Many people who are addicted to alcohol, and wish to stop drinking, feel they can do so “cold turkey” and on their own. However, about one half of all people who have an alcohol dependency suffer from alcohol withdrawal syndrome when they stop drinking. Alcohol withdrawal syndrome can be very dangerous if not monitored by a medical professional. Delirium tremens (DTs) is one of the four categories of alcohol withdrawal syndrome that is particularly dangerous, and can be deadly if not treated appropriately. But, what exactly is delirium tremens, and what are appropriate delirium tremens treatments?
Alcohol Withdrawal and Delirium Tremens
Generally, alcohol withdrawal symptoms begin to show up about 5-8 hours after the last drink. Typical minor withdrawal symptoms include increased anxiety, body temperature, heart rate and blood pressure, insomnia and hand tremors. Symptoms usually peak around 72 hours after the last drink and subside in about five to seven days. Medical professionals use a chart called the Clinical Institute Withdrawal Assessment of Alcohol Scale to score people who have stopped their alcohol use, determine what level of withdrawal symptoms to expect and subsequent treatment, if any. Scores range from 0-67, and people who score lower than 8 are monitored but rarely treated with medication. People with scores between 8 and 15 are monitored and treated with benzodiazepines (sedatives), if necessary. And those scoring over 15 indicate symptoms that are severe and will require close monitoring to prevent seizure and delirium tremens. Delirium tremens, or DTs, is a severe form of alcohol withdrawal. About 1%- 5% of cases of DTs result in death. Delirium tremens can appear within 48 to 72 hours after the last drink, and is characterized by visual and auditory hallucinations, disorientation, rapid heart rate, high blood pressure, fever, agitation and profuse sweating. Whether an individual will suffer from delirium tremens depends on a number of factors including age, liver function, other medical problems, level of daily alcohol use, and history of past seizures or episodes of delirium tremens.
Delirium Tremens Treatments
Despite the danger of this category of alcohol withdrawal syndrome, research regarding delirium tremens treatments is sparse. Most rely on studies conducted over 40 years ago. However, all identified treatments focus on safely transitioning alcohol out of the body while reducing the symptoms and effects of withdrawal. Since the main issues surrounding severe alcohol withdrawal are related to hallucinations and agitation, treatment is usually performed in a secured hospital or intensive care setting. Treatment measures are individualized to the patient and include the following:
- Treating hallucinations: offering reassurances and reorienting individuals to time, place and date
- Treating physical problems: close monitoring of vital signs and treating for hydration, hypertension, cardiac function and nutritional needs
- Treating anxiety and insomnia: using sedative medications to calm patients and help them sleep
Although delirium tremens is considered relatively uncommon, it is a dangerous category of alcohol withdrawal syndrome that can result in death if not treated properly. If you or a loved one wishes to quit drinking, consult a doctor to see if your situation requires close monitoring by a medical professional during the critical first eight days. Sources: Recognition and Management of Withdrawal Delirium (Delirium Tremens) Alcohol Withdrawal Syndrome