5 Facts About Delirium Tremens

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Delirium tremens is one possible symptom or form of alcohol withdrawal. Also known as DTs, this symptom is relatively rare and usually occurs in instances of severe, long-term chronic abuse of alcohol. 

Below we talk more about the delirium tremens definition and what you should know about this symptom of major withdrawal. 

What Are Delirium Tremens?

Delirium tremens refer to a severe form of withdrawal from alcohol, relating to sudden changes in mental state and the central nervous system. 

Below are five key things to know about delirium tremens and severe withdrawal symptoms due to the cessation of alcohol use. 

1. Delirium Tremens Definition

Delirium tremens is also known as alcohol withdrawal delirium or AWD. According to the definition of delirium tremens, this is the most serious type of withdrawal from alcohol. AWD affects only people with a history of heavy alcohol use.

If someone stops drinking suddenly or reduces their alcohol intake quickly, they may experience the condition. Other risk factors include having a head injury, already being sick, or not eating enough when reducing alcohol usage.

Ongoing, heavy drinking irritates and excites the nervous system. If you drink daily, your central nervous system becomes dependent on the presence of alcohol. Your body can’t easily adapt to a lack of alcohol at this point.

2. Certain People Are at a Higher Risk of DTs Than Others

You are at risk of alcohol withdrawal delirium or DTs if you’ve been drinking heavily for a long time or have a history of AWD.

If you have a history of experiencing withdrawal symptoms, a history of delirium tremens or you have other health problems along with alcoholism; your risk is higher. For example, medical conditions and comorbid conditions like liver disease or heart failure create more risk of DTs with the abrupt cessation of alcohol use. 

People who drink heavily and have brain damage, mental disorders, or a history of seizure disorders may also be at an elevated risk.

3. The Symptoms of Alcohol Withdrawal Can Be Deadly

Delirium tremens symptoms usually occur within three days of cutting down or stopping alcohol use. Sometimes they can take a week or more to appear, though. These symptoms of delirium tremens can include:

  • Disorientation
  • Visual hallucinations
  • Auditory hallucination
  • Tactile hallucinations
  • Rapid heart rate
  • Increases in breathing rate
  • High blood pressure
  • Fever
  • Stupor
  • Extreme sweating
  • Changes in mental status 
  • Profound confusion
  • Loss of consciousness

The symptoms of severe alcohol withdrawal are an emergency, requiring immediate medical attention.

At first, it can seem like someone is only experiencing mild alcohol withdrawal or moderate withdrawal symptoms, but they can become severe quickly and unexpectedly. 

4. DTs can be Rare

While the complications of withdrawal from alcohol can be scary and fatal, delirium tremens is rare. 

Around 50% of people who use alcohol will have some level of withdrawal symptoms if they stop, but only around 3-5% will experience delirium tremens.

The mortality rate is low in people who go through even severe alcohol withdrawal syndrome, but the right treatment is critical for alcoholic patients since it is a possibility. 

5. Early Treatment is Critical

Since  alcohol withdrawal symptoms  can be severe, someone must get help before trying to stop.

Hospitals and detox centers have staff who can monitor patients at risk as they’re going through withdrawal. Symptoms and vitals can be regularly checked, and medications or other medical care can reduce symptoms.

Along with reducing complications and potentially saving someone’s life, appropriate withdrawal treatment can also help someone be more comfortable after detox. If they’re more comfortable, they’re likely to go into treatment after completing their detox program.

What Happens During Alcohol Withdrawal?

While delirium tremens may be a severe medical emergency in alcohol withdrawal, it’s certainly not the only possible effect. Going through alcohol withdrawal can lead to physical and emotional symptoms.

Common symptoms of even mild or moderate withdrawal include:

  • Tremors
  • Anxiety
  • Insomnia
  • Nightmares
  • Increased heart rate
  • Nausea and vomiting
  • Headache
  • Sweating
  • Irritability
  • High blood pressure

When you drink consistently over a period of time, your central nervous system goes through a period of instability as it tries to get back into balance.

If a medical professional believes you could be experiencing symptoms of withdrawal syndrome, they’ll go over your medical history and symptoms and provide a physical exam. They’ll look for signs of withdrawal from alcohol dependence syndrome, like tremors, an irregular heart rate, fever, or dehydration. A doctor could also perform a toxicology screen to determine your blood level of alcohol. 

The Clinical Institute Withdrawal Assessment of Alcohol (CIWA-Ar) is a set of questions a healthcare professional can use to diagnose alcohol withdrawal syndrome. The questions go over the symptoms that can occur, and then a health care provider grades the level of severity for your symptoms on a scale from 0-7.

There are ten total symptoms the severity scale measures.

Someone with minor withdrawal symptoms would have a lower score on the assessment of alcohol withdrawal. 

delirium tremens

Alcohol Withdrawal Seizures

Another complication of AWS that can occur is the development of seizures. The risk of seizures is rare but serious when patients with alcohol withdrawal. Seizures can start as early as day two for some people, while DTs most often appear between days three to four. During DTs is when someone has the highest risk of the rapid onset of seizures. 

  • When you have an alcohol use disorder, your drinking leads the central nervous system to slow down in response to your brain producing more GABA.
  • GABA is an inhibitory neurotransmitter. 
  • With abstinence from alcohol, your nervous system is no longer stable again, and there is a flood of excitatory neurotransmitters and abnormal electrical activity in the brain. 
  • Benzodiazepines can help reduce the risk of a seizure during withdrawal.
  • Around 10% of people in alcohol detox have seizures. Seizures are scary, but they also tend to be a warning sign of the potential development of delirium tremens. 
  • If you experience a seizure during detox, you will need emergency medical treatment.
  • Someone with a pre-existing seizure disorder or traumatic injury of the brain and a history of alcohol abuse may be at a higher risk of this symptom during withdrawal. 

Treatment of Alcohol Withdrawal in California

Treating AWS is symptoms-guided, and it depends on the severity of the symptoms of the individual.

For minor symptoms or mild withdrawal, a health care provider might say that you can go through withdrawal at home, but someone will have to stay with you until you stabilize. Your doctor could prescribe a sedative, such as Valium or Klonopin, for the initial days of minor alcohol withdrawal. 

Even if you’re going through withdrawal at home, you should prepare to receive counseling and check in with a medical professional throughout the process.

For moderate-to-severe symptoms, most people need inpatient care. You can receive inpatient medical detox treatment at a hospital or rehab facility. Your treatment team will do testing and monitoring, provide you with IV fluids to prevent dehydration, and treat symptoms you’re experiencing.

There’s no way to determine the severity of alcohol withdrawal beforehand. Not everyone with a history of heavy alcohol consumption has severe alcohol withdrawal symptoms. Some people with a less heavy history of use require inpatient treatment for alcohol withdrawal. It all depends on the person and their dependence on alcohol. 

Once you get through detox for acute alcohol withdrawal, your treatment process isn’t over. You should still consider rehab for the underlying drinking problem that led you to experience withdrawal symptoms in the first place.

What Happens After You Detox?

Detox is just one step on your journey to recovery. It’s an important, critical step, but it’s not in and of itself an addiction treatment. The goal of detox is to keep you safe and stabilize you.

Then, you have to decide how you’re going to avoid relapsing.

A rehab program is the best option for many people to work through the thought patterns, triggers, and experiences that led to the development of excessive drinking. You can also receive treatment for underlying mental health issues during a rehab program.

To get on a path to a sober life, you have to complete detox with supportive care and professional medical advice. Please contact Opus Health by calling 855-953-1345 to begin your journey and receive treatment for alcohol addiction and alcohol dependence. 


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