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What is Delirium Tremens (DTs)?

“When was the last time you woke up and wished you’d had just one more drink the night before? I have never regretted not drinking. Say this to yourself, and you’ll get through anything.”

-Meredith Bell

A condition known as delirium tremens is a complication that can happen when people stop drinking alcohol. It occurs as a part of alcohol withdrawal, but it becomes much worse than the common symptoms. If proper medical treatment is not obtained right away, it can be a fatal condition.

Alcoholism is a very serious condition, and it is dangerous to stop drinking cold turkey. Those who attempt it are taking a major risk, and need to be warned of the dangers.

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What is Delirium Tremens?

Delirium tremens is a severe form of alcohol withdrawal symptoms. It is a condition that can begin suddenly, and without any warning at all. It involves severe changes to the nervous system. A person’s mood is also impacted once it begins.

Most people will refer to the condition as DTs. But there are those who have given it other nicknames as well. Among them are:

  • The Horrors
  • The Shakes
  • The Bottleache
  • Quart Mania
  • Ork Orks
  • Gallon Distemper
  • The Zoots
  • Seeing Pink Elephants

These nicknames have been given in an attempt to make the situation seem lighter than it really is. In reality, delirium tremens is nothing to take lightly. It is a very serious condition, and if it is left untreated, it can result in death.

When someone stops drinking, they will suffer from alcohol withdrawal. This is the body’s way of responding once they are no longer drinking. Over time, the body gets used to having its daily dose of alcohol. Once the person stops, it is as if the body does not know how to respond. It can almost be as if it goes into a state of shock, and it can take some time to recover from that.

Alcohol withdrawal symptoms can begin as soon as six hours after the last drink has been consumed. Most people will experience the following:

  • Symptoms of anxiety
  • Nausea
  • Vomiting
  • Excessive sweating (hot or cold)
  • Trouble sleeping
  • Headaches
  • Shaky hands

They will also have cravings for alcohol, and will not experience any further complications. Some people will eventually experience DTs, which is when their symptoms will become much worse. They will also have new ones that they did not have in the beginning.

Not everyone who drinks is considered to be at risk for experiencing DTs. But there are some factors that could put them more in danger of it. People are more likely to have the condition when they:

  • Have gone through alcohol withdrawal at some point in the past.
  • Stop drinking but fail to eat enough food afterwards.
  • Have suffered from a head injury, illness or infection, and also have a history of heavy drinking.
  • Generally consume between four and five pints of wine, seven to eight pints of beer, or one pint of hard liquor each day for several months.
  • Have been drinking alcohol regularly for ten years or more.

It needs to be stated that these are not the only criteria for DTs. Sometimes people look at this list and think that means that they are in the clear. That is not true at all. The real risk factor for delirium tremens is having been an alcoholic. It is a condition that can happen to anyone.

What are the Symptoms of DTs During Alcohol Withdrawal?

Someone who is experiencing DTs may notice that the alcohol withdrawal they were having is getting worse. In addition, they may notice the onset of new symptoms that are extremely troubling.

The most common symptoms of delirium tremens includes:

  • The onset of sudden, severe confusion
  • Bodily tremors
  • Abrupt changes in the way they think
  • Extreme agitation and irritability
  • Falling into a deep sleep that can last as long as 24 hours, or longer
  • Feelings of fear
  • Feelings of excitement
  • Having tactile, auditory or visual hallucinations
  • Experiencing quick bursts of energy
  • Rapid mood swings
  • Feeling restless
  • Becoming sensitive to touch, light and sound
  • Experiencing a stupor
  • Feeling sleepy and fatigued

It is also common for people to experience seizures, and they can occur when other symptoms are not yet present. There have been people who have experienced chest pain, a stomachache and a fever.

It is very difficult to say how long it may take before DTs begin after the last drink. Most people can expect for it to start within 48 to 96 hours. However, there have been cases when people got delirium tremens seven to ten days following their last drink. It varies from person to person.

This means that no one should ever think that they are in the clear. When people stop drinking, they often feel safe from DTs as long as they can make it past four days. The truth is that it can happen much later than that.

People should expect to receive treatment for delirium tremens for anywhere between seven to ten days. There are some who may make it through treatment in a shorter period of time, and for others, they may need longer. It really all depends on the individual.

There are many factors that can influence the duration of DTs. If the individual was drinking for a longer period of time, it may take longer to recover. The same is true if they were drinking a lot each day. Their general health and well-being also plays a significant role.

What is Delirium Tremens, or DTs?

Celebrities Who Have Died From Alcohol Withdrawal

It is no secret that there have been many celebrities that have lost their lives as a result of alcohol addiction. Unfortunately, many choose to quit drinking on their own. When they do, they put themselves at risk for suffering from delirium tremens. There are a few for whom this ended up having deadly consequences.

