Delirium Tremens: How Long Does This Symptom Of Alcohol Abuse Last?

Alcohol withdrawal delirium, a severe and potentially life-threatening complication of alcohol withdrawal, includes conditions such as Delirium Tremens (DT), which can be terrifying both for the person experiencing it and for their loved ones. Individuals with alcohol use disorder (AUD) who suddenly stop drinking after a long period of heavy alcohol consumption are at risk of developing DT. Understanding the symptoms, causes, duration, and treatment for delirium tremens is essential to providing appropriate care and support for those affected.

What Is Severe Alcohol Withdrawal (Delirium Tremens)?

Delirium tremens is a severe form of alcohol withdrawal that typically occurs in individuals with a history of prolonged, heavy drinking. It is characterized by sudden and severe mental or nervous system changes, often accompanied by extreme agitation, confusion, hallucinations, and seizures. DT is considered a medical emergency that requires immediate intervention, as it can quickly escalate to life-threatening complications if left untreated.

The onset of delirium tremens usually begins within 48 to 96 hours after the last drink, though it can sometimes occur as late as seven to ten days after cessation. The symptoms result from the brain’s overactivity after alcohol is suddenly removed, leading to dangerous chemical imbalances in the central nervous system.

How Common Is DT?

While delirium tremens is one of the most severe manifestations of alcohol withdrawal, it is not extremely common. Approximately 3% to 5% of individuals who undergo alcohol withdrawal will experience DT. However, the risk is higher for those with a history of chronic alcohol abuse, multiple previous episodes of withdrawal, or other co-occurring medical conditions. These are significant risk factors that can complicate withdrawal and heighten the likelihood of experiencing dangerous symptoms.

It’s important to note that while DT is relatively rare, alcohol withdrawal syndrome (AWS), in general, is much more common and affects up to 50% of individuals who struggle with alcohol use disorder. The severity of alcohol withdrawal symptoms can range from mild anxiety and tremors to the more dangerous DT and seizures.

Delirium Tremens Symptoms and Causes

The delirium tremens symptoms can be alarming and severe. Early signs often include intense anxiety, agitation, and confusion. As the condition progresses, more serious symptoms may emerge, including:

Hallucinations

People with DT often experience vivid, frightening hallucinations, which can involve seeing, hearing, or feeling things that aren’t real.

The person may not know where they are, what time it is, or who they are. They may be unable to recognize familiar people.

They may be restless, hyperactive, or exhibit sudden, intense movements.

Seizures can occur in some individuals experiencing DT, and they pose a significant risk of injury or death.

Shaking or trembling is common and can affect the entire body.

High fever, excessive sweating, and dehydration are also frequent in people with DT.

The cardiovascular system may become overactive, increasing the risk of heart complications.

delirium tremens

How Much Do You Have to Drink to Develop Delirium Tremens?

The risk of developing delirium tremens is directly related to the quantity and duration of alcohol consumption. People who consume excessive amounts of alcohol over a prolonged period, typically 10 years or more, are at the highest risk of developing DT. On average, individuals who develop DT have been consuming more than eight drinks per day for several years. However, it’s not just the quantity that matters; the frequency of withdrawal episodes also increases the risk.

People who have experienced severe withdrawal symptoms in the past are more likely to develop delirium tremens during subsequent episodes. Therefore, it is crucial for individuals who have undergone alcohol withdrawal before to seek medical attention before attempting to quit drinking.

Alcohol Withdrawal Symptoms and Timeline

Alcohol withdrawal symptoms can range from mild to severe and can occur within hours to days after the last drink. The timeline of alcohol withdrawal symptoms can vary depending on several factors, including the amount and frequency of alcohol consumption, the duration of alcohol use, and individual tolerance.

