# Delerium Tremens **URL:** \ **Category:** Factual Questions\ **Created:** [May 7, 2004, 4:47am UTC](https://boards.straightdope.com/t/delerium-tremens/243961 "2004-05-07T04:47:09Z")\ **Posts on this page:** 20\ **Page:** 1
**Author:** ![Mathochist](https://avatars.discourse-cdn.com/v4/letter/m/c89c15/32.png) [@Mathochist](https://boards.straightdope.com/u/Mathochist)\ **Post date:** [May 7, 2004, 4:47am UTC](https://boards.straightdope.com/t/delerium-tremens/243961/1 "2004-05-07T04:47:09Z")
I’ve just come from watching the episode of M_A_S\*H wherein Hotlips’ friend gets off the sauce and has an attack of the DTs at the end. [This thread](http://boards.straightdope.com/sdmb/showthread.php?t=115330) basically explains that the hallucinations, tremors, and chills are somehow a product of the brain having become accustomed to operating under sedation and is now somewhat in overdrive. What I’m wondering, though, is why the preponderance of “bug” hallucinations? As far as I can remember, every reference I’ve heard to DT hallucinations has been of bugs in one’s food, crawling on one’s skin, or something like that. Why bugs? ---
**Author:** ![David\_Simmons](https://avatars.discourse-cdn.com/v4/letter/d/9de053/32.png) [@David\_Simmons](https://boards.straightdope.com/u/David_Simmons)\ **Post date:** [May 7, 2004, 5:04am UTC](https://boards.straightdope.com/t/delerium-tremens/243961/2 "2004-05-07T05:04:34Z")
DT’s are often portrayed as funny in theatrical works. However, DT’s are serious and can be fatal. As to the idea of ‘bugs,’ who knows? Pink elephants used to be in vogue and next year it might be something else. ---
**Author:** ![Zabali\_Clawbane](https://avatars.discourse-cdn.com/v4/letter/z/ecd19e/32.png) [@Zabali\_Clawbane](https://boards.straightdope.com/u/Zabali_Clawbane)\ **Post date:** [May 7, 2004, 5:05am UTC](https://boards.straightdope.com/t/delerium-tremens/243961/3 "2004-05-07T05:05:58Z")
Just a theory, but maybe their sickened mind (as in impaired and unable to correctly process information) interprets the crawly sensation (which I’d figure a mind in overdrive could produce) as that of a bug? Maybe their vision is disturbed too, but they aren’t well enough to think straight, so it all falls together to mean “bugs” to them? People who have bad acid trips often hallucinate about bugs, rats, snakes etc. too. I might not be too far off with my theory at that. ---
**Author:** ![Nametag](https://sea3.discourse-cdn.com/straightdope/user_avatar/boards.straightdope.com/nametag/32/406_2.png) [@Nametag](https://boards.straightdope.com/u/Nametag)\ **Post date:** [May 7, 2004, 5:23am UTC](https://boards.straightdope.com/t/delerium-tremens/243961/4 "2004-05-07T05:23:59Z")
From [here](http://www.emedicine.com/EMERG/topic123.htm): > [@](#): > > Pathophysiology: DT is caused by the direct effect that ethanol has on the benzodiazepine-GABAa-chloride receptor complex. Persistent effects of ethanol lead to the down-regulation of the receptor complex. When ethanol is withdrawn, a functional decrease in the inhibitory neurotransmitter GABA is seen. This results in an unopposed increase in sympathetic activity with a resultant increase in plasma and urinary catecholamines. Ethanol also acts as an N-methyl D-aspartate receptor antagonist. Withdrawal of ethanol leads to increased activity of these excitatory neural receptors. As far as the bugs go, I think it’s unlikely that people are actually hallucinating bugs. More likely they are hallucinating shapes or movements, and interpreting them as bugs (or snakes, etc.). The pink elephant hallucinations are are harder to explain – can anyone confirm whether that’s actually something that one sees with the DTs? ---
