremens are associated with alcoholism. Psychoses are caused by prolonged hard drinking, the use of surrogates or technical fluids, craniocerebral injuries, and pathological changes in the tissues of internal organs. A significant role in the development of the disease is played by chronic alcohol intoxication and metabolic disorders in the brain against its background.

Classification of psychoses

Narcologists distinguish 6 types of alcoholic delirium.

Type of delirium Description


Symptoms develop gradually. Pathology has pronounced stages that successively replace each other


Has an acute onset. The patient does not suffer from hallucinations and delusions. There is a lack of coordination, anxiety, fear


It is characterized by fragmentary hallucinations. Delusional ideas are sketchy. Anxiety manifests itself in the form of undulating attacks


It starts like a typical psychosis. At the next stage, the hallucinations are reduced. The patient makes repetitive movements associated with professional activities or household activities (dressing and undressing)


Occurs on the basis of professional delirium. Accompanied by severe clouding of the patient's consciousness. The key symptom is movement disorders


It is typical for patients who have experienced a fever before. Symptoms are similar to those of schizophrenia

The signs of each type of delirium tremens are specific, which facilitates the diagnosis when patients enter clinics.

Symptoms of delirium

Classical psychosis begins gradually. Narcologists distinguish the prodromal period and 3 stages of delirium. Symptoms of delirium tremens continuously increase within 2-8 days. Up to 10% of patients experience two or three attacks separated by short (60 minutes to 24 hours) recovery periods. The classic form of delirium ends acutely - a person suffering from psychosis falls into a deep, prolonged sleep. In 1/4 of patients, a gradual recovery from fever is noted.

The first stage of psychosis is accompanied by changes in a person's mood. Anxiety is replaced by euphoria. Then the emotional state of the patient worsens, signs of depression appear. The pace of speech accelerates, movements become sharp.

The second stage of psychosis is accompanied by hallucinations at the time the patient falls asleep. Persons suffering from delirium see nightmares. Sleep remains superficial. Awakening does not allow a person to separate dreams and reality. During the daytime, the patient observes visual illusions that contribute to the deterioration of his mood and the increase in anxiety. The transition to the third stage of fever is accompanied by the development of insomnia. The intensity and duration of hallucinations increase.

The completion of the third phase of psychosis means the exit from delirium. In 90% of cases, this happens abruptly, in 10% - gradually. The patient is tired, his mood fluctuates from enthusiastic-sentimental to oppressive-hysterical. Men suffer from mild hypomania, women experience depression. Patients of both sexes remember their hallucinations well, but cannot separate them from the real events of the past days. The consequences of delirium tremens depend on the general state of human health and the intensity of changes in the tissues of internal organs against the background of alcoholism.

Therapeutic measures

Treatment of delirium tremens is carried out in a clinical setting. The patient is placed in the narcological or psychiatric department of the hospital. Doctors conduct detoxification therapy and support the vital functions of the body.

The therapeutic course begins with plasmapheresis. Infusion therapy involves the infusion of saline solutions and glucose to the patient. Vitamins and nootropics remain standard appointments. Psychotropic drugs are ineffective and are rarely used against the background of insomnia or severe psychomotor agitation.


The possibility of complete recovery of the patient depends on the form of psychosis and the timeliness of treatment. The symptoms of classic delirium are successfully stopped by narcologists. Some patients suffer from residual effects - memory impairment or psycho-organic syndrome. Severe psychosis and multiple organ failure against the background of intoxication of the body can lead to death.


How to provide first aid for delirium tremens?

A person with signs of psychosis should be put to bed and ensured that he does not leave it until the arrival of a narcologist. A person can be given cold drinking water. Communication with persons who are in a fever should be carried out taking into account the unconsciousness of their actions. Swearing and screaming will only increase the patient's anxiety.

Are there measures to prevent delirium?

Avoiding psychosis will help avoid the systematic use of alcohol-containing liquids.

Learn more