Certified Addiction Counselor (CAC) Practice

Which of the following withdrawal symptoms occurs last during alcohol withdrawal?

1. Tremors

2. Seizures

3. Delirium tremens

4. Visual hallucinations

The correct answer is: Delirium tremens

During alcohol withdrawal, delirium tremens (DTs) is considered to occur later in the withdrawal process compared to other symptoms. DTs typically arise in individuals who have been consuming large amounts of alcohol over a long period and may manifest between 48 to 96 hours after the last drink. Tremors usually start to appear within 6 to 8 hours after the last drink and can be one of the earliest signs of withdrawal. Seizures can occur within 12 to 48 hours and are often one of the acute symptoms experienced during the initial phase of withdrawal. Visual hallucinations can also occur but typically present earlier than delirium tremens, often seen within 24 to 48 hours. Delirium tremens is a severe and potentially life-threatening condition characterized by confusion, agitation, severe autonomic instability, and perceptual disturbances. It requires immediate medical intervention and is a reflection of a more prolonged and severe withdrawal process, which is why it is the last symptom to emerge among the options provided. This timing highlights the progression and severity of alcohol withdrawal and underscores the importance of careful monitoring and intervention in those experiencing withdrawal symptoms.