**Author:** ![Zabali\_Clawbane](https://avatars.discourse-cdn.com/v4/letter/z/ecd19e/32.png) [@Zabali\_Clawbane](https://boards.straightdope.com/u/Zabali_Clawbane)\ **Post date:** [May 7, 2004, 5:34am UTC](https://boards.straightdope.com/t/delerium-tremens/243961/5 "2004-05-07T05:34:19Z")
> [@Nametag](#): > > As far as the bugs go, I think it’s unlikely that people are actually hallucinating bugs. More likely they are hallucinating shapes or movements, and interpreting them as bugs (or snakes, etc.). That, rephrased, is what I just said. 🙂 ---
**Author:** ![Nametag](https://sea3.discourse-cdn.com/straightdope/user_avatar/boards.straightdope.com/nametag/32/406_2.png) [@Nametag](https://boards.straightdope.com/u/Nametag)\ **Post date:** [May 7, 2004, 6:02am UTC](https://boards.straightdope.com/t/delerium-tremens/243961/6 "2004-05-07T06:02:56Z")
> [@Zabali\_Clawbane](#): > > > [@Nametag](#): > > > > As far as the bugs go, I think it’s unlikely that people are actually hallucinating bugs. More likely they are hallucinating shapes or movements, and interpreting them as bugs (or snakes, etc.). > > That, rephrased, is what I just said. 🙂 Well, yes, but I preceded MY statement with an irrelevant link and quote. There’s a right way and a wrong to do these things, you know… ---
**Author:** ![hlanelee](https://avatars.discourse-cdn.com/v4/letter/h/3bc359/32.png) [@hlanelee](https://boards.straightdope.com/u/hlanelee)\ **Post date:** [May 7, 2004, 12:06pm UTC](https://boards.straightdope.com/t/delerium-tremens/243961/7 "2004-05-07T12:06:44Z")
First, you feel something crawling on you, then your brain decides “BUGS” for lack of further reference. Listen to someone that knows, tactile hallucinations are the worst. ---
**Author:** ![Qadgop\_the\_Mercotan](https://sea3.discourse-cdn.com/straightdope/user_avatar/boards.straightdope.com/qadgop_the_mercotan/32/83_2.png) [@Qadgop\_the\_Mercotan](https://boards.straightdope.com/u/Qadgop_the_Mercotan)\ **Post date:** [May 7, 2004, 12:43pm UTC](https://boards.straightdope.com/t/delerium-tremens/243961/8 "2004-05-07T12:43:39Z")
One tactile hallucination very common in Delerium Tremens is “formication”. Literally the “creeping of ants”. The most common real-life equivalent to this hallucination actually having bugs crawl on one. ---
**Author:** ![Mathochist](https://avatars.discourse-cdn.com/v4/letter/m/c89c15/32.png) [@Mathochist](https://boards.straightdope.com/u/Mathochist)\ **Post date:** [May 7, 2004, 3:55pm UTC](https://boards.straightdope.com/t/delerium-tremens/243961/9 "2004-05-07T15:55:50Z")
> [@hlanelee](#): > > First, you feel something crawling on you, then your brain decides “BUGS” for lack of further reference. Listen to someone that knows, tactile hallucinations are the worst. So the upshot is that the portrayal in this M_A_S\*H episode in particular – the woman first sees “things” crawling in her food, identifies them as bugs, then throws her tray away as they start crawling on her – is more cinematic than accurate? Yes, yes, I understand that movies and TV are not reality, but I tend to see blue skies in both and I’m not going to assume that’s _not_ real. This is what I have the board for: to hash out the part I’m not sure on. ---
**Author:** ![AllShookDown](https://avatars.discourse-cdn.com/v4/letter/a/d9b06d/32.png) [@AllShookDown](https://boards.straightdope.com/u/AllShookDown)\ **Post date:** [May 7, 2004, 5:53pm UTC](https://boards.straightdope.com/t/delerium-tremens/243961/10 "2004-05-07T17:53:18Z")
For what it’s worth, my mother had DT’s and she never mentioned bugs. She saw bears climbing the clothesline poles in the back yard and the five of us kids hanging on meathooks in the front hall where our coat hooks were. ---
