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What is Delirium Tremens?

On a cold December night, the doors to the triage area in St. Mary’s hospital in New York burst violently inwards. Several gloved and masked men and women surrounded the frantic and spastic man forced onto the rolling stretcher.

A plethora of wispy gloved hands covered the man, pushing him against the stretcher, securing him to it.

Following behind the stampede of emergency technicians rocketing the man through those double doors, was a woman sobbing maniacally into a messy jumble of paper towels in her hands. Loose strands fell and hovered gently to the floor, as she was kept from following the man on the stretcher by another staff member.

The mumblings of the man in the room got louder, no words seemed to have escaped him but rather, the occasional guttural howls that echoed throughout the hallways, further driving the women into her paper towels.

Dr. Hernandez, the attending for the night, was on his way to the triage area responding to his pager. He was a heavy set man and a relatively new doctor to join the world famous hospital and research facility. Overzealous and trying to make his name known, he hurried down the hall to respond to the code blue beckoning his name every minute on the intercom.

Passing the grieving women outside the double doors, he entered the brightly lit room and words began being shot at him.

Male. Mid 40’s. Suffering from alcohol withdrawals.

Ricky Burncoe.

Dr Hernandez tried speaking softly to the incoherent man.

But only confusion cascaded across Ricky’s face as he tried to stand back up. He seemed to be in a hurry to be somewhere he hardly knew. The veins running along his forehead seemed to pulsate randomly at some internal strife or dialogue.

The stream of sweat permeating from him seemed to only glisten at the bright incandescent light above him, exposing the drenched and battered t-shirt he wore.

After more failed attempts to communicate with the deranged man, the doctor softly, and to Ricky’s complete inattention, injected him with a psychoactive drug, eventually quelling him to a light sleep.

What Happened?

The following happened in 1993 to a man which will fortunately live and go on later to become the co-author for the controversial book, Professional Lives, Personal Struggles: Ethics and Advocacy in Research on Homelessness.

Ricky Burncoe was a well established and respected stock broker. He was, what he considered himself to be, a casual smoker and drinker. He would occasionally smoke whenever he was drinking. He mentions how he only started drinking when hanging around friends and how, without him noticing, it eventually led to him drinking nearly every day.

As the days began compounding one above the other, his alcohol tolerance rose. The more he drank, the more his tolerance rose and so on repeating in a cycle. After some time, he says he no longer drank because of friends, but only to keep the “shakes” from coming.

Multiple times he makes the mention of him losing the appeal of alcohol and felt to be in a prison he didn’t really know how to escape. 

After nearly a year had passed, of the constant abuse, he made a decision to finally end it and put a stop to it. He quit drinking cold turkey. He figured that if he ever wanted to quit drinking, he needed to take that first step and fight through the shakes, and that afterward everything would get better.

Of course, events didn’t quite turn out the way he expected by not taking into account a very serious and deadly level of alcohol withdrawals: delirium tremens, otherwise known as the DT’s.

Fortunately, he recovered from delirium after being treated, but many are not as lucky.

What are Delirium Tremens?

Delirium tremens are part of the alcohol withdrawal process, but only to those which had a heavy alcohol usage daily for extended periods of times. Typically most alcohol abusers don’t reach the deadly stage of delirium, but rather experience the far more common symptoms such as hangovers or nausea. Delirium derives its name from the latin word which mean “going to the furrow”, to metaphorically symbolize a process for “plowing downhill”.

What Causes Delirium Tremens?

The causes for delirium, unlike most narcotic withdrawals, can be narrowly traced down to a physiological dependence on alcohol’s two main chemical components: ethanol and methanol. Both these chemical markers function as positive modulators for receptors in the brain which, after long and arduous usage, creates more neural pathways to bind the chemicals. This is why after drinking for long periods of time, stopping abruptly causes a massive “systems failure” in a region of the brain trying to make sense of a loss of what it has been considering a vital receptor.

What are the Signs and Symptoms of Delirium Tremens?

Symptoms can begin to be felt around 3 to 5 days after the intake has stopped, leaving many to believe after only the first day that there is no danger in not getting treatment and dealing with it extemporaneously. Delirium will begin its onset by sharp pangs of nausea, followed by heavy sweating, disorientation, confusion, and high blood pressure. A very telling symptom are the vivid and severe nightmares that happen even for days after it’s over.

Incoherent mumbling is an easily noticeable sign, which is why it’s important to seek treatment before then, giving people an understanding of what is going on, instead of wondering if it’s some other medical (psychological) issue.

How are Delirium Tremens Treated?

For a safe and successful way to treat delirium, is undoubtedly medical intervention and treatment. Medication is given to bind to those empty receptors in the brain, slowly contracting the number of receptors. Medication typically must be followed through from anywhere to a week or months depending on the individual.

For ages before modern medicine, and even slipping in towards our time today, alcohol withdrawal and its consequent onset of delirium has been vastly misunderstood and trivialized in much of the past and even today’s media. The term “pink elephants”, which refers to the hallucinations of someone suffering from delirium tremens, has been far removed to the point it’s seemed as simply as the delusions of someone intoxicated, when in fact, its to reference the portal of death that lies just beyond those gates.

Currently, in the United States, there are around 18 million alcohol abusers. Of those a probable 12 percent will suffer some kind of withdrawal. What’s more, is that of those 12 percent, 4 to 6 percent will end up dying due to untreated delirium tremens. In simply bringing up awareness to these issues, we can curtail those numbers, but it ultimately starts with the actions we take now.


Catalina T.

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