Understanding Alcohol Withdrawal Delirium: Symptoms, Timeline, Treatment, and ICD-10 Codes

Alcohol withdrawal delirium (AWD) is a severe and potentially fatal condition that occurs when chronic heavy drinkers suddenly stop consuming alcohol. Symptoms range from mild anxiety to life-threatening seizures. Alcohol delirium can present in various forms depending on the severity of withdrawal and prior alcohol use.

Early recognition and medical intervention are crucial to managing the condition safely and effectively. 

Cadabam’s Anunitha provides specialised detox and rehabilitation services, ensuring comprehensive medical supervision and personalised care for individuals facing AWD. 

What Is Alcohol Withdrawal Delirium? 

Alcohol withdrawal delirium (AWD), also commonly referred to as delirium tremens (DT), is a severe complication of alcohol withdrawal.

It occurs in dependent individuals following sudden alcohol withdrawal and causes confusion, tremors, hallucinations and autonomic instability, requiring urgent medical intervention. 

Understanding alcohol withdrawal delirium ICD 10 codes is essential for clinicians to manage the condition efficiently.

Causes of Alcohol Withdrawal Delirium 

The causes of alcohol withdrawal delirium can be narrowed down to these factors: 

• Long-term heavy alcohol consumption 

• Abrupt cessation of alcohol intake 

• History of alcohol withdrawal symptoms 

• Poor nutrition and dehydration 

• Co-existing mental health disorders 

• Liver dysfunction and metabolic imbalances 

Alcohol delirium often results from a combination of these factors rather than a single cause. 

Symptoms of Alcohol Withdrawal Delirium 

Alcohol withdrawal delirium (AWD) is a severe and potentially life-threatening condition that occurs when a person with alcohol dependence stops drinking suddenly.   

Symptoms can develop within a few hours to a couple of days after the last drink and progressively worsen. Recognising alcohol intoxication with delirium ICD 10 codes helps in timely medical intervention.

Early Symptoms 

Early symptoms may include:

• Anxiety and restlessness – A sense of unease, nervousness, and difficulty staying calm. 

• Tremors (shaking hands or body) – Uncontrollable shaking, making tasks like holding objects difficult. 

• Sweating and rapid heartbeat – The body reacts to alcohol absence with increased heart rate and perspiration. 

• Nausea and vomiting – The digestive system struggles to adjust, leading to discomfort. 

• Difficulty sleeping – Insomnia or disrupted sleep patterns are common in early withdrawal. 

These early signs may indicate alcohol abuse with intoxication delirium ICD 10 and should not be ignored.

Severe Symptoms (Delirium Tremens) 

As the condition worsens, severe and dangerous symptoms appear. 

These symptoms require urgent medical attention, as untreated AWD can lead to severe complications, including coma or death. 

Early intervention, proper hydration, and medical detoxification can help ensure a safer recovery. 

These symptoms look like: 

The most critical symptoms of alcohol withdrawal delirium, often indicating delirium tremens alcohol content, include:

• Severe confusion and disorientation – Sufferers may have difficulty recognising their surroundings or remembering basic details. 

• Hallucinations – seeing, hearing or feeling things that are not there, often leading to extreme distress. 

• High blood pressure and fever – The body’s stress response can lead to dangerously elevated vitals. 

• Seizures – A significant risk of AWD, seizures can be life-threatening without immediate medical care. 

• Agitation and aggressive behaviour – A person may become irritable or exhibit unpredictable outbursts. 

Monitoring delirium tremens alcohol content helps medical teams assess the severity and urgency of AWD.

Who Is at Risk and Risk Factors of Alcohol Withdrawal Delirium? 

Alcohol withdrawal delirium (AWD) is more likely to affect individuals with a history of chronic and heavy alcohol use. Those most at risk include: 

• Long-term heavy drinkers – People consuming large amounts of alcohol for years. 

• Individuals with previous withdrawal symptoms – Those who have experienced mild to severe withdrawal in the past. 

• People with underlying health conditions – such as Liver disease, malnutrition, or neurological disorders increase the risk. 

• Individuals with co-occurring mental health disorders – Depression, anxiety, and other conditions can complicate withdrawal. 

• Those who stop drinking suddenly – Abrupt cessation, rather than gradual reduction, increases AWD risk.  

For individuals at risk, there is a need for medical supervision to prevent dire consequences and facilitate a safe withdrawal process.

Stages and Timeline of Alcohol Withdrawal Delirium

Alcohol withdrawal delirium consists of three stages. Mild manifestations are tremors and anxiety in 6-12 hours. There are hallucinations, major confusion, and seizures after 24-72 hours. Symptoms resolve in 4–7 days, but fatigue and emotional swings persist. Safety requires medical observation. 