**Author:** ![plnnr](https://avatars.discourse-cdn.com/v4/letter/p/7ea924/32.png) [@plnnr](https://boards.straightdope.com/u/plnnr)\ **Post date:** [May 7, 2004, 5:58pm UTC](https://boards.straightdope.com/t/delerium-tremens/243961/11 "2004-05-07T17:58:33Z")
> [@Qadgop the Mercotan](#): > > One tactile hallucination very common in Delerium Tremens is “formication”. Literally the “creeping of ants”. The most common real-life equivalent to this hallucination actually having bugs crawl on one. Is this phenomenon also associated with opiates? Both my uncle and brother were on morphine for pain control towards the end of their lives, and both would complain about the “bugs crawling on them.” They also tended to fidget with their fingers, as if they were trying to unravel a knot or knitting, but that’s probably for another thread. ---
**Author:** ![SpoilerVirgin](https://avatars.discourse-cdn.com/v4/letter/s/4491bb/32.png) [@SpoilerVirgin](https://boards.straightdope.com/u/SpoilerVirgin)\ **Post date:** [May 7, 2004, 7:12pm UTC](https://boards.straightdope.com/t/delerium-tremens/243961/12 "2004-05-07T19:12:31Z")
Delusions of Parasitosis aren’t just associated with DT’s. They’re the subject of my favorite Straight Dope column ever: [What’s up with people who think they’re infested with bugs?](http://www.straightdope.com/columns/000623.html). The column links to a [website](http://www-personal.usyd.edu.au/~sdoccett/fact/delpara.htm#delus) with more information, including some references to DT’s. ---
**Author:** ![Zabali\_Clawbane](https://avatars.discourse-cdn.com/v4/letter/z/ecd19e/32.png) [@Zabali\_Clawbane](https://boards.straightdope.com/u/Zabali_Clawbane)\ **Post date:** [May 7, 2004, 11:21pm UTC](https://boards.straightdope.com/t/delerium-tremens/243961/13 "2004-05-07T23:21:19Z")
Yeah, I had a crawly feeling when I was in the hospital recovering from my hysterectomy. I HATED it. As long as I wasn’t quite asleep, it seemed like bugs (June bugs in my case) were crawling on me. When I opened my eyes, I saw no bugs. I realized it was the pain medication, and was still grateful for it’s relief. Still, I wouldn’t want to do that again. ---
**Author:** ![Moirai](https://avatars.discourse-cdn.com/v4/letter/m/96bed5/32.png) [@Moirai](https://boards.straightdope.com/u/Moirai)\ **Post date:** [May 8, 2004, 2:20am UTC](https://boards.straightdope.com/t/delerium-tremens/243961/14 "2004-05-08T02:20:56Z")
The DTs can be fatal, as **QtM** pointed out. I seem to remember a nurse on a detox unit estimating that 5-15% of people who experience delirium tremens die from them. I just wish I hadn’t been detoxing at the time… ---
**Author:** ![Milum](https://avatars.discourse-cdn.com/v4/letter/m/ea666f/32.png) [@Milum](https://boards.straightdope.com/u/Milum)\ **Post date:** [May 8, 2004, 3:33am UTC](https://boards.straightdope.com/t/delerium-tremens/243961/15 "2004-05-08T03:33:39Z")
Continued drug-induced sensations that are perceived by the experiencing organism as pleasure-piled-upon-pleasure without respite , must, by virtue of the chemical nature of the brain, be counteracted by an equal amount of displeasure in order to bring about a necessary return to the mind’s normal set point. So in this case the human mind, directed by desperation, searches long and hard until it finds some proper deep subconscious dark fear that can effect a return to normalcy. Bugs do fine, thank you, most of the time. But other times people die, ---
**Author:** ![David\_Simmons](https://avatars.discourse-cdn.com/v4/letter/d/9de053/32.png) [@David\_Simmons](https://boards.straightdope.com/u/David_Simmons)\ **Post date:** [May 8, 2004, 3:38am UTC](https://boards.straightdope.com/t/delerium-tremens/243961/16 "2004-05-08T03:38:57Z")
> [@Milum](#): > > Continued drug-induced sensations that are perceived by the experiencing organism as pleasure-piled-upon-pleasure without respite , must, by virtue of the chemical nature of the brain, be counteracted by an equal amount of displeasure in order to bring about a necessary return to the mind’s normal set point. I didn’t know that! ---
