Delirium Tremens (DTs)

Delirium Tremens is a Severe Form of Alcohol Withdrawal
Heavy drinkers are at risk of developing a severe form of withdrawals known as [Delirium Tremens](http://www.nlm.nih.gov/medlineplus/ency/article/000766.htm) (DTs). An individual dealing with delirium tremens needs to be medically supervised because there is a risk of death. Advances in medical treatment have improved things, but in the past the mortality rate from DTs was as high as 35%. It is now about 10%. Most of those who pass through alcohol withdrawals will not experience DTs. When it does occur, it is treated as a medical emergency.

The Symptoms of Delirium Tremens
The symptoms of delirium tremens tend to become apparent within the first 72 hours after the last alcoholic drink. Those individuals who make it past this time period with symptoms are far less likely to develop DTs. In rare cases, these symptoms can begin anywhere up to 10 days following the last drink. The symptoms of delirium tremens include:

* _Seizures_ can occur even in the individual with no previous history of epilepsy. These episodes tend to be of the [tonic-clonic](http://www.epilepsy.com/epilepsy/seizure_tonicclonic) variety where the whole body shakes violently. The risk of having this symptom tends to be highest between 6 and 48 hours into withdrawal.
* _Confusion_. Most individuals who pass through alcohol withdrawal will experience some type of foggy thinking. This tends to be a lot more severe in cases where the individual has DTs.
* There can be _agitation or increased excitement_.
* _Hallucinations_ are common and tend to be visions of moving animals such as snakes or rats. The individual can also have hallucinations where they actually feel insects crawling on their skin.
* There will often be _high states of anxiety_ where the individual will feel certain that something really bad is about to happen.
* The individual can also experience _elevated pulse, blood pressure, and temperature_.

As well as the above, the individual will also experience other symptoms associated with alcohol withdrawas such as:

* Nausea and vomiting
* Insomnia
* Sweating
* Mood changes
* Loss of appetite
* Depression

The Causes of Delirium Tremens
Delirium tremens is most likely to occur when an individual has been a heavy drinker for many years. Those who drink heavily every day over a period of a few months are also at risk of experiencing DTs. The body adapts so well to dealing with alcohol that it struggles when the chemical is removed. It is also possible for people with a history of alcoholism to enter DTs due to an infection or injury. Those individuals who have a history of alcohol withdrawal will be more at risk of developing these more extreme symptoms.

The exact cause of delirium tremens is still debated. One of the most likely reasons is that long term alcohol use interferes with the body’s ability to regulate a neurotransmitter called [GABA](http://en.wikipedia.org/wiki/Gamma-Aminobutyric_acid). In chronic alcohol abuse, the body mistakes alcohol for GABA and reacts to this by reducing its production of the neurotransmitter. When alcohol levels in the body fall too low, it means that there is not enough GABA for proper functioning. This is dangerous because this neurotransmitter is required for regulating excitability within the nervous system.

The Treatment of DTs
The usual treatment for delirium tremens is to keep the individual sedated using [benzodiazepine](http://www.justice.gov/dea/concern/benzodiazepines.html). There are a number of different types of this psychoactive drug with the most common being Librium and Valium. This type of sedation works by reducing the excitability of the nervous system which is causing most of the symptoms of DTs. It is also usual to try to keep the environment of the individual as calm as possible so as to reduce the risk of hallucinations and anxiety.

Assessing the Risk of DTs
Those people who wish to escape alcohol addiction will often require at least some type of assistance. Because of the potential severity of delirium tremens, it is vital that those individuals who are at risk of developing these symptoms be identified. For this reason, there have been different diagnostic assessment tools created to determine this risk. These assessments can be carried out by medical professionals and be used to determine the most appropriate treatment for the individual. Those who are at risk of DTs will most often require some type of in-patient detox where they will be medically supervised. It may sometimes be necessary to keep the individual in an intensive care until the dangers have passed.

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