Alcohol Withdrawal – Hallucinosis, Delirium & Prevention

Alcohol Withdrawal

Alcohol-dependent people are driven by a strong desire to consume alcohol. Their body becomes used with large amounts of alcohol intake and 3-8 hours after the last sip of alcohol the withdrawal symptoms will appear. This is why it so difficult for chronic heavy drinkers to stop drinking.

The withdrawal symptoms might include: sickness, craving for alcohol, sweating, trembling or simply feeling terribly awful. Therefore people might depend on alcohol to prevent these symptoms. Most of the symptoms might go after 5-7 days of alcohol abstinence but the craving might last a lot longer.

Other severe symptoms of alcohol withdrawal might include tremors and seizures.

Tremors – Tremors might begin 5-10 hours after the last intake of alcohol and might be accompanied by high blood pressure, sweating, rapid pulse, insomnia, nightmares, irritability, vomiting and nausea. Usually they will peak at 24 to 48 hours after the last alcohol drink.

Seizures – Usually seizures might occur 6 to 48 hours after the last sip of alcohol and many seizures might occur within several hours.

The most severe reactions to alcohol withdrawal are Alcoholic Hallucinosis and Delirium Tremens.

Alcoholic Hallucinosis

Also known as alcohol-induced psychotic disorder or alcohol-related psychosis, alcohol hallucinosis is it occurs only in alcoholics and results from alcohol abuse or withdrawal. It is a pretty rare disorder that is seen only in alcoholics with a history of very heavy drinking over many consecutive years.

The phenomenon might occur during or after acute intoxication with the possibility of developing delirium tremens. It might develop within 12 to 24 hours after the last drink and it could last for days when the heavy drinking stops all of a sudden.

Alcoholic Hallucinosis

It usually involves auditory hallucinations, most often threatening or accusatory voices but it could involve visual hallucinations as well.

The visual hallucinations usually include similar, small, moving objects such as falling coins, crawling worms or bugs. Sometimes the patients might feel the worms or insects crawling on their on their skin. It is a tactile hallucination called formication.

What causes alcoholic hallucinosis and its mechanism are still unclear. It’s very likely to be a problem of dopamine presence in the limbic system. Before the hallucinosis begins there might be some other symptoms that might warn the people of what might come next.

The alcoholic hallucinosis occurs in about 20% of the hospitalized alcoholics.

The most common symptoms that might precede alcoholic hallucinosis are dizziness, indisposition, insomnia, headache and irritability.

Another similar manifestation of alcohol withdrawal is Delirium Tremens. But delirium tremens is a much more serious diagnosis than alcoholic hallucinosis.

Most of the time nutritional supplements are used to treat people with alcohol related hallucinations as the heavy drinkers might suffer from mineral and vitamins deficiency.

Delirium Tremens (DT)

This is the most dangerous stage of alcohol withdrawal and it is experienced by 5% of the people that withdraw from alcohol.

Delirium tremens might also be caused by withdrawal other sedative-hypnotics such as barbiturates or benzodiazepines.

DT is most dangerous when it comes as a reaction to alcohol withdrawal. The main symptoms include fever, nightmares, disorientation, hallucinations, disorientation and other signs of hyperactivity.

It usually occurs 3 to 10 days after the last drink and the symptoms are worse at night. The most disturbing hallucinations include visions of snakes, rats or insects.

The rate of mortality associated with DT is about 35% without treatment and 15% with treatment.

Delirium tremens is treated with benzodiazepines. To prevent death high doses might be required. Sometimes the patient has to be sedated for a week or more until withdrawal ends.

Severe Alcohol Withdrawal Symptoms


To prevent any serious symptoms of alcohol withdrawal heavy drinkers should get the help of a doctor. A doctor might advices of how to quit alcohol safer.