The fact that it is possible to die from not drinking is something that is pretty baffling. If excessive alcohol use is bad for people, it would seem that stopping would be a good thing. While it is good, it can also lead to serious complications in the form of DTs. This is something that singer, Amy Winehouse, experienced firsthand.

Amy’s death served to shine the spotlight on the dangers of alcohol withdrawal. Her family believes that because she was trying to quit drinking, withdrawal symptoms may have played a major role in her death.

Dr. Harry Haroutunian of Rancho Mirage, California explained it best when he said, “Alcohol chronically consumed in high quantities is like pressing down on a coiled spring. When you abruptly stop drinking, you release that force and the spring goes ‘Pow!’ There is this massive unopposed excitatory chemical release which affects all areas of the body.” He went on to say that, “Alcohol withdrawal is one of the most fatal complications of all drugs.”

Amy met the criteria for someone who was predisposed to delirium tremens. She frequently drank to excess and then went through her own version of alcohol withdrawal. That means she simply quit drinking for a period of time. It happens frequently on college campuses, and elsewhere all over the United States.


Actor, Nelsan Ellis, was best known for his role on the HBO television series, True Blood. He passed away at only thirty-nine years of age, and at first, complications with heart failure was reported to be the cause.

Later, his manager, Emily Saines, revealed the real reason behind the actor’s death. The heart failure was caused because of his attempt to stop abusing alcohol on his own. It has been a lifelong struggle for him, but it was one that he had decided to tackle without professional help.

Nelsan had been in an out of rehab many times for both drug and alcohol addiction. He suffered through many relapses and finally decided to take matters into his own hands. His family reported that he experienced a number of side effects due to alcohol withdrawal, including low blood pressure, a racing heart and a blood infection. His liver was also swollen and his kidneys shut down.

His family believes that he would want his story to be known. They are very vocal about the need for treatment for anyone who suffers from alcoholism or drug addiction.


Delirium Tremens Statistics in the U.S.

It is important to recognize the fact that DTs do happen all the time in our country. N one is immune to them if they struggle with alcoholism. The delirium tremens statistics are grim, and they tell us that:

  • For those who suffer from seizures due to alcohol withdrawal, more than 90% of them occur within 48 hours after the last drink.
  • Less than 3% of them take place five to twenty days after the last drink.
  • The likelihood of suffering from DTs increases with the number of past withdrawals.
  • In the same way, the severity of the seizures is like to be worse in those with a history of alcohol withdrawal.
  • As many as 5% of people who are diagnosed with DTs will die from them.
  • Once a patient receives medical attention, the risk of death decreases substantially.

Can DTs be Avoided if Someone Quits Drinking Cold Turkey on Their Own?

Remember, not everyone will experience delirium tremens when they stop drinking. Still, the risk of this condition is going to be there, which is why quitting cold turkey, without professional help is not recommended. There is a lot of information available online regarding natural alcohol detox remedies. But that does not mean that they are safe, or should be attempted.

Some people believe that combining the right supplements can help with alcohol withdrawal symptom and prevent DTs. There is information on using:

  • Vitamin B Complex
  • Thiamine
  • Vitamin C
  • Selenium
  • Zinc
  • Magnesium
  • Amino acids
  • L-glutamine
  • Milk thistle
  • Alpha Lipoic Acid
  • Melatonin
  • Valerian Root

There is nothing wrong with this list, but it is dangerous to try to use these supplements to avoid DTs. At the very least, alcoholics should be talking with their doctors to put a plan of action into place.

Tapering off alcohol sounds like it might be a good idea. Many of the top wellness websites actually recommend it, but that is a recommendation we cannot get behind. They claim that it can reduce the severity of alcohol withdrawal symptoms, but for most people it does not.

There is very little research to support the idea that tapering off alcohol will reduce the effects of withdrawal. Also, it is a known fact that people can experience delirium tremens even if they attempt a very slow taper. It is a method that can work with other types of drugs, but only in a medical setting.

The Harms Reduction for Alcohol website advises people to change the type of alcohol they drink when they want to stop. They state that they should switch to beer just so that they can keep the shakes and sweats to a minimum. Again, this is not going to be effective, and it should not be attempted because of the potential risk of DTs.

The Best Way to Prevent Delirium Tremens

The best way to prevent DTs is to opt for professional treatment. Patients need to be in a medical facility because they are equipped to provide them with the appropriate care. With the right kind of withdrawal treatment, it may be possible to avoid delirium tremens altogether.

Alcoholism is a very serious addiction, and it can be one of the most difficult drugs to stop using. The withdrawal symptoms people experience can become severe, and patients need close medical monitoring during recovery.

