Alcohol misuse is a serious problem throughout the UK. There are estimated to be more than 600,000 alcohol-dependent drinkers in England alone and less than a fifth of these are currently receiving treatment for their condition. Prolonged heavy drinking can lead to a number of complications. Alcohol is a causal factor in many illnesses and health conditions, including liver disease, heart disease and several forms of cancer. It can cause Wernicke Korsakoff Syndrome, which is a condition similar to dementia and heavy alcohol use can also lead to alcohol use disorders including alcohol addiction.

Over time you can develop a physical and psychological dependency on alcohol. Your tolerance will increase, meaning you need to drink more and more, feeding this vicious cycle.

Your brain and central nervous system come to depend on chemicals related to your alcohol consumption and your entire system is depressed.

When these chemicals are removed because you stop drinking or drastically reduce your alcohol consumption, you can suffer a range of alcohol withdrawal symptoms as your body and brain react.

What is Delirium Tremens?

Delirium tremens, also known as ‘the DTs’, is the name given to the worst of a spectrum of alcohol withdrawal symptoms. Withdrawal symptoms can still be severe even without developing into DTs however.

Delirium tremens generally develop after a person withdrawing from alcohol has already been experiencing ‘regular’ withdrawal symptoms for a while.

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Delirium Tremens Causes and Risk Factors

Before considering the causes of delirium tremens it can be useful to ask ‘what is alcoholism?’. Alcohol addiction is characterized by a compulsion to continue to use alcohol despite negative consequences and this ensures that alcohol intake is kept high over a prolonged period.

This contracts brain tissues destroys brain cells and, crucially, depresses the central nervous system. When alcohol intake drops suddenly the system reacts, which can trigger withdrawal symptoms in some people.

Some risk factors for people to progress from alcohol withdrawal symptoms to delirium tremens include:

  • Heavier drinking prior to withdrawal
  • Previous experience with alcohol withdrawal symptoms
  • Some underlying physical and mental health conditions
  • Certain medications
  • Age, with older drinkers more likely to experience DTs

Delirium Tremens Symptoms

Delirium tremens tend to follow from other, less severe withdrawal symptoms, which may get worse with the onset of DTs.

These could include but are not limited to:

  • Nausea and vomiting
  • Headaches and muscle aches
  • Fatigue
  • Anxiety
  • Insomnia
  • Mood swings
  • Confusion
  • Fever and chills
  • Heart palpitations
  • Increased heart rate and/or blood pressure

Other symptoms generally associated with the most severe cases identified as delirium tremens could include:

  • Involuntary tremors and spasms – commonly known as ‘the shakes’
  • Visual, auditory or tactile hallucinations
  • Extreme confusion
  • Seizures

How Long Does Delirium Tremens Last?

If you experience alcohol withdrawal symptoms, these will generally start to exhibit between 6 and 24 hours after you stop drinking. More severe symptoms that may develop into delirium tremens may start to appear between 12 to 48 hours after the last drink and can continue for several days.

They will usually peak in 5 days but in some cases could last for 8-10 days, depending on the severity of the alcohol problem and other factors.

Delirium Tremens Diagnosis

Diagnosing the DTs involves assessing the type and severity of the withdrawal symptoms being experienced and can only be done by a medical professional. A formal withdrawal from alcohol scale such as the Clinical Institute Withdrawal Assessment scale is often used for this.

Delirium Tremens Treatment

For any heavy drinker who is at risk of severe alcohol withdrawal including the symptoms of delirium tremens, it is always recommended that they undergo alcohol detox in a clinical environment, whether this is at a rehab, a hospital or a similar medically supervised setting.

Treatment of alcohol withdrawal will involve supervision and support but severe withdrawal symptoms such as the DTs are also likely to require prescription medication and may require other forms of medical intervention. If a person attempts to quit or go ‘cold turkey’ without expert help and experienced DTs, they could well end up in an intensive care unit.

Detox is only a part of the recovery journey, however. In order to make a long-term recovery from alcohol addiction, you will also need to learn about relapse prevention to remain sober moving forward. Otherwise going through the trials of the DTs may all have been for nothing.

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How Can I Get Help?

Rehab is the most effective way to treat a longstanding alcohol problem. As well as helping you to detox in a safe, controlled environment, you will undergo therapies and treatments designed to help you deal with the root causes of your drinking and to develop strategies for relapse prevention.

An aftercare package and support groups can also help you to maintain your sobriety after the main part of the program ends.

If you or a loved one is in the grip of alcohol addiction, contact us today for confidential advice or to start the admissions process moving.

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What is it like to have delirium tremens from alcohol withdrawal?

It is very unpleasant to suffer delirium tremens from alcohol withdrawal as you will experience a range of symptoms that could include aches, tremors, nausea, extreme anxiety, hallucinations and seizures. Medication can help to mitigate some symptoms and it is always best to undergo alcohol detox in a controlled environment such as alcohol rehab.

Is Delirium Tremens serious?

Delirium tremens is the most serious of a range of alcohol withdrawal symptoms. It is considered to be a medical emergency and usually requires hospitalisation if the sufferer is not already in a supervised clinical setting such as rehab. It can result in severe symptoms such as withdrawal seizures and can even result in death.

Is Delirium Tremens common?

Delirium tremens is very serious but, thankfully, it isn’t very common. According to American Addiction Centers around half of the people with an alcohol problem will experience symptoms of alcohol withdrawal. Around one in 20 of these people will exhibit symptoms of delirium tremens.4 It’s worth remembering, though, that DTs is the most severe of a spectrum of symptoms and any withdrawal can be unpleasant, painful and potentially dangerous.

John Gillen - Director at Ocean Recovery

John Gillen - Author - Last updated: December 22, 2023

John is one UK’s leading professionals in the addiction recovery industry. Pioneering new treatment techniques such as NAD+ and ongoing research into new therapy techniques such as systematic laser therapy, John is committed to providing the very best treatment for people throughout the UK and Europe. During his extremely busy schedule, John likes to regularly update our blog section with the latest news and trends in the industry to keep visitors to our site as well informed as possible on everything related to addiction treatment.

Dr Adel Ghaly

Dr Adel Ghaly - Clinical Reviewer - Last reviewed: August 29, 2023

MB BCh, Psychological Medicine (Substance Misuse Psychiatry) from 2002

Dr Adel Ghaly is a registered Doctor who is a specialist psychiatrist. Dr Ghaly gained an MB BCh in 1982 from Assiut University and has since become a substance misuse specialist and psychiatrist. After gaining his qualification in Psychological Medicine (Substance Misuse Psychiatry) in 2002, Dr Ghaly has worked in hospitals and as a specialist trainer recognised by the GMC.

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