**Author:** ![ccwaterback](https://avatars.discourse-cdn.com/v4/letter/c/df705f/32.png) [@ccwaterback](https://boards.straightdope.com/u/ccwaterback)\ **Post date:** [May 8, 2004, 3:41am UTC](https://boards.straightdope.com/t/delerium-tremens/243961/17 "2004-05-08T03:41:55Z")
> [@AllShookDown](#): > > For what it’s worth, my mother had DT’s and she never mentioned bugs. She saw bears climbing the clothesline poles in the back yard and the five of us kids hanging on meathooks in the front hall where our coat hooks were. It will be whatever freaks you out, you will see lots of that. But many people will laugh at the sight, only remembering later now horrifying it actually was. ---
**Author:** ![DoctorJ](https://sea3.discourse-cdn.com/straightdope/user_avatar/boards.straightdope.com/doctorj/32/2904_2.png) [@DoctorJ](https://boards.straightdope.com/u/DoctorJ)\ **Post date:** [May 8, 2004, 3:53am UTC](https://boards.straightdope.com/t/delerium-tremens/243961/18 "2004-05-08T03:53:52Z")
Genuine DTs are pretty rare. In my two years of medical residency, I’ve seen more acute alcohol withdrawal than you can shake a stick at, and I’ve seen one, maybe two cases of real, honest-to-God delerium tremens. The last one I saw is described in [this LiveJournal post](http://www.livejournal.com/users/thejtrain/18062.html#cutid1). He didn’t have any bug sensations–it was mostly objects flying toward him from all directions. The next day, he sat in his room in the ICU and had a simplistic but otherwise coherent political debate with himself. I couldn’t interrupt it. When my attending checked on him eight hours later, it was still going on. DTs are also, as others have pointed out, VERY dangerous. The figure everyone has quoted to me is a 50% mortality rate, though I understand that is based on old data. ---
**Author:** ![Qadgop\_the\_Mercotan](https://sea3.discourse-cdn.com/straightdope/user_avatar/boards.straightdope.com/qadgop_the_mercotan/32/83_2.png) [@Qadgop\_the\_Mercotan](https://boards.straightdope.com/u/Qadgop_the_Mercotan)\ **Post date:** [May 8, 2004, 3:55am UTC](https://boards.straightdope.com/t/delerium-tremens/243961/19 "2004-05-08T03:55:37Z")
> [@David Simmons](#): > > I didn’t know that! Probably because it’s not been demonstrated as true. Certainly an artificial high is often followed by a low. But not for everyone, especially “casual” users, who don’t show signs of addiction. And frankly, for a hard-core addict, the suffering induced by the drug is probably an order of magnitude greater than the sum total of all the pleasure given by the drug. I don’t believe the “chemical nature of the brain” demands an exact balance of pain and pleasure. ---
**Author:** ![David\_Simmons](https://avatars.discourse-cdn.com/v4/letter/d/9de053/32.png) [@David\_Simmons](https://boards.straightdope.com/u/David_Simmons)\ **Post date:** [May 8, 2004, 3:59am UTC](https://boards.straightdope.com/t/delerium-tremens/243961/20 "2004-05-08T03:59:38Z")
> [@Qadgop the Mercotan](#): > > Probably because it’s not been demonstrated as true. > > Certainly an artificial high is often followed by a low. But not for everyone, especially “casual” users, who don’t show signs of addiction. > > And frankly, for a hard-core addict, the suffering induced by the drug is probably an order of magnitude greater than the sum total of all the pleasure given by the drug. > > I don’t believe the “chemical nature of the brain” demands an exact balance of pain and pleasure. Irony is a dangerous game. I probably shouldn’t use it in cases like this because someone might actually believe it. [Next page](https://boards.straightdope.com/t/delerium-tremens/243961.md?page=2)