  • Mild symptoms: These can occur within 6-12 hours after the last drink and may include:
  • Anxiety
  • Insomnia
  • Tremors
  • Nausea and vomiting
  • Headaches
  • Moderate symptoms: These can occur within 12-24 hours after the last drink and may include:
  • Increased heart rate and blood pressure
  • Sweating
  • Flushing
  • Irritability
  • Mood swings
  • Severe symptoms: These can occur within 24-48 hours after the last drink and may include:
  • Seizures
  • Hallucinations
  • Confusion
  • Disorientation
  • Delirium tremens (DTs)

Understanding the timeline and severity of alcohol withdrawal symptoms is crucial for recognizing when to seek medical help. Early intervention can prevent the progression to more severe symptoms, including delirium tremens.

How Long Does Delirium Tremens Last?

Delirium tremens typically lasts between 48 and 72 hours after the onset of symptoms, but in severe cases, it can last up to 10 days. The timeline of DT varies based on several factors, including the individual’s level of alcohol dependence, general health, and the presence of any co-occurring medical or mental health conditions.

  • Onset: Symptoms usually begin within 48 to 96 hours after the last drink, but in some cases, they can take up to a week to develop.
  • Peak intensity: The symptoms of DT usually peak within 24 to 48 hours after the onset. This is the period when the individual is at the highest risk of life-threatening complications.
  • Resolution: Symptoms often start to subside after 72 hours, but in some cases, delirium and agitation can persist for up to a week or longer. Full recovery from DT requires time, and the individual may need ongoing medical care to ensure a safe and complete recovery. Delirium tremens treatment is crucial in managing the condition and preventing complications, often requiring immediate medical attention and hospitalization.

Who Is at Risk for Delirium Tremens?

Not everyone who drinks heavily will develop delirium tremens, but certain factors significantly increase the risk. Those at the highest risk include:

Chronic heavy drinkers

Individuals who consume large amounts of alcohol over many years are at the greatest risk of developing DT.

People who have experienced severe alcohol withdrawal symptoms, including seizures, in the past are more likely to develop DT in future withdrawal attempts.

Those with underlying medical conditions, such as liver disease, cardiovascular disease, or malnutrition, are at a higher risk of developing severe withdrawal symptoms, including DT.

Individuals with mental health disorders, such as anxiety, depression, or bipolar disorder, are at greater risk of experiencing severe alcohol withdrawal.

The Substance Abuse and Mental Health Services Administration (SAMHSA) provides resources for those at risk of DT, emphasizing the importance of seeking professional help to navigate the complexities of alcohol use disorder and its withdrawal symptoms.

Can You Die from Delirium Tremens?

Yes, delirium tremens can be fatal if not properly treated. The mortality rate for individuals with untreated DT ranges from 5% to 15%. The risk of death is due to complications such as seizures, heart attack, stroke, or severe dehydration. Additionally, the agitation and confusion associated with DT can lead to dangerous behaviors that put the individual at further risk of injury or death.

However, with prompt medical intervention, the prognosis for people with DT improves significantly. The mortality rate drops to less than 1% when patients receive appropriate care in a medical setting.

Complications and Consequences of Delirium Tremens

Delirium tremens is a severe and potentially life-threatening complication of alcohol withdrawal. If left untreated, DTs can lead to serious consequences, including:

  • Death: The mortality rate for DTs is up to 37% if left untreated, and up to 15% even with proper treatment.
  • Seizures: DTs can cause seizures, which can lead to brain damage, injury, or even death.
  • Cardiovascular problems: DTs can cause high blood pressure, rapid heartbeat, and cardiac arrhythmias, which can lead to heart attack, stroke, or cardiac arrest.
  • Respiratory problems: DTs can cause respiratory depression, which can lead to respiratory failure, pneumonia, or acute respiratory distress syndrome (ARDS).
  • Dehydration and electrolyte imbalance: DTs can cause dehydration and electrolyte imbalance, which can lead to seizures, muscle weakness, and cardiac arrhythmias.

The severe nature of delirium tremens underscores the importance of seeking immediate medical attention. Prompt treatment can significantly reduce the risk of these serious complications.

