This patient is experiencing one of the most feared complications of alcohol withdrawal, which is delirium tremens. This is typically seen about 2-4 days after the patients last drink. Classically seen in a situation where the patient has to stay in the hospital for an extended amount of time (becomes an inpatient) and cannot drink alcohol.

Clinical features:

• Altered mental status, hallucinations, autonomic hyperactivity, anxiety, seizures, tremors, psychomotor agitation, insomnia, and nausea.

Treatment:

• Longer-acting benzodiazepines (e.g. diazepam).