Why Quitting Alcohol Cold Turkey Can Be Dangerous

Stopping use of any substance after you’ve developed a dependence can lead to what experts call withdrawal syndrome. Withdrawal is one of the characteristic signs of substance use disorder. According to official criteria, withdrawal is either:

• The characteristic symptoms of stopping the use of a particular substance, like alcohol
• Using the substance to relieve or to avoid those symptoms
• Or both

Withdrawal occurs when you become physiologically dependent on a substance. If you drink heavily and frequently, your body and brain begin to adapt to it. You’ll find you need more and more alcohol to get the same effect. You can become dependent, leading to withdrawal if you try to stop.

There are many similarities in what withdrawal feels like from one substance to another, but there are differences too. Alcohol is unique enough that there is a distinct condition experts recognize called alcohol withdrawal syndrome.

There is no definitive amount or duration of drinking that leads to withdrawal syndrome when you try to stop. Everyone is different, but the more heavily you drink and the more frequently, the likelier it is that you will go through withdrawal when stopping.

Symptoms of alcohol withdrawal may begin six to eight hours after you stop drinking. Common symptoms include:

• Anxiety
• Depression
• Fatigue,
• Jumpiness
• Tremors
• Irritability
• Mood swings
• Clouded thinking
• Nightmares

In addition, people may experience headaches, sweating, insomnia, appetite loss, nausea, vomiting, and increased heart rate. There is also a severe type of withdrawal from alcohol caused delirium tremens.

Not everyone experiences severe withdrawal, but the risk is there. About half of people with alcohol use disorder experience withdrawal syndrome when stopping. Approximately 10% of people have more serious consequences from quitting drinking.

When a heavy, long-term drinker stops consuming alcohol, the central nervous system responds to adjust to the change. These adjustments can lead to severe, life-threatening symptoms and complications:

1. Seizures

A risk of untreated alcohol withdrawal is the onset of seizures. They typically begin within the first 48 hours after stopping drinking. Seizures can even occur much later, up to 20 days later.

Researchers have found that the chances of having seizures in withdrawal increases with the number of times someone has been through the process already. The accumulated changes to the brain from drinking heavily and stopping repeatedly seem to contribute to seizures.

2. Delirium Tremens

Delirium tremens is a serious and dangerous condition that some people develop within a few days of quitting alcohol. It is most likely to occur in someone who has been drinking heavily for many years. Symptoms of delirium tremens include:

• Excessive sweating
• Racing pulse
• High heart rate
• High blood pressure
• Hallucinations
• Tremors
• Agitation
• Confusion
• Disorientation
• Fever

Delirium tremens can be fatal. The risk of dying from it is significantly reduced with proper medical support. This includes supportive therapy, such as fluids, supplements, and benzodiazepines.

3. Wernicke-Korsakoff Syndrome

This is a related complication rather than a direct result of alcohol withdrawal. It often co-occurs and can intensify withdrawal symptoms. Wernicke-Korsakoff is a thiamine (vitamin B1) deficiency that causes nervous system symptoms.

Heavy alcohol use damages the lining of the intestines, which limits the amount of thiamine absorbed into the bloodstream. The deficiency can cause cognitive impairment, an abnormal gait, delirium and disorientation, and eye muscle paralysis.

Some of the symptoms clear up with treatment for withdrawal and deficiency. Many people end up with some permanent issues, such as memory problems. Patients with Wernicke-Korsakoff syndrome who do not receive treatment can die.

4. Mental Health Symptoms

Alcohol withdrawal may trigger mental health symptoms or worsen existing conditions. Most common are depression, anxiety, and insomnia. Anxiety is not unusual in people who misuse alcohol because many use it to self-medicate this feeling. Withdrawal can cause acute anxiety within a couple days of stopping.

Depression is also fairly common, and it can be fatal. Some studies estimate that 15% of people in alcohol withdrawal are at high risk for suicide. Withdrawal may worsen existing depression or trigger new symptoms.

Less commonly, withdrawal can cause psychotic symptoms, for instance, the hallucinations characteristic of delirium tremens. Even without delirium tremens, some patients develop these auditory, tactile, and visual hallucinations.

5. Protracted Withdrawal Syndrome

Protracted withdrawal syndrome, or PWS, affects some people going through alcohol withdrawal. It is a long-term condition that may persist for up to a year. PWS causes symptoms similar to acute withdrawal: anxiety, depression, insomnia, tremors, high blood pressure, and high heart rate.

In some people, PWS causes opposite types of symptoms. Instead of elevated heart rate and blood pressure, it slows down the nervous system. These patients experience a lower metabolic rate and low energy.

6. Relapse

Another risk of quitting cold turkey is the possibility of a relapse to heavy, dangerous drinking. Alcohol withdrawal syndrome can last for several days, causing so much discomfort that you turn to drinking again. The risk here is that you will binge dangerously, which could cause alcohol poisoning or an accident.

PWS is a special concern for people in recovery from alcohol use disorder. When the symptoms persist for so long, it can become very difficult to abstain.

The risks of detoxing from alcohol should not deter you from doing it. Detox can be safe with proper medical care, and it’s a lot safer than continuing to drink heavily. Long-term alcohol abuse can lead to liver disease, digestive problems, heart disease, increased cancer risk, and more, even death.

The safest way to detox and stop drinking is to do so under the care of experienced medical professionals. Luxury rehab for alcohol addiction includes two main strategies:

1. Supportive care. This simply means providing fluids to keep you hydrated and nutrients to address deficiencies. It may also include care for other conditions you have that complicate your ability to recover. Important nutritional supplements include electrolytes, especially magnesium, thiamine, and folic acid.
2. Medication. Doctors can also provide important medications that make withdrawal easier and safer. Benzodiazepines, sedatives, are usually the first-line treatment. They reduce withdrawal symptoms like anxiety and seizures. Patients may also be given additional medications to supplement these, including antiseizure drugs or antipsychotics.