Initial Phase: 6–12 Hours After Last Drink

Early signs of withdrawal appear:

• Mild anxiety, restlessness, and nausea begin 

• Increased heart rate and slight tremors appear 

Peak Phase: 24–72 Hours After Last Drink 

Symptoms reach their most severe:

• Hallucinations, severe confusion, and seizures peak 

• Increased risk of autonomic instability and cardiovascular complications 

Recovery Phase: 4–7 Days After Last Drink 

Symptoms gradually improve:

• Symptoms gradually subside 

• Fatigue, mood instability, and lingering cognitive impairments persist 

Monitoring these stages ensures proper care and documentation of alcohol withdrawal delirium ICD-10 codes.

Factors That Determine the Timeline  

Several key factors influence how quickly and severely alcohol withdrawal delirium develops:

• Duration and severity of alcohol use - The longer and heavier a person drinks, the greater their risk of developing severe alcohol dependence and withdrawal symptoms. 

• Individual health status and liver function - A person's overall health and liver function significantly impact how their body processes alcohol and recovers from its effects. 

• Previous history of withdrawal symptoms - If someone has experienced withdrawal symptoms before, they are more likely to have more severe and potentially dangerous withdrawal episodes in the future. 

Accurate awareness of these factors is crucial when referencing alcohol withdrawal delirium ICD 10 during treatment planning.

Diagnosis of Alcohol Withdrawal Delirium and ICD-10 Codes 

Clinical diagnosis of alcohol withdrawal delirium (AWD) has to be very precise. Physicians interview the individual about alcohol use and symptoms, and mental status. Laboratory evaluation, such as blood tests and a neurologic exam, excludes other diseases. Early intervention is guaranteed through accurate diagnosis, preventing life-threatening complications. 

Diagnostic Criteria  

Doctors diagnose AWD based on: 

• History of chronic alcohol consumption – Heavy, long-term drinking raises risk. 

• Extreme withdrawal symptoms – Tremors, seizures, confusion, and hallucinations. 

• Autonomic instability – Changing blood pressure, sweating, and fever. 

• Cognitive impairment – Disorientation, memory loss, or agitation. 

• Medical professionals may use the CIWA-Ar (Clinical Institute Withdrawal Assessment for Alcohol) tool for assessment. 

The CIWA-Ar tool may be used to assess alcohol withdrawal severity.

Relevant ICD-10 Codes  

The ICD-10 system classifies AWD under specific medical codes for diagnosis and treatment documentation: 

• F10.231 – Alcohol withdrawal delirium 

• F10.221 – Alcohol intoxication with delirium 

• F10.232 – Alcohol withdrawal with perceptual disturbance 

These codes help ensure appropriate medical care, insurance coverage, and clinical follow-up of alcohol-related disorders.

Treatment Options for Alcohol Withdrawal Delirium 

Treatment for AWD focuses on stabilisation, symptom management and relapse prevention. A person may require hospitalisation, medication and supportive care. A structured treatment plan that includes detoxification, medical monitoring and psychological support helps those affected to manage withdrawal safely and maintain long-term sobriety. Early intervention reduces complications and improves outcomes. 

Medical Detoxification 

Detoxification is the first step in treating AWD. In a medically supervised setting, the person receives: 

• IV fluids and electrolytes – Prevent dehydration and maintain balance. 

• Monitoring of vital signs – Ensures stability and prevents complications. 

• Gradual alcohol tapering (if needed) – Reduces withdrawal severity. 

• Detox should never be attempted alone, as AWD can be life-threatening. 

Detox should be done under supervision to manage alcohol delirium safely.

Medications Used in Treatment  

Doctors prescribe medications to manage symptoms and prevent severe complications: 

• Benzodiazepines (Diazepam, Lorazepam) – Control seizures and anxiety. 

• Antipsychotics (Haloperidol, Quetiapine) – Treat hallucinations and agitation. 

• Beta-blockers (Propranolol) – Reduce rapid heart rate and blood pressure spikes. 

• Medication use depends on symptom severity and individual history, ensuring safe withdrawal. 

Medications are carefully titrated based on delirium tremens alcohol content to safely manage symptoms like seizures and agitation.

Importance of Medical Supervision 

AWD can escalate rapidly, making medical supervision essential. Medical professionals: 

• Monitor vital signs – Ensure that blood pressure, heart rate and temperature remain stable. 

• Prevent complications – Intervene immediately if seizures or hallucinations occur. 

