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.
Dangerous Side Effects of Alcohol Withdrawal – Grand Mal Seizures, Dehydration and Severe Anxiety and Depression
“Grand mal seizures” are among the most serious potential complications that can accompany alcohol withdrawal. When considered on its own, in fact, the risk of a grand mal seizure is itself a strong case for medical supervised detox in any instance of habitual problem drinking.
Grand mal seizures are a symptom of the more severe form of alcohol withdrawal known as delirium tremens (mentioned earlier), and are characterized by a loss of consciousness and muscle contractions. The following signs and symptoms may also occur in the event of a grand mal seizure, according to the Mayo Clinic:
- A scream at the beginning of a seizure
- Loss of bowel and bladder control
- Unresponsiveness after convulsions
- A period of disorientation afterwards
- Severe headaches and/or sleepiness following the seizure
Grand mal seizures warrant immediate medical attention— most especially if they last for more than five minutes, are followed by more seizures, cause a physical injury that requires a doctor, co-occur with other medical conditions such as pregnancy or diabetes, or are followed by prolonged loss of consciousness or respiration.
In addition to grand mal seizures, dehydration is a little-known and under-estimated—but potentially serious—side effect of alcohol withdrawal. Dehydration can occur as a result of the nausea, diarrhea and vomiting that often happen during the early stages of withdrawal. When someone is dehydrated, that can compromise their basic mental and physical functioning. Because severe dehydration can cause death, this potential side effect of alcohol withdrawal is a bona fide medical emergency that requires immediate medical attention.
Alcohol withdrawal can also be characterized by severe anxiety and/or depression. These symptoms, if left untreated for even a short period, can prompt suicidal thoughts and behaviors resulting in death.
Still other side effects of alcohol withdrawal that can be dangerous include:
- Sleep disturbances
- Hallucinations, mental confusion and other psychiatric disturbances
- 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.
How Medically Supervised Detox Reduces the Dangers of Alcohol Withdrawal
In the event of a grand mal seizure, dehydration, high levels of anxiety and/or depression, or other potentially serious side effects of alcohol withdrawal, there are life-saving advantages to choosing medically supervised detox over a do-it-yourself process. Some of the more important advantages include:
- An in-depth medical assessment at the start of detox that can better determine whether a client may be at higher risk of grand mal seizures and other serious complications
- An individualized plan of care that can address these issues should they occur
- 24/7, round-the-clock medical monitoring of vital signs, including hydration levels
- Trained medical staff who can intervene effectively and immediately when a grand mal seizure or other complication occurs
- Quicker triage, where needed, to area hospitals and emergency rooms if/when there are complications that need even more involved medical care
- The invaluable reassurance that you are not alone— (that there are others going through the very same process, maybe even in the room next-door)—and that you are in safe hands
For more information about the dangers of alcohol detox at home, see the following articles: