Before attempting alcohol detox, there are some life-saving facts that you need to know— including why medically supervised withdrawal is an imperative for chronic heavy drinkers. Put on your alcohol recovery life jacket here:
“Alcohol detox” refers to the process of quitting drinking after heavy or prolonged alcohol consumption. This withdrawal process is characterized by physical symptoms ranging in severity from mild to life-threatening.
“Stopping cold turkey” is the slang expression for a sudden and complete withdrawal: rather than a gradual tapering down of daily alcohol consumption, you quit drinking suddenly and completely in one go of it. In this sense, “stopping cold turkey” is a form of alcohol detox, but is never advised because of the health dangers. These are especially pronounced and can be life-threatening for chronic and heavy drinkers.
In actuality, there are very real dangers to any form of at-home alcohol detox, even of the less drastic variety (a more gradual taper that you do on your own without medical supervision). These dangers help to illustrate why— for anyone with a drinking problem—medically supervised alcohol detox is the best prospect of a safe and complete withdrawal that is also more comfortable.
This article will outline the dangers of alcohol detox at home and stopping cold turkey, based on firsthand information from an addiction-certified psychiatrist and research in the field of addiction treatment. The good news is that supervised detox followed by treatment has helped many alcoholics find lasting freedom from addiction.
Seizures and Delirium Tremens – Why Do-It-Yourself Alcohol Detox Is So Dangerous
When asked why do-it-yourself alcohol detox is so dangerous, Dr. Edward Zawadzki, the medical director at Beach House Center for Recovery, has a one-word answer: “seizures.” Seizures are a severe and life-threatening complication in alcohol withdrawal affecting more than five percent (or one in 20) of untreated alcohol withdrawal cases, according to a report by the National Institute on Alcohol Abuse and Alcoholism. By the NIAAA’s account, more than 90 percent of withdrawal-related seizures occur within the first 48 hours after cessation of drinking.
What the medical community has learned from past experience—when, Dr. Zawadzki recalled, “you used to go to your primary doctor and they’d give you a week of Librium and tell you how to taper it [for alcohol withdrawal]”—is that “there’s a mortality rate with seizures and it’s not small.” Even today, “every once in a blue moon you’ll see someone who tries to detox with a week’s worth of Librium or valium from the doctor … it can be deadly.”
Just how deadly? As many as five percent of people who are hospitalized for delirium tremens (DT) will die, a 2014 article in The New England Journal of Medicine (NEJM) said. (The death rate is probably much higher among those who go without medical treatment.)
“Delirium tremens” is the term used to describe severe and life-threatening cases of alcohol withdrawal that can involve seizures and (as the name suggests) delirium, characterized by hallucinations and the rapid fluctuation of cognition and attention.
“Old mortality studies show that the mortality rate of delirium tremens has up to a 30 or 40 percent mortality rate,” Dr. Zawadzki said. He said those numbers “have varied over the years but it’s not pretty.” As illustration of his point, the NEJM pegged the mortality rate for delirium tremens at between five and 25 percent (admittedly lower but still high).
Risk Factors for Delirium Tremens During Alcohol Detox
A September 2017 study listed the risk factors for the development of DT. These include:
- A history of sustained drinking
- A history of previous DT
- Age greater than 30
- The presence of a concurrent illness
- The presence of significant alcohol withdrawal in the presence of an elevated alcohol level
- A longer period since the last drink (i.e., patients who present with alcohol withdrawal more than two days after their last drink are more likely to experience DT than those who present within two days)
Who Is Most at Risk of Alcohol Withdrawal Dangers?
Chronic and heavy drinkers are most at risk, by extension of the fact that “drinking a six or 12-pack every night after work presents far more seizure-related dangers than episodic binge drinking,” according to Dr. Zawadzki.
He described how, for example, “college students may hit it hard and you don’t really hear about withdrawal syndrome.” In contrast, though, “it’s so common for people to come in to the ER having had a seizure and been found by a spouse or family member in bed. The horror stories happen all the time.” In a great majority of these cases, the patient is the “12-pack a night guy.”
One of the more extreme examples from among the clients Dr. Zawadzki treats was a man who drank 56 beers at night after work. When binge drinking becomes a more extended pattern, in other words, that is when withdrawal-related seizures are far more likely.
Other Complications of Alcohol Detox & Severe Withdrawal
Seizures are not the only serious and potentially life-threatening complication of severe alcohol withdrawal. Other complications can include:
- Anxiety, depression, sleep disturbances, hallucinations, mental confusion and other psychiatric disturbances (depending on severity, these, too can be dangerous)
- Chronic memory disorder (a.k.a. Wernicke-Korsakoff syndrome)
- Heart disorder and cardiac failure
The Case for Medically Supervised Detox
Medically supervised detox is the best way to avoid and manage these complications of severe alcohol withdrawal safely and effectively. Early intervention (via detox and treatment) have succeeded in lowering the mortality rate from DT and other complications to less than five percent, from a mortality rate that in the 20th century was as high as 37 percent, according to the September 2017 study mentioned above. There the researchers noted that today there are an estimated eight million alcohol-dependent people in the United States alone— and, at least 500,000 cases of severe withdrawal that require medical intervention.
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