• Emotional support – Individuals are often distressed during withdrawal. 

Supervised care significantly reduces risks and improves recovery outcomes. 

Complications of Alcohol Withdrawal Delirium  

If left untreated, AWD can lead to serious health risks, including 

• Seizures – Uncontrolled electrical activity in the brain. 

• Severe dehydration – vomiting and sweating lead to fluid loss. 

• Cardiac complications – high blood pressure and irregular heartbeat. 

• Cognitive decline – Long-term memory loss and confusion. 

• Early medical intervention prevents life-threatening outcomes. 

Delayed intervention in alcohol intoxication with delirium, ICD 10 can result in these life-threatening complications.

Prevention of Alcohol Withdrawal Delirium  

The best way to prevent AWD is gradual alcohol reduction under medical supervision. Regular health check-ups, proper nutrition, hydration, and mental health support help reduce risk. Seeking professional help before withdrawing from alcohol ensures a safe and controlled withdrawal process and prevents serious complications. 

Strategies to Prevent Alcohol Withdrawal Delirium 

Key strategies can help reduce the risk and severity of alcohol withdrawal delirium:

• Gradual alcohol withdrawal – Avoid sudden cessation to avoid severe withdrawal. 

• Medical supervision – Detoxification under professional supervision ensures safety. 

• Nutritional intake – Vitamins and water stabilise the body. 

• Counselling and support groups – Treat emotional and psychological issues. 

• Triggers avoidance – Identify and cope with situations leading to relapse. 

Preventing alcohol delirium through gradual withdrawal and medical supervision is essential for long-term recovery.

Reducing Alcohol Intake Safely  

Abruptly quitting alcohol causes severe withdrawal symptoms. The safest method to stop drinking alcohol is to do so gradually and under medical supervision. 

Hydration, nutritional supplements and a customised quitting strategy increase the likelihood of the body adopting while reducing the intensity of withdrawal. This makes the entire process less difficult and safer. 

Seeking Professional Help for Alcohol Withdrawal Delirium  

Professional medical treatment is essential for the recovery of AWD. The rehabilitation centre offers the following services: 

• Continuous supervision – Guarantees safety during withdrawal. 

• Treatment and Medication – Helps in managing symptoms and cravings. 

• Counselling and Life Skills Rehabilitation – Eliminates chances of relapse or recurrence. 

With the aid of trained professionals, the chances of having a successful recovery and staying sober for the long term are greatly enhanced. 

Cadabam’s: Your Trusted Partner in Managing Alcohol Withdrawal Delirium  

At Cadabam’s, we offer specialised care for people with AWD. We ensure safe and effective withdrawal management with specialised detox programmes, medical monitoring, and psychological support. 

Our experienced professionals create individualised recovery plans that address physical and emotional challenges. Whether through inpatient treatment or ongoing therapy, we support your lasting sobriety.  

Your journey to recovery starts here; contact Cadabam’s today.

If you are searching for a solution to your problem, Cadabam’s Anunitha’s De-Addiction Centre can help you with its team of specialised experts. We have been helping thousands of people live healthier and happier lives for 30+ years. We leverage evidence-based approaches and holistic treatment methods to help individuals effectively address Alcohol Addiction. Get in touch with us today. You can call us at +91 96111 94949.

FAQs 

How does alcohol cause delirium?  

Alcohol affects the brain’s neurotransmitters, slowing down its function. Chronic alcohol use disrupts regular brain activity. When alcohol levels drop suddenly, the brain overcompensates, leading to confusion, hallucinations, and agitation—key symptoms of delirium. Long-term heavy drinking significantly increases the risk of alcohol-induced delirium. 

How does withdrawal cause delirium? 

During alcohol withdrawal the brain struggles to restore balance after prolonged alcohol withdrawal. This sudden change leads to hyperactivity of the nervous system, causing severe confusion, tremors, hallucinations and even seizures. The risk is highest in heavy drinkers who stop drinking suddenly and without medical supervision. 

What does delirium tremens look like?  

Delirium tremens presents as severe agitation, intense confusion, violent tremors, hallucinations, and extreme sweating. A person may struggle to differentiate reality from illusions. They might appear disoriented, anxious, or aggressive, often unable to control body movements. Without immediate treatment, delirium tremens can become life-threatening. 

What is the most serious withdrawal symptom associated with alcoholism?  

Seizures and delirium tremens are the most critical and threatening symptoms of alcohol withdrawal. Seizures can result in unconsciousness, utmost confusion and vegetative instability with a possibility of death. Timely medical help, fluid replacement, and drug treatment are vital to prevent complications and achieve a safe recovery.