Alcohol is a cultural touchstone in places all around the world. Every drinking country has its signature brews, drinking games, and hangover cures. In the United States, alcohol is the most commonly used recreational psychoactive substance, and it’s also the most widely available. But in a place where alcohol is commonplace, we also share another cultural commonality. The shakes, bottleaches, pink elephants, quart mania, and barrel-fever all describe one of the most dangerous consequences of alcoholism. Today, it’s called delirium tremens, and it’s what happens to some people who become chemically dependent on alcohol and try to quit cold turkey.
If you recognize that you have a problem with alcohol, wanting to quit is a good decision, and it’s one that will ultimately lead to healthier living than if you keep drinking. However, around half of people with moderate to severe alcohol use disorders will experience uncomfortable withdrawal symptoms when they try to cut back or stop drinking alcohol altogether. These symptoms can be as mild as irritability and as severe as seizures. Quitting addictions cold turkey can seem like ripping off a band-aid. It’ll hurt, but at least it won’t prolong your suffering. However, quitting alcohol cold turkey on your own can be dangerous and even life-threatening.
Going through detox may seem like a quick and simple option, but there are more than a few reasons why it may not be worth the risk. If you’ve recently recognized that you need to make a change in your drinking habits and you’d like to quit, learn more about safe alcohol detox and why the at-home variety may be more dangerous than it’s worth.
Alcohol is a psychoactive chemical that affects your brain by depressing excitability in your central nervous system. Alcohol affects a naturally occurring chemical called gamma-aminobutyric acid (GABA), which is responsible for regulating excitement and promoting relaxation and allowing sleep. Alcohol intoxication is when your brain is flooded with the chemical and impairs your nervous system, causing sedation, hypnosis, loss of motor control, slurred speech, and other depressant effects. Repeated alcohol abuse can cause you to develop a tolerance to the chemical as your brain gets used to it. If you continue to drink, you’ll start to become chemically dependent. At that point, your brain is not only used to alcohol’s presence in your brain, but it also adapts to alcohol, integrating it into normal brain functions.
You may start producing less of your own inhibitory, relaxing chemicals. You may even produce more excitatory chemicals to counteract alcohol in your body. If you stop drinking or cut back, it will be like you have a chemical imbalance in your brain. You’ll start to experience over-excitement in the nervous system as a result. Symptoms of this include insomnia, anxiety, irritability, mood swings, agitation, tremors, confusion, and even seizures.
Chemical dependence on alcohol isn’t permanent. After about a week of detox, your brain chemistry will return to normal, and you will stop experiencing alcohol withdrawal symptoms. However, addiction is longer lasting. Though you might not feel physical withdrawal symptoms, you may have intense cravings and compulsions to drink, even after detox. Addiction treatment and therapies can help you learn to deal with cravings with positive coping mechanisms to avoid a relapse.
Still, in that first week of withdrawal, your nervous system is sent into overdrive. Without help, the symptoms can be extremely unpleasant and even deadly.
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Delirium tremens (DT) is the most severe reaction that can come from a nervous system depressant withdrawal. Half of the people who stop drinking alcohol experience withdrawal. Three to five percent of these people also experience delirium tremens. Developing a chemical dependence on alcohol and then stopping abruptly may increase your risk of experiencing DT. It’s caused when your nervous system’s communication pathways are thrown out of balance to the point where it becomes too excitable. This can cause a number of disturbing symptoms like nightmares, agitation, extreme confusion, disorientation, hallucinations, fever, high blood pressure, sweating, fast heart rate, and seizures. What makes these symptoms even more dangerous is how fast they can appear. After about two to three days, delirium tremens can come on suddenly. If you are on your own, the sudden onset of confusion, seizures, and fever can be extremely dangerous.
DT fatalities usually come from very high fevers and sometimes from severe seizures. Seizures aren’t usually deadly on their own, but they can cause injuries, especially if you are up and moving around. People with cardiovascular conditions that are vulnerable to high blood pressure and heart rate may also be at risk of a heart attack. Without treatment around a quarter of DT, cases can be deadly. However, treatment radically decreases your risk of DT related, life-threatening complications.
If detox is dangerous, why bother? There are a lot of barriers to treatment and sobriety, but the threat of uncomfortable symptoms is one of the most common. However, the dangers of detox can be significantly mitigated with medical treatment, and continuing in active alcoholism may be even more dangerous. Excessive drinking can lead to several deadly diseases and health complications later in life. Drinking can cause high blood pressure, heart disease, cancer, mental health problems, learning problems, and social problems.
Alcohol abuse can damage your nervous system which can cause cognitive impairment. It can even cause a condition called neuropathy in which your nerves are damaged, causing pain in your extremities and even the loss of motor function and mobility.
Alcoholism can also cause damage to your liver and lead to diseases like fatty liver disease, which can impair your liver’s ability to filter your blood. But it can also cause more permanent damage in the form of diseases like alcoholic hepatitis and cirrhosis.
These liver problems are often fatal without a transplant.
Going through withdrawal in a hospital setting or medical detox are your safest options. Medical detox involves 24-hour medically managed care for about five to ten days, depending on your specific needs. Through treatment, you will be monitored at all times to prevent serious medical complications. Safety will be the number one priority, and you may be given medications to help wean you off of the alcohol without causing extreme withdrawal symptoms. Other medications may be used to alleviate uncomfortable symptoms.
On-staff clinicians will also help determine the next step after detox that can best treat your substance use disorder. If you were addicted to alcohol, it might take more than a week of detox to address fully. Addiction treatment can help you avoid relapse and address any underlying issue that initially contributed to your substance use problems. Once you complete detox, your clinicians will connect you to treatment resources that are ideal for your needs.
U.S. Centers for Disease Control and Prevention. (2018, January 3). CDC – Fact Sheets-Alcohol Use And Health – Alcohol. Retrieved from https://www.cdc.gov/alcohol/fact-sheets/alcohol-use.htm
Cleveland Clinic. (2018, June). Alcoholic Liver Disease. Retrieved from http://www.clevelandclinicmeded.com/medicalpubs/diseasemanagement/hepatology/alcoholic-liver-disease/
National Institute on Drug Abuse. (2016, February). 8: Medical detoxification. Retrieved from https://www.drugabuse.gov/publications/teaching-packets/understanding-drug-abuse-addiction/section-iii/7-medical-detoxification
Schuckit. (2017, July 06). Recognition and management of withdrawal delirium (delirium tremens). Retrieved from https://escholarship.org/uc/item/08b9z9th
U.S. National Library of Medicine. (2019, January 1). Delirium tremens: MedlinePlus Medical Encyclopedia. Retrieved from https://medlineplus.gov/ency/article/000766.htm
WebMD. (2017, March 20). What is GABA? Retrieved from https://www.webmd.com/vitamins-and-supplements/qa/what-is-gaba