Arielle Cruz
Alcohol withdrawal can be deadly, and hundreds of people in the United States die from it each year. According to the National Institute on Alcohol Abuse and Alcoholism, alcohol is the most commonly used substance in the United States, with over 75% of individuals aged 12 and older reporting lifetime consumption. While the average person can remove alcohol from their diet without consequence, those with alcohol abuse disorders should be mindful of the potentially life-threatening repercussions of quitting cold turkey. Alcohol withdrawal symptoms can range from mild to severe, with more serious symptoms such as seizures and delirium tremens (DTs) leading to death. However, with proper medical