Addiction glossary

Delirium Tremens (the DTs)

By Gary Clinton·Addiction specialist·Author of Never Give Up·Updated June 2026

Delirium tremens — "the DTs" — is the most severe form of alcohol withdrawal. It is a medical emergency that can be fatal, and it's the single biggest reason heavy drinkers should never quit suddenly on their own.

If someone is withdrawing from alcohol and becomes confused, severely shaky, feverish, hallucinating or has a seizure, treat it as an emergency — call 999 / 112 now.

The signs and the timing

The DTs usually appear roughly 48–72 hours after the last drink, though they can come later. Warning signs include severe tremor, deep confusion or disorientation, agitation, sweating and fever, racing heart, and vivid hallucinations. Earlier withdrawal symptoms — shaking, sweating, anxiety, nausea — can be the prelude, and seizures may occur.

Who's at risk — and the safe route

Risk is highest for long-term heavy daily drinkers, anyone who's had withdrawal seizures or DTs before (see the kindling effect), and those stopping abruptly. The safe route is a medically supervised detox or taper — never white-knuckle cold turkey from heavy drinking. Please speak to a doctor before you stop; this is one withdrawal where help isn't optional.

Frequently asked questions

How soon do the DTs start after the last drink?

Typically around 48 to 72 hours after stopping, though they can appear later. Earlier withdrawal signs like tremor, sweating and anxiety often come first and are a warning to get medical help.

Can delirium tremens kill you?

Yes — untreated, it can be fatal, which is why it's a medical emergency. With prompt hospital treatment, the outlook is much better, so never wait it out at home.

How do you prevent the DTs?

Don't stop heavy drinking suddenly on your own. A doctor-supervised detox — often with medication and monitoring — prevents severe withdrawal and keeps you safe.

More from the glossary: alcohol withdrawal · the kindling effect · detox · or browse the full glossary.

Gary Clinton
Gary Clinton
Ireland's addiction specialist — CBT-qualified therapist, bestselling author of Never Give Up, and an ex-addict himself. Private one-to-one help for professionals, online and worldwide.

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