What Is Delirium Tremens?

Delirium tremens (DTs) is a dangerous and life-threatening condition caused by alcohol withdrawal. It is a medical emergency that demands immediate, intensive care. 

While the term “alcohol withdrawal” covers a broad range of symptoms, delirium tremens is defined as a specific, severe condition. It is marked by extreme instability in the body’s systems, confusion, and hallucinations. DTs usually affect people who have consumed heavy amounts of alcohol for a sustained period of time and then suddenly stop or significantly cut back.

Take Action This Alcohol Awareness Month

If you or a loved one is struggling with alcohol dependency, don’t wait for withdrawal to become a medical crisis like delirium tremens. Alcohol withdrawal is dangerous and can be fatal without proper care.

This Alcohol Awareness Month, prioritize safety and stability. If you are planning to stop drinking or are already experiencing severe withdrawal symptoms, seek professional help immediately. Call Coastal Detox of Southern California today for expert medical stabilization and compassionate care. Your safety is our primary concern.

Understanding Delirium Tremens

Regularly drinking large amounts of alcohol changes the chemistry of the brain. Alcohol acts as a depressant, slowing down the central nervous system (CNS) and disrupting the balance of neurotransmitters involved in creating feelings of calmness and excitement. 

The brain adjusts to the regular presence of alcohol, so when the person suddenly stops drinking or drastically reduces the amount they consume, the brain chemistry is significantly unbalanced, triggering the severe physical symptoms associated with DTs. 

Delirium tremens typically begins 48 to 96 hours (2 to 4 days) after the last drink, though it can start as late as 10 days later. It follows earlier, milder withdrawal symptoms like shaking, anxiety, and slight increases in heart rate.

Signs and Symptoms of Delirium Tremens

The most critical signs of delirium tremens include:

• Severe Confusion: The person is deeply disoriented, unable to focus, and has reduced awareness of themselves and their surroundings. This is often reported as feeling “cloudy” or “not fully there.”
• Hallucinations: Sensory hallucinations, especially visual, i.e., seeing things that aren’t there.
• Extreme Agitation: The person is severely restless, disturbed, unable to sit still, and unable to gain control of their motor skills and mental state.

Physical symptoms include:

• Severe Tremors: Uncontrollable shaking in parts of the body, especially the hands. The person is unable to steady these tremors on their own.
• Elevated Vital Signs: Rapid heart rate (tachycardia), high blood pressure (hypertension), and heavy sweating (diaphoresis).
• Fever: A dangerously high body temperature (hyperthermia).
• Seizures: Full-body convulsions, which can be deadly. 

How Long Does Delirium Tremens Last?

Delirium tremens is typically a short-lived, but intensely severe, condition.

While the overall alcohol withdrawal process can last for weeks, the severe symptoms of DTs usually resolve relatively quickly with proper medical care.

• Duration of Delirium Tremens: DTs symptoms, once they begin, typically last for 1 to 3 days (24 to 72 hours). In rare, complicated cases, symptoms may persist longer, but the most severe, life-threatening period is generally within the first few days of onset.
• Total Alcohol Withdrawal Timeline: The entire period of physical and psychological adjustment after stopping heavy alcohol use is longer than the DTs phase.
  • Milder Withdrawal: Symptoms like anxiety, hand tremors, nausea, and insomnia typically begin within 6 to 12 hours after the last drink and peak around 24 to 48 hours.
  • Severe Withdrawal/DTs Onset: In cases of severe alcohol withdrawal, DTs and seizures generally begin between 48 and 96 hours after the last drink, though sometimes later.
  • Post-Acute Withdrawal Syndrome (PAWS): After the initial (acute) physical symptoms subside, some people experience PAWS, which includes protracted symptoms like mood swings, sleep disturbances, and cravings. PAWS can last for weeks or months.

Who is at Risk of DTs?

Though rare, delirium tremens can potentially happen to anyone who is heavily dependent on alcohol and at risk for withdrawal symptoms. Some factors that make DTs more likely are:

• Having had DTs before.
• Having a history of alcohol withdrawal seizures.
• Older age.
• Other health conditions, like liver disease, pancreas issues, or previous head injury.
• Very heavy and long-term alcohol consumption.

Heavy alcohol use is defined by the Centers for Disease Control as:

• 8 or more drinks per week for women
• 15 or more drinks per week for men

Delirium Tremens Treatment

Delirium tremens is a life-threatening emergency that requires professional medical care. Heavy drinkers should not attempt to quit “cold turkey” on their own. 

If you suspect that someone is experiencing DTs, call 9-1-1 or transport them to the nearest hospital immediately. Be sure to share as much information as you can about the person’s history of alcohol use. 

If you or someone you love is a heavy drinker who is ready to get sober, admission into a medical detox facility like Coastal Detox of Southern California is the best option so they can receive the constant medical monitoring and supportive medications they need. 

During the initial detox phase, the main goal is to stabilize the patient’s physical symptoms. Coastal Detox adheres to the medical guidance for managing alcohol withdrawal syndrome through:

1. 1. Stabilizing medications: Benzodiazepines are the most important class of medications for treating delirium tremens. Our medical director will prescribe and administer drugs like lorazepam, diazepam, or chlordiazepoxide in doses and frequency based on the patient’s symptoms. This suppresses physical tremors, prevents seizures, and eases the state of overactive agitation that is common in early alcohol withdrawal. 
   2. Supportive care: Alcohol withdrawal is very often accompanied by dehydration, malnutrition, and nutrient imbalances. Our clinicians administer fluids, vitamins and minerals (especially B vitamins, magnesium, and potassium) to help support patients’ physical recovery and speed the healing process.

• Continuous monitoring: 24/7 monitoring of vital signs is extremely important, especially during the first week of alcohol withdrawal. Our nurses check patients’ heart rate, blood pressure, temperature, and breathing rate continuously throughout the day and night so they can immediately respond to any dangerous heart rhythms, breathing failure, or deadly fevers.

Beyond DTs to Lasting Recovery

Delirium tremens is a severe, potentially fatal condition that can occur in the early onset of alcohol withdrawal, but treating DTs is not enough to fully recover from heavy alcohol use. While a hospital or medical detox can stabilize the patient, it’s critical to transition from detox to rehab to fully address the underlying issues that led the person to drink to the point of dependence and withdrawal. 

Coastal Detox of Southern California is a fully integrated detox and residential facility, so patients seamlessly transition from detox to inpatient rehab once they are medically stable and no longer in danger of experiencing DTs. In residential alcohol treatment, our patients work through individual therapy, group sessions, holistic practices, and family counseling to get to the heart of their substance use and create a plan for lasting sobriety. 

Seizures, withdrawal symptoms, and DTs are your body’s way of saying, “enough is enough.” Our admissions line is open 24 hours a day, so we’ll be here to help when you’re ready to get started.