How Is Delirium Tremens Diagnosed?

Diagnosing delirium tremens requires a comprehensive evaluation of the individual’s medical history, alcohol use, and withdrawal symptoms. Doctors will assess the patient’s vital signs, mental state, and physical condition. Blood tests may be performed to evaluate electrolyte levels, liver function, and hydration status.

The clinical presentation of DT, including severe agitation, confusion, hallucinations, and tremors, is often enough to confirm the diagnosis. In some cases, additional testing may be needed to rule out other potential causes of the symptoms, such as infections, head injuries, or other medical conditions.

Treatment for Delirium Tremens

Delirium tremens is a stark reminder of the dangers of untreated alcohol use disorder. For those who survive DT, the focus must shift to long-term recovery and preventing future episodes of alcohol withdrawal.

The treatment of delirium tremens focuses on stabilizing the patient’s condition and preventing life-threatening complications. To effectively treat alcohol withdrawal, especially in cases of DT, timely medical intervention is crucial to manage symptoms and avoid severe complications such as seizures and cardiovascular issues. DT is considered a medical emergency, and treatment typically takes place in a hospital or specialized detox facility. The key components of treatment include:

  • Detoxification: Medical detox is the first step in recovery and involves managing withdrawal symptoms safely.
  • Rehabilitation: Addiction treatment programs such as inpatient or outpatient rehab provide addiction therapy services, counseling, and support to help individuals understand the root causes of their addiction and develop coping strategies for long-term sobriety.
  • Support groups: Peer support groups like Alcoholics Anonymous (AA) offer ongoing support and accountability for individuals in recovery.
  • Relapse prevention: Learning to recognize triggers and developing strategies to avoid relapse is crucial for maintaining long-term recovery.
  • Medications: Benzodiazepines are the primary treatment for DT, as they help to calm the nervous system and prevent seizures. In some cases, antipsychotic medications or sedatives may also be used to manage agitation and hallucinations.
  • IV fluids: Rehydration is essential for managing DT, as dehydration is common due to excessive sweating, vomiting, and fever.
  • Monitoring: Continuous monitoring of vital signs, heart rate, and blood pressure is critical to ensure the patient’s safety during the acute phase of DT.
  • Nutritional support: Malnutrition is common in people with AUD, and nutritional deficiencies, such as low levels of thiamine (vitamin B1), can worsen DT. Supplementation is often provided to prevent complications like Wernicke-Korsakoff syndrome.
delirium tremens symptoms

Medical Emergency: When to Seek Help

Delirium tremens is a medical emergency that requires immediate attention. If you or someone you know is experiencing any of the following symptoms, seek help immediately:

  • Severe symptoms: If you are experiencing severe symptoms such as seizures, hallucinations, confusion, or disorientation, seek help immediately.
  • Difficulty breathing: If you are experiencing difficulty breathing, rapid heartbeat, or chest pain, seek help immediately.
  • Severe vomiting: If you are experiencing severe vomiting, diarrhea, or abdominal pain, seek help immediately.
  • Fever: If you have a fever over 101.5°F (38.6°C), seek help immediately.
  • History of DTs: If you have a history of DTs or have experienced severe alcohol withdrawal symptoms in the past, seek help immediately.

Remember, timely treatment is crucial in preventing complications and reducing the risk of death from delirium tremens. If you are experiencing any of these symptoms, call emergency services or seek immediate medical attention.

Receive Treatment for Alcohol Addiction at Immersive Recovery

If you or someone you love is struggling with alcohol addiction and facing the risk of delirium tremens, seeking professional help is crucial. Immersive Recovery offers comprehensive alcohol addiction treatment, including medically supervised detox and personalized rehabilitation programs. Our experienced team provides compassionate care and evidence-based addiction therapy services to help individuals achieve lasting recovery.

Don’t wait until the consequences of alcohol addiction become life-threatening—contact us today to begin your journey to a healthier, sober future.