Nearly 14.5 million people ages 12 and older in the U.S. had an alcohol use disorder (AUD) in 2020, but only about 10% received any type of formal treatment.[1] One of the biggest obstacles facing people struggling with alcoholism and sobriety is alcohol withdrawal.

Alcohol withdrawal occurs after long periods of consistent, heavy drinking. It usually requires professional medical care, as at-home detox is risky and unlikely to be successful. One of the biggest dangers of detoxing from alcohol alone is delirium tremens (DTs), a severe set of alcohol withdrawal symptoms that can result in death.

What Happens During Alcohol Withdrawal?

Alcohol is a central nervous system (CNS) depressant that slows down brain function. After regular alcohol abuse, the brain compensates for the ongoing slowed-down activity by increasing excitatory and inhibitory mechanisms in the CNS.

Over time, the brain and body adapt to having alcohol in the system, resulting in physical dependence on alcohol. Once dependence develops, the brain will continue to produce excitatory signals and act in a state of hyper-arousal, even when there is no alcohol in the body. The overactivity in the brain receptors without the presence of alcohol is what causes alcohol withdrawal symptoms.

Symptoms of alcohol withdrawal usually appear between 6-24 hours after your last drink. Common symptoms of alcohol withdrawal include:[2]

• Anxiety
• Shaky hands
• Headache
• Nausea
• Vomiting
• Insomnia
• Sweating
• Confusion
• Racing heartbeat
• High blood pressure
• Fever
• Heavy sweating

What are Delirium Tremens (DTs)?

Delirium tremens (DTS) are the most severe form of alcohol withdrawal. DTs occur after long-term heavy drinking, usually in people who have gone through alcohol withdrawal in the past. It is a life-threatening condition that can be fatal without prompt medical care.

DTs are most likely to occur 12-48 hours after your last drink and usually last for 3-4 days. Symptoms may fluctuate during the delirium tremens timeline, and some symptoms may persist longer than others.

Delirium Tremens Symptoms

DTs can be scary and severe. Symptoms of delirium tremens include:

• Agitation
• Aggression
• Auditory hallucinations
• Confusion
• Irritability
• Impaired consciousness
• Nausea
• Sweating
• Seizures
• Tactile hallucinations
• Tachycardia
• Trembling
• Tremors
• Visual hallucinations

Delirium tremens can be fatal. Symptoms can worsen quickly and unexpectedly. If you think you may have DTs when you stop drinking, you must detox at a drug and alcohol detox facility near you.

Who is at risk of Delirium Tremens?

Some people are more likely to experience complications during alcohol withdrawal than others. People who are most at risk for DTs include:

• Excessive and heavy drinkers
• Long-term drinkers
• Older adults who have been drinking for many years
• People who have gone through alcohol withdrawal in the past
• Individuals with a history of seizures
• Having co-occurring mental health conditions
• Drinking higher amounts of alcohol in the weeks leading up to detoxification
• Lacking a well-balanced diet

Overall, about 5% of people who go through alcohol withdrawal will experience DTs.[3]

The best way to prevent delirium tremens is to avoid drinking too much alcohol. According to the American Dietary Guidelines, men should have no more than 2 drinks per day and women should have no more than 1 drink per day. If you drink more than this on a daily basis and do so for several years, you could be at risk of DTs.

How is Delirium Tremens Treated?

Without appropriate treatment, DTs have a mortality rate of up to 37%. As a result, it is essential to get medical treatment any time you go through alcohol withdrawal.[3]

If you are already showing symptoms of DTs, it will be treated as a medical emergency, sometimes requiring hospitalization or admittance to the intensive care unit (ICU). However, if you haven’t started having withdrawal symptoms yet, you can check into a local alcohol detox center where they can take preventative measures to keep you safe. Standard treatments for delirium tremens involve medications such as:

• Benzodiazepines – CNS depressants like Librium (chlordiazepoxide), Valium (diazepam), Ativan (lorazepam), and others can manage most of the symptoms of alcohol withdrawal. In particular, benzos can reduce the risk of withdrawal seizures, agitation, and anxiety. Barbiturates are the first medications providers prescribe to manage DTs.
• Barbiturates – If benzodiazepines alone are not effective at treating DTs, barbiturates may also be prescribed. Barbiturates, such as phenobarbital, are powerful CNS depressants that can reduce seizures and irritability.
• Antipsychotics – Antipsychotics like Haldol (haloperidol) and others may be used in low doses to reduce symptoms of psychosis like hallucinations and tremors.

Patients should also be closely monitored during detox by medical professionals, ensuring heart rate, blood pressure, and other important vitals stay in a safe range.

Staying Sober After Detox: Alcohol Use Disorder Treatment

Chronic drinkers who experience DTs when they stop drinking are at an increased risk of having DTs again if they relapse and withdraw. People who want to stay sober after detox usually require a comprehensive alcohol use disorder (AUD) treatment program.

Detox can last up to two weeks in advanced cases. After detox, alcoholism treatment often lasts 30-90 days depending on your needs. Alcohol rehab involves:

• Individual therapy
• Group therapy
• Family therapy
• Holistic therapy
• Relapse prevention
• Aftercare support

Cognitive-behavioral therapy (CBT) is the most widely used alcohol addiction therapy. CBT can help you identify the root causes of your drinking, develop healthy coping skills, identify potential relapse triggers, and stay sober in the long term.

Many people drink to cope with difficult emotions or mental health conditions like anxiety, depression, or bipolar disorder. Between 30-50% of people who struggle with alcoholism also have at least one co-occurring mental health condition.[4] If you suffer from depression, anxiety, or other psychiatric symptoms, you may require dual diagnosis treatment to overcome both issues simultaneously.

After rehab, most people benefit from aftercare. Aftercare may include sober housing, Alcoholics Anonymous (AA) meetings, mental health counseling, medication management, or an alumni program.

Find an Alcohol Detox and Rehab Center in New Jersey Today

Getting alcoholism treatment is beneficial to anyone trying to stop drinking, but it is crucial in people at risk for delirium tremens (DTs). Without medical treatment, DTs can become life-threatening.

The compassionate staff at Moving Mountains Recovery understand the medical necessity associated with alcohol withdrawal. That’s why we partner with some of the most highly-rated alcohol detox centers in New Jersey. Our admissions counselors can verify your insurance, connect you with a trusted detox center, and help you arrange a transition to one of our outpatient alcohol rehab programs once your detox is complete.

The sooner you get help, the easier detox will be. Call today to start your recovery.

References:

1. National Institute on Alcohol Abuse and Alcoholism (NIAAA): Alcohol Facts and Statistics, Retrieved Jan 2023 from https://www.niaaa.nih.gov/publications/brochures-and-fact-sheets/alcohol-facts-and-statistics
2. R Saitz, M.D., National Library of Medicine: Introduction to Alcohol Withdrawal, Retrieved Jan 2023 from https://www.ncbi.nlm.nih.gov/pmc/articles/PMC6761824/
3. A Rahman, M Paul, Aug 2022, National Library of Medicine: Delirium Tremens, Retrieved Jan 2023 from https://www.ncbi.nlm.nih.gov/books/NBK482134/
4. I L. Petrakis, M.D., G Gonzalez, M.D., R Rosenheck, M.D., and J H. Krystal, M.D., National Institute on Alcohol Abuse and Alcoholism (NIAAA): Comorbidity of Alcoholism and Psychiatric Disorders, Retrieved Jan 2023 from https://pubs.niaaa.nih.gov/publications/arh26-2/81-89.htm