Ask the Addiction Experts: What Are Delirium Tremens and Are They Dangerous?

By: Anna Ruokis, RN

Delirium tremens (more commonly known as DTs) are the most severe form of alcohol withdrawal that can happen when a person with heavy and long-term alcohol usage stops drinking suddenly. DTs can start anytime between one and five days after the person’s last drink.

Most people assume DTs are the same symptoms as what you would typically experience with any withdrawal from alcohol such as nausea, vomiting, tremors, restlessness, etc. Unfortunately, DTs are much more dangerous and can be deadly.

Symptoms of delirium tremens include:

  • Confusion or severe disorientation (the most common sign!)
  • Severe anxiety and/or agitation
  • Hallucinations
  • Paranoia
  • Siezures
  • Hyperthermia (high body temperature)
  • Tachycardia (increased heart rate)
  • Death

What increases the risk of DTs?

  • A history of DTs in the past or seizures during alcohol withdrawals
  • Many instances of suddenly stopping heavy alcohol use
  • Heavy alcohol use
  • Using other substances along with the alcohol (such as sedatives or anything else that depresses the nervous system)
  • Increased age (DTs are rarer in people under the age of 30, but can still occur)
  • Chronic medical issues such as kidney, heart and/or liver disease

How long do DTs last?

DTs can last up to 7 days. In some rare instances, some people experience DTs for up to 2 weeks, especially if they are not being treated for withdrawal and are detoxing on their own at home.

How are DTs treated?

The best way to prevent and treat DTs is by going to a medical facility—a detox specialty unit and/or a hospital emergency room—so withdrawal symptoms are treated by medical professionals.

With professional treatment of DTs, the priority is to lower or depress the nervous system to stable levels by administering medications to safely help manage the DTs. Alcohol use depresses the nervous system, and heavy, long-term use has kept it depressed for a long time. When alcohol is suddenly stopped in these situations, the nervous system abruptly goes in the opposite direction becoming hyper-stimulated which can cause many withdrawal symptoms including DTs.

The most common medications for this treatment are benzodiazepines such as Ativan® (lorazepam), but other medications can be used.

Replenishing the vitamins, minerals and electrolytes that were lost from chronic alcohol use is also important because this helps stabilize the body and nervous system. The most common deficiencies in chronic alcohol use disorder are thiamine (vitamin B1), folate (vitamin B9) and magnesium.

In addition, medical staff monitors clients for safety and watch out for any worsening symptoms.

Can you safely detox at home from long-term or heavy alcohol use?

Do not try to detox from alcohol on your own at home—this is very dangerous and cause permanent disability or death! Delirium tremens is a medical emergency and if untreated can be fatal. Common causes of death are from the inability to effectively regulate body temperature, abnormal heart rhythms, seizures and/or exacerbation of existing medical issues.

It is critical to go through detox at an emergency room or a qualified medical detox facility, so that you can detox safely with the help of skilled medical professionals. Getting treatment quickly will help to decrease the risk of experiencing severe withdrawal symptoms and DTs.

Pine Rest provides addiction treatment services at every care level to support the recovery journey. At our residential detox in Grand Rapids, Michigan, clients are monitored 24/7 by medical staff to ensure safety. As soon as clients arrive, they are given medications to prevent or reduce withdrawal symptoms and cravings. In addition, they will receive genuine care and compassion from a staff highly trained in addiction, who will also provide support, knowledge, and resources to help begin their journey in recovery and sobriety. If you or a loved one needs help, please call us at 866.852.4001.

You are not alone! We can support you or your loved one at every step of recovery.

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