Alcohol detox is the process of removing toxins from the body that are related to drinking. It allows the body to become accustomed to what it feels like to no longer have alcohol. At the same time, it can make recovery much more comfortable for the patient because it decreases the severity of withdrawal. Some people even report that they never experienced some of the symptoms they were expecting because of detoxing.

It can take some time for people to get through alcohol withdrawal. But most patients should begin feeling more like themselves within seven to ten days with the proper treatment.

Doctors should be very careful to look at each patient’s situation closely to determine the proper treatment. In most cases, a medical detox will be needed, and patients may need to take medications to help with their symptoms.

This type of program also keeps patients in contact with a team of medical professionals at all times. They should be closely monitored by nursing staff 24 hours a day. That way, they can intervene if the patient begins to show signs of DTs or other complications. It is the best way to provide care for someone who is recovering from alcoholism.

Common Medications for Alcohol Withdrawal

There are a number of medications that doctors may prescribe to help patients get through alcohol withdrawal. Some of these include:

  • Librium – This is a benzodiazepine that is commonly used to treat alcohol withdrawal symptoms. When used along with an anticonvulsant, it can help patients stay relaxed and avoid seizures.
  • Gabapentin – This is an anticonvulsant drug that is frequently used to treat seizure disorders. It can also be used to treat pain. When used for alcohol withdrawal, it can treat insomnia, anxiety, gastrointestinal problems and other symptoms.
  • Valium – This is another benzodiazepine medication that may be given to patients to decrease their symptoms of anxiety.
  • Clonidine – This is a medication for high blood pressure that can help to relieve many of the signs of alcohol withdrawal. It helps patients stay comfortable and is very effective in the beginning stages of detox.
  • Atenolol – This is a beta-blocker, and it works by reducing the severity of tremors and slowing down the heart rate. This drug works very well when it is combined with a benzodiazepine.

Vivitrol is a newer medication that has shown to be very effective at treating alcohol withdrawal symptoms. This drug is an extended-release form of naltrexone, which is an opioid receptor antagonist. It is given once every thirty days in the form of an injection.

Many people have experienced great success when using this drug. That is why more treatment programs have started offering Vivitrol services. It works the best when it is combined with a good counseling program.

Delirium Tremens Treatments

When a patient presents with delirium tremens, the treatment team has a few different goals in mind. They want to control the patient’s level of agitation and decrease their risk of having seizures. They also want to decrease the risk of death or injuries. Rather than treat them in the emergency room, the team will most likely transfer them to a locked inpatient area, or an ICU.

Managing and treating delirium tremens is quite an involved process. A doctor must determine if the patient has any other underlying conditions. They will get a full medical examination and the appropriate blood work. An IV will be started to make sure the patient stays hydrated. The team will also monitor their vital signs frequently.

Medications will probably need to be administered via IV as well. The patient may receive Valium or Ativan to help them remain calm. An anticonvulsant drug like Gabapentin may also be given to prevent seizures.

During the patient’s hospital stay, they may talk with someone about attending an alcohol rehab center. They will be encouraged to stop drinking and given other alternatives for treatment. Before they are discharged, the proper arrangements will be made for ongoing care.

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What is the Outlook for Someone Who Recovers From Delirium Tremens?

Someone who comes to the hospital with DTs may find that the condition continues to impact them. It is not unusual for people to experience some of the related alcohol withdrawal symptoms for a year or more. They may have frequent emotional mood swings that are difficult to predict or control. They may feel tired all the time and want to sleep as much as they can. Ironically, they may also suffer from insomnia when they try to sleep.

Delirium tremens can really take its toll. That is why a professional treatment program is so highly recommended. Patients should consider whether an inpatient or outpatient rehab program would benefit them. At the very least, they should make an appointment with their doctor and begin attending Alcoholics Anonymous meetings.

If someone continues to drink after having recovered from DTs, they are putting themselves in a very dangerous situation. It is very likely that they will experience the condition again, if they decide to try and stop drinking. The best course of action is complete and total sobriety, and there are programs to help them reach that goal.

Of course, relapses do happen, but they can be prevented. It is best to go through a high quality alcoholism treatment program to get help.

Northpoint Evergreen Bellevue

Beginning Your Alcoholism Recovery Today

At Northpoint Evergreen Bellevue, we have been able to work with many struggling alcoholics. We know how it feels when you have a desire to stop drinking, but you are not sure you can do it. Our goal is to give you the tools and treatment you need to be successful.

We offer Vivitrol services, and can provide referrals for patients for detox. Afterwards, our intensive outpatient program can be an incredible source of support for the recovery journey ahead.

Do you have questions about recovering from alcoholism or delirium tremens? Please contact us.

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