Timing & Intensity of Alcohol Withdrawal Symptoms by Dr. Melissa Bregger @MelBreggs
Alcohol abuse is dangerous. It leads to financial strain, relationship problems, and puts the well-being of our loved ones in danger. Every day, alcohol poisoning claims the lives of at least six people. Among these individuals, 30% suffer from alcoholism.
It’s generally considered fine for a person to have a drink on special occasions. For some people, these “occasional drinks” become more-and-more frequent. Eventually, the person forms a habit of binge drinking. This is what leads to alcoholism.
To counter the effects of alcoholism, treatment programs can help a person successfully stop using the substance. During such a treatment program, withdrawal symptoms are very common in the majority of people. There are various withdrawal effects that can develop and the most feared and dangerous is known as delirium tremens (DTs).
This post takes a look at signs of delirium tremens. We also consider what this is and help people understand how an alcohol detox center in Texas, such as Stonegate Center, might be able to help.
What is Delirium Tremens?
Before we dive deeper into the process of how DTs affect a person, we should provide an overview of what this condition is.
As noted, Delirium tremens is essentially a complication that is associated with alcohol withdrawal. The condition is not exceptionally common, but it can be life-threatening in many situations. This is why awareness is so critical among people with alcoholism – as well as those currently undergoing a treatment program.
Delirium tremens is considered the severest form of withdrawal from alcohol and ethanol substances. It can manifest itself as a large range of symptoms. The symptoms associated with delirium tremens are much more serious than those linked to mild alcohol withdrawal. Thus, the condition is generally recognized by the severity of symptoms that a patient express.
It’s also important to note that delirium tremens is considered a medical emergency. With this in mind, patients experiencing symptoms should seek professional medical assistance. Loved ones of people with alcohol use problems also need to understand the symptoms that may signal the development of delirium tremens. This ensures they can recognize the condition in a loved one who is going through a period of recovery from alcohol use disorder.
There’s a pathophysiological process linked to the development of DTs. The condition is primarily caused by the alterations in neurotransmitters found in the patient’s brain.
A heavy drinker has an increase in the release of neurotransmitters classified as endogenous opiates. Chronic alcohol consumption also causes a consistent activation of a GABA-A receptor. This is the gamma-aminobutyric acid-A receptor. The release of GABA neurotransmitters may be increased in the brain. Furthermore, a glutamate receptor known as postsynaptic N-methyl-D-aspartate is up-regulated. This means activity in this particular glutamate receptor is increased significantly.
In addition to these effects, receptors for dopamine and serotonin are also stimulated with a consistent intake of alcoholic beverages.
This is how addiction to alcohol develops in the patient. As the addiction grows, there is a more consistent physiological effect in the brain.
During alcohol cessation with a medical detox program, the patient will no longer experience this upregulation and inhibitory effects of receptors in the brain. The detox would then lead to the development of withdrawal symptoms.
In patients with mild to moderate alcoholism, the effects may not be severe. There may be agitation, irritation, and even a depressed mood. A few physical symptoms may manifest, as well. Among those with a more severe level of alcohol addiction, however, symptoms can turn out to be quite dangerous.
Changes in brain chemicals happen when a person stops using alcohol. The brain now needs to return to normal, but due to the serious imbalance in neurotransmitters, the patient is likely to experience adverse effects. Among these, most consider the worst possible side-effect to be delirium tremens.
How to Know If I’m Suffering from DTs?
The primary characteristic associated with the development of delirium tremens is generally considered the severity of the symptoms. More common symptoms of alcohol withdrawal tend to be milder. Even in patients with severe symptoms, the cause will not always be delirium tremens.
Some of the minor symptoms that may signal alcohol withdrawal include:
It’s possible for more severe symptoms to develop without the presence of delirium tremens. A few of the more major symptoms that the patient may experience include:
- Tremors that affect the entire body
- Hypertension, leading to an increase in blood pressure
- Auditory hallucinations
- Visual hallucinations
- Diaphoresis, causing the patient to sweat excessively
When symptoms are exceptionally severe, this may be an indication that the person is in need of urgent medical attention. It could be a sign that DTs had developed.
Here are a few more common symptoms associated with delirium tremens:
- Severe agitation
- Dangerously high blood pressure levels
- Autonomic hyperactivity, which can include tachycardia
- A high fever may develop
- Both visual and auditory hallucinations
- A rapid heart rate is common
- Rapid tremors that affect the muscles
- Lethargy and stupor are also very common in patients with DTs
- Movement of the eyes may be adversely affected
- The patient may find that they are extremely sensitive to lights
- There may also be an increase in the sensitivity to sounds
- There may be an overall confusion noted in the person
One of the major issues associated with delirium tremens is the fact that it has quite a high rate of mortality. This means a significant number of people experience life-threatening effects. Many of these also end up dying due to the condition. Early intervention becomes a critical factor in increasing the chances of survival for the patient.
It’s estimated that up to 5% of patients who are undergoing an alcohol detox program may experience delirium tremens. The specific prevalence depends on the study that is being reviewed. Some studies do note a lower prevalence of around 3%.
How Long Do DTs Last?
There’s generally a higher risk for delirium tremens and severe alcohol withdrawal symptoms in some patients. It’s known that people who stop drinking suddenly may be at a higher risk of such complications. This is due to the sudden restriction of alcohol in the body – which tends to cause alcohol withdrawal syndrome.
There are several factors that can affect the timeline of delirium tremens. Some people may experience the condition only for a short while. In others, however, the symptoms may last for several days to weeks.
With this in mind, before a patient can ask how long do DTs last, they need to consider their unique situation.
A few factors that can affect the recovery time from delirium tremens include:
- The duration of alcoholism is an important factor to consider. People who have been abusing alcohol for longer may find that they are in recovery for a greater period of time. People who have been suffering from alcoholism for more than a decade have the highest risk of severe DT symptoms.
- The severity of alcoholism also affects both the risk of delirium tremens and the duration of recovery. Those who were heavy and chronic drinkers may have a harder time recovering from the condition. These individuals may also experience more severe symptoms.
Factors like the general well-being of the patient also need to be taken into consideration. A patient who’s in good health, apart from their alcoholism, may have a better prognosis and faster recovery time. This is in comparison to a patient with underlying conditions, such as heart disease, diabetes, and mental problems. These individuals may require more intensive care and might take significantly longer to recover from the condition.
When delirium tremens develop, most patients who receive adequate treatment will be able to recover within an estimated five days. This is because of the worse symptoms of the conditions can last up to a five-day period.
At the same time, it’s important to note that not all symptoms will resolve within this period. Some of the symptoms associated with the condition may continue to present an issue to the patient, even long after treatment was provided. These may include a frequent feeling of exhaustion, as well as sleep disturbances. Some patients also continue to experience mood swings after the DTs have subsided.
Can You Die from Delirium Tremens?
When looking at delirium tremens, one of the major factors to consider is that people can, in fact, die from the condition. This is why such an urge is placed on helping patients in recovery understand the symptoms that relate to DTs. Even if the patient does not have DTs, the development of severe symptoms needs to be considered an urgent matter to address.
Studies have found that the mortality rate associated with delirium tremens is alarmingly high. In people who do not receive treatment early on, an estimated 37% will die from the condition. Even when treatment is initiated, there are still some patients that may face life-threatening events – and deaths have been recorded in patients who are in treatment for DTs as well.
Early intervention for delirium tremens can help to increase the chances of survival for the patient. When treatment is not initiated at an early stage, the patient may experience even more severe symptoms.
Treatment Options for Delirium Tremens
Delirium tremens need to be treated as soon as it’s noted in a patient. The treatment differs from patient-to-patient. Some patients may require treatment in an intensive care unit. This is because of the severity associated with delirium tremens.
Either a fixed schedule or a symptom-triggered regimen may be prescribed to the patient. With a fixed schedule regimen, the patient is provided medication to assist in the treatment of delirium tremens as specific times every day. With a symptom-triggered treatment plan, the medication will be administered when the patient expresses symptoms associated with the condition.
Strict and continuous medical supervision is highly advised for patients who have developed delirium tremens.
Primary treatments will focus on helping to reduce the symptoms linked to delirium tremens. This includes reducing the risk of mortality among patients with the condition. There is also a need to provide medication that may help to reduce the risk that the patient may suffer a seizure.
A few benzodiazepines have been approved for use in patients undergoing treatment. Meds used to treat delirium tremens may include:
An intravenous administration of the drugs is often preferred. This helps to ensure the active chemicals are rapidly absorbed into the bloodstream. The working action is significantly faster with this type of administration route.
Following treatment, long term alcohol detox may be needed. This may help to reduce the risk of the patient experiencing a relapse. Upon relapse, there may be a new risk of developing delirium tremens. Inpatient rehab for alcoholism will usually be advised for the first few weeks during recovery.
Can Delirium Tremens Be Prevented?
There are factors that may help to reduce the risk of delirium tremens. The main factor that may help to minimize the risk would be to address the alcoholism early on. Patients need to realize the negative health effects that alcohol abuse has on their life. They should also understand the risks with heavy use. This includes the higher risks that come with cessation when they become a heavy alcohol user.
At the same time, loved ones also come into play here. Those with a close friend or family member who experience problems with alcohol should seek out help early on. They should not continue to delay seeking help for the loved one. The longer they wait, the more serious the alcoholism may become. When an alcohol detox program is implemented during these earlier times, the withdrawal symptoms will generally be less severe, and recovery time may be much shorter.
Delirium tremens is a serious complication associated with alcohol withdrawal. The condition can cause hallucinations and even a collapse in the cardiovascular system. People undergoing alcohol detox need to understand the symptoms associated with delirium tremens. This ensures the condition can be identified early on. Medical treatment can help to improve the outcome and prognosis of the condition.
Struggling with Drug Addiction or Alcoholism?
Don’t let the fear of delirium tremens prevent you from getting the medical care you need! For many alcoholics, the best-case scenario is to attend a medical detox near you, followed by long-term inpatient treatment or outpatient
At Stonegate Center, we offer 45-day programs for alcohol abuse as well as 60-day and 90-day programs for alcohol abuse. Each program consists of individual counseling, group therapy, and equine and recreational therapy. By being a part of our recovery community in Texas, you’ll gain access to our extensive Alumni community.
So, give us a call at (817) 993-9733, email us at admissions @stonegatecenter.com, or fill out our insurance verification form. We are in-network with Blue Cross Blue Shield (BCBS) of Texas, Aetna, Cigna, Ambetter, PHCS Multiplan, and HealthChoice of Oklahoma.
Regardless, we look forward to having you on our 125+ acre campus located in Azle, Texas!
John Eckelbarger is a Business Development Representative for Stonegate Center. With a BSA in Chemistry from the University of Texas at Austin, he has an interest in the neurobiology of addiction & pharmacology of drugs. He hopes to bolster Stonegate Center to the forefront of addiction medicine through bold, innovative content. He is currently pursuing his MBA in Finance from Texas Christian University.