Some people who go through alcohol withdrawal develop a condition called delirium tremens (DTs). What are delirium tremens, who is at greatest risk of developing these symptoms, and can the experience actually be fatal?
What Is Alcohol Withdrawal?
When a person becomes addicted to a drug, the continued presence of the substance can alter their body’s ability to naturally maintain appropriate levels of various brain chemicals.
Alcohol causes increased levels of gamma-aminobutyric acid (GABA), which is the primary inhibitory neurotransmitter in the human body. This means that it slows the passages of electrical impulses throughout the central nervous system (CNS), which has a sedating effect.
GABA is countered by glutamate, which is the main excitatory neurotransmitter. Glutamate speeds the delivery of messages through the CNS, which can increase alertness, enhance attention, and boost energy.
A healthy body will maintain a relatively equal balance of GABA and glutamate. But when a person abuses alcohol for an extended period, their body will rely on the drug to trigger GABA production. When that person suddenly stops drinking, their GABA levels can plummet, causing an imbalance with glutamate.
Common symptoms that can result from this imbalance include:
- Cravings for alcohol
- Excessive perspiration
- Anxiety
- Agitation and irritability
- Headache
- Heart palpitations
- Increased blood pressure
- Nausea
- Insomnia
According to the Cleveland Clinic, about 50% of people who develop an addiction to alcohol experience withdrawal symptoms like these when they quit drinking. In most cases, symptoms peak with about three or four days after a person’s last drink, then slowly subside over the next five to 10 days.
Though alcohol withdrawal can be uncomfortable, it usually doesn’t pose a significant health risk. But for the small number of people who develop delirium tremens, withdrawal can be both painful and dangerous.
What Are Delirium Tremens?
Delirium tremens, which are commonly referred to as the DTs, are a set of particularly distressing and dangerous alcohol withdrawal symptoms. Today, this condition is often referred to as alcohol withdrawal delirium, or AWD.
Symptoms
Someone who develops delirium tremens will experience symptoms such as:
- Profound confusion or disorientation
- Hallucinations
- Paranoia
- Hyperthermia (dangerously high body temperature)
- Tachycardia (racing heart rate)
- Uncontrolled muscle movements
- Seizure
Timeline
Delirium tremens symptoms usually begin to occur with 48—72 hours (two to three days) after a person’s last drink, though there have been cases of people who first developed symptoms of the DTs more than a week after they stopped drinking.
Risk Factors
According to a May 2018 report in the Journal of Clinical and Experimental Hepatology, experts estimate that 0.7%—1.8% of people who go through alcohol withdrawal have delirium tremens.
The risk of developing the DTs is higher among people who:
- Have been drinking excessively for 10 years or longer
- Have previously gone through alcohol withdrawal
- Have malnutrition and certain other medical concerns
- Are also withdrawing from other substances
Effects
Describing delirium tremens as life-threatening is not an exaggeration. At one time, about 35% of people who developed delirium tremens died. Today, thanks to advances in the ability to diagnose and treat this condition, the anticipated mortality rate is about 2%.
How Are Delirium Tremens Treated?
The danger and unpredictability of delirium tremens underscore the importance of getting professional help to withdraw from alcohol if you have a history of heavy drinking. If you try to get through withdrawal on your own, by the time you develop the DTs it may be too late to get effective treatment.
When you enter a detoxification (detox) program, you will be under the constant care of professionals who are familiar with all aspects of alcohol withdrawal, including delirium tremens.
Treatment for the DTs may involve several prescription medications, including:
- Benzodiazepines to alleviate anxiety
- Phenobarbital to stop convulsions
- Antipsychotics to treat hallucinations
Detox professionals may also administer thiamine (vitamin B1) and other vitamins to reduce the risk of severe complications such as Wernicke-Korsakoff syndrome.
In addition to providing these medications, your treatment team can also monitor your vital signs to ensure that you remain stable throughout the withdrawal process.
What Are the Signs of Alcohol Addiction?
The best ways to reduce your risk of delirium tremens is to drink only in moderation or not at all. If you find it difficult or impossible to take either of these steps, you may benefit from treatment for alcohol addiction.
The clinical term for alcohol addiction is alcohol use disorder. As established in the fifth edition of the Diagnostic and Statistical Manual of Mental Disorders (DSM-5) symptoms of this condition can include:
- Frequently drinking more, or for a longer period of time, than you originally intended
- Having powerful urges to drink
- Devoting substantial amounts of time to drinking and recovering from the effects of alcohol
- Drinking in circumstances that clearly pose a significant risk, such as combining alcohol with other drugs or drinking and driving
- Continuing to drink even after you’ve experienced a medical or mental health problem that was caused or worsened by alcohol use
- Continuing to drink even after incurring some type of social or interpersonal damage (such as a lost relationship or being arrested) that was caused or made worse by your alcohol use
- Ending or reducing your participation in important activities because of your alcohol use
- Failing to pay bills, keep appointments, or fulfill other responsibilities at home, in school, or at work due to your alcohol use
- Developing tolerance, which means that you need to drink larger amounts of alcohol to experience the drug’s effects
- Having withdrawal symptoms when you try to stop drinking or are prevented from using alcohol for a short period of time
- Wanting to quit drinking, but being unable to stop
If any of the symptoms above look familiar to you, your best first step may be to consult with your doctor or schedule an assessment with a reputable addiction treatment provider near you.
Alcohol use disorder is a treatable condition – but if you fail to get proper care, you may experience a range of life-threating problems, including delirium tremens.
Find Treatment for Alcohol Addiction in Tampa Bay
Tampa Bay Recovery offers personalized outpatient care for adults who have been struggling with addictions to alcohol and other drugs. We also offer dual diagnosis services for those who have co-occurring mental health conditions.
Treatment options at our outpatient rehab in Tampa Bay include detox, a partial hospitalization program (PHP), and an intensive outpatient program (IOP).
To learn more about how we can help you or a loved one, or to schedule a free consultation, please visit our Admissions page or call us today.
