What is Delirium Tremens and is it a Medical Emergency?
Nearly 50% of people who abuse alcohol will experience symptoms of withdrawal when they stop drinking. These symptoms can range from minor headaches and discomfort to more severe symptoms involving upset stomach, tremors, seizures, and more.
Detoxing from alcohol without medical supervision is not encouraged due to the agonizing and potentially fatal symptoms that some people experience. Approximately 5% of people who experience alcohol withdrawal will experience severe and life-threatening symptoms which are known as delirium tremens.
What are Delirium Tremens (DTs)?
Delirium tremens, or DTs for short, are the most severe form of alcohol withdrawal syndrome. DTs are rare but life-threatening. They typically only occur in people who have drank heavily for many years and have previously experienced severe withdrawal symptoms. Without prompt medical treatment, DTs can quickly escalate into fatal symptoms.
Symptoms of Delirium Tremens
Symptoms may vary in intensity and may change over the course of time. Symptoms usually begin like regular alcohol withdrawal, but progress into something more severe. Common symptoms of DTs include:
- Changes in consciousness
Causes and Risk Factors
Alcohol abuse slows down brain functioning, making the brain work more to overcome symptoms of sedation and intoxication. As the body gets used to overcompensating to process alcohol and carry out essential body functions, it eventually adapts to having alcohol in the system. Then, when alcohol is suddenly removed, the brain’s neurons are still in an over-excited state, resulting in a state of hyper-arousal during which symptoms of withdrawal occur.
Withdrawal symptoms are normal for people who abuse alcohol frequently or are physically dependent on it, but some people experience worse symptoms than others. Generally, the more severe a person’s alcoholism, the more severe their withdrawal symptoms will be.
Factors that may increase the risk of developing delirium tremens include:
- Having previously experienced moderate to severe alcohol withdrawal
- Consuming more alcohol in the weeks before withdrawal
- Older age
- Having underlying health issues such as liver disease, heart disease, or traumatic brain injury
- Certain medications and supplements
- Having structural brain lesions, hypokalemia (low potassium levels), or Thrombocytopenia (low blood platelet count)
Some studies have found that people who developed DTs were also more likely to be Black or Hispanic, unemployed, homeless, and have a co-occurring mental health condition.[2,3] Individuals belonging to these populations are also more likely to have higher rates of alcohol-related mortality.
Medical Treatment for Delirium Tremens and Alcohol Withdrawal
DTs are considered a medical emergency because symptoms can be fatal. It is highly recommended to seek treatment before symptoms of alcohol withdrawal begin because symptoms can progress very quickly. Obtaining medical care before starting detox can help patients avoid severe withdrawal symptoms altogether.
In order to treat delirium tremens, doctors need to slow down the activity in the central nervous system (CNS). As a result, DTs are often treated with depressant medications, such as:
- Benzodiazepines – Benzos like chlordiazepoxide (Librium), diazepam (Valium), and lorazepam (Ativan) increase GABA in the brain and reduce activity in the CNS. These medications are very effective at treating symptoms of alcohol withdrawal, but large doses are sometimes required.
- Antipsychotics – Antipsychotics such as haloperidol (Haldol) may be used to treat agitation, aggression, hallucinations, or other symptoms of psychosis that may occur during DTs.
- Barbiturates – Barbiturates are depressant drugs such as phenobarbital that can be used to reduce CNS activity if benzodiazepines are ineffective.
Aside from medication, patients should remain under 24-hour care until their symptoms have passed and they are no longer dependent on alcohol.
Delirium Tremens Timeline
The timeline and severity of symptoms may vary from one person to the next. Early symptoms of alcohol withdrawal usually begin 6 to 24 hours after stopping drinking. Symptoms will escalate over the next 12 to 48 hours. Between hours 36 and 48, high-risk individuals may develop DTs.
Overall, DTs can last for 3-4 days. The condition is not permanent, but it can be scary. In very severe cases, particularly in older individuals, symptoms may last up to 8-10 days after the last drink.
Can Alcoholics Prevent Delirium Tremens?
Trying to drink in moderation and only detoxing under medical supervision can help patients avoid DTs. Of course, the best way to prevent severe withdrawal symptoms is to avoid getting hooked on alcohol in the first place. People can do this by adhering to the American Dietary Guidelines for alcohol consumption which is 2 drinks per day for men and one drink a day for women maximum.
Alcohol Detox and Rehab in West Palm Beach, Florida
The Mandala Healing Center is committed to treating each person as a whole, integrating a healthy lifestyle that will help our patients truly heal from the inside out. Our alcohol detox and rehab program can help you detox safely, avoid delirium tremens, and embark on a sober journey.
Don’t wait any longer for the transformative care you deserve. Call now to speak with a qualified team member. Mandala’s Admissions Coordinators are available 24 hours a day. All calls and forms are 100% free and confidential.