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What are the Risk Factors for Delirium Tremens?

Alcohol abuse is a common problem in the United States, partially because of how normalized drinking is. While occasional use of alcohol is okay, excessive drinking can lead to an alcohol use disorder. According to the National Institute of Alcohol Abuse and Alcoholism, nearly 30 million people suffered from alcohol use disorder in 2021.[1]

One of the most concerning parts of alcoholism is the risk of severe and life-threatening alcohol withdrawal symptoms. Once your brain and body become accustomed to the presence of alcohol, you will rely on it to function properly. Suddenly stopping your use of alcohol could lead to potentially life-threatening symptoms that must be managed by a reputable medical detox program. 

One concern when it comes to alcohol withdrawal is a condition called delirium tremens or DTs. This condition is life-threatening and often leads to death among individuals who do not receive medical care. Some people may be at a higher risk for delirium tremens (DTs) than others.

What are Delirium Tremens (DTs)?

Delirium tremens (DTs) are the most severe form of alcohol withdrawal. In some cases, DTs can be life-threatening, especially among individuals who do not receive the proper medical care. You can develop DTs when you stop drinking suddenly after having a moderate to severe alcohol use disorder.[2]

When you drink alcohol, it slows down activity in your central nervous system (CNS). At the same time, your CNS attempts to increase activity to keep your body functioning properly. After periods of heavy drinking, the CNS becomes accustomed to functioning in this way because it starts anticipating alcohol. 

If you suddenly stop drinking, your CNS will continue to work in overdrive. However, the alcohol is no longer causing depressant effects. Because your CNS is overactive, you can develop the symptoms of alcohol withdrawal.

What are the Symptoms of DTs?

Delirium tremens can cause a variety of symptoms. Some are mildly uncomfortable, while others are extremely difficult to cope with and even life-threatening. If you think you are experiencing the symptoms of DTs, you must receive medical treatment immediately.

The common symptoms of delirium tremens include:

  • Tremors and shakes
  • Confusion 
  • Agitation and anxiety 
  • Symptoms of psychosis such as hallucinations, delusions, and paranoia 
  • Sensory distortions and disorientation 
  • Excessive sweating 
  • Seizures 
  • Hyperthermia 
  • Headaches 
  • Nausea and vomiting 
  • Fast heart rate 

According to the National Library of Medicine, delirium tremens have a mortality rate of up to 37% among individuals who do not receive treatment.[2]

What are the Risk Factors for Delirium Tremens?

The cause of delirium tremens is suddenly stopping the consumption of alcohol after a period of heavy drinking. However, not everyone who experiences alcohol withdrawal will develop this condition. Certain risk factors make you more likely to experience delirium tremens than other people. 

The risk factors for delirium tremens include:[3]

Experiencing alcohol withdrawal in the past, especially seizures or DTs

If an individual has previously experienced alcohol withdrawal symptoms, particularly seizures or delirium tremens (DTs), they are at a higher risk of developing DTs in subsequent episodes of alcohol withdrawal. This suggests that their body may be more prone to severe withdrawal symptoms.

Multiple instances of stopping heavy alcohol use 

Repeatedly stopping heavy alcohol consumption can increase the risk of developing delirium tremens. Each time heavy drinking is halted, the body goes through withdrawal, and the cumulative effect of these episodes can heighten the chances of experiencing severe withdrawal symptoms, including DTs.

Having a severe alcohol use disorder

Individuals with a severe alcohol use disorder, also known as alcoholism, are at an increased risk of developing delirium tremens. Chronic and excessive alcohol consumption leads to changes in the brain and body, making them more susceptible to severe withdrawal symptoms.

Being addicted to other substances that slow down your CNS, like benzodiazepines or opioids 

Concurrent addiction to substances that depress the central nervous system (CNS), such as benzodiazepines or opioids, can elevate the risk of delirium tremens. These substances can further compound the effects of alcohol withdrawal on the CNS, intensifying the severity of symptoms.

Being an older adult 

Older adults are at a higher risk of experiencing delirium tremens during alcohol withdrawal. The aging process can make individuals more vulnerable to the physiological and neurological effects of alcohol withdrawal, potentially leading to more severe symptoms.

Having other medical conditions like nutritional deficiencies or heart and liver disease 

Pre-existing medical conditions can increase the risk of delirium tremens. Nutritional deficiencies, especially thiamine (vitamin B1) deficiency commonly associated with heavy alcohol use, can impair brain function and exacerbate withdrawal symptoms. Additionally, heart and liver diseases can further compromise the body’s ability to handle the stress of alcohol withdrawal, potentially increasing the risk of delirium tremens.

If you are going to develop delirium tremens, the symptoms will begin approximately one to three days after your last drink. The symptoms of DTs typically peak around the 4th or 5th day of withdrawal, making it vital that you are under the care of a medical detox program. 

How to Prevent Delirium Tremens

The easiest way to prevent delirium tremens is to limit your alcohol intake. If you abuse alcohol heavily, you are more at risk of developing the condition. But what can you do if you are already struggling with a severe alcohol use disorder?

If you are currently struggling with severe alcohol addiction, the best way to prevent delirium tremens is to attend an alcohol detox program before your symptoms of withdrawal begin. These programs can provide you with the necessary treatments and medications to ensure that you do not experience severe symptoms of alcohol withdrawal. 

With that being said, you should never attempt to detox from alcohol at home, especially if you have any risk factors for delirium tremens. Doing so could result in severe and even life-threatening symptoms of alcohol withdrawal. By attending an alcohol detox center, you can rest assured that you will remain safe, comfortable, and motivated in your recovery.

Finding Help for Alcohol Abuse and Alcoholism

If you or a loved one struggle with alcoholism, it’s time to consider professional help. At Mandala Healing Center, we offer a full continuum of care, from alcohol detox to inpatient treatment and aftercare services. In doing so, we can offer you a strong foundation of sobriety to give you the best shot at maintaining long-term recovery from alcoholism. 

To learn more about our alcohol rehab program, contact Mandala Healing Center today. 


  1. The National Institute of Alcohol Abuse and Alcoholism (NIAAA): Alcohol Use Disorder (AUD) in the United States, Retrieved June 2023 From
  2. The National Library of Medicine: Delirium Tremens, Retrieved June 2023 From
  3. The National Library of Medicine: Risk factors for the development of delirium in alcohol dependence syndrome, Retrieved June 2023 From