Delirium tremens is a dangerous condition caused by sudden alcohol or benzodiazepine withdrawal, resulting in hallucinations, confusion, and arrhythmias. Treatment includes low-dose sedatives and antipsychotic drugs. Medical intervention is necessary to reduce the mortality rate from 30% to 5%. Gradually reducing benzodiazepine use is recommended.
Delirium tremens is a hallucinatory and delusional state often induced by cessation of daily alcohol consumption or during recovery from alcoholism. It can also occur when people quickly withdraw from regular use of benzodiazepines such as Xanax® or Valium®. Sudden withdrawal from barbiturates such as phenobarbital can also produce this condition.
Recovering alcoholics often refer to that rough period of alcohol abstinence as DT. Delirium tremens usually occurs within a day of your last drink or dose of medication, but can occur several days after you stop drinking. The condition, if left untreated, can be fatal in about 30% of those who stop heavy drinking long-term.
Delirium tremens immediately affects the brain, causing it to secrete various hormones such as GABA and serotonin in high quantities to try to find balance in the state of not drinking. These hormones can also decline rapidly. The neurological effects cause confusion, great anxiety, and sometimes visual and auditory hallucinations. However, their main dangerous effect is that the body responds to the up and down gear changes of neural chemicals by causing difficulty breathing, rapid heart rate and severe arrhythmias, as well as abnormally high blood pressure. A single arrhythmia can cause death if left untreated.
Since most alcoholics are generally in poor health and may suffer from nutritional deficiencies and liver disease, the body has difficulty adjusting to this state and this can increase mortality rates if left untreated. Treatment of delirium tremens is low-dose sedatives, perhaps an irony for those addicted to benzodiazepines. Extreme emotional disturbance may also warrant treatment with an antipsychotic drug such as Haldol®. The person experiencing the condition may be violent, making medical monitoring and interventions difficult without an antipsychotic.
Delirium tremens is a medical emergency, and its effects are the reason chronic alcoholics shouldn’t attempt a “cold turkey” approach to stopping drinking. With medical intervention, the death rate from delirium tremens drops to 5%. Most medical experts believe that recovery from alcoholism is best undertaken in a hospital or alcohol treatment center. Additional participation in programs such as Alcoholics Anonymous is encouraged to support and maintain recovery.
Long-term use of benzodiazepines should never be discontinued with cessation of all benzodiazepines. Instead, most doctors believe that gradually reducing the amounts of benzodiazepines taken is the best way to stop such use and can help people avoid delirium tremens. Under the guidance of a doctor or psychiatrist, levels are reduced very gradually, often by quarters of a milligram per week. Narcotics Anonymous and similar programs can provide support during and after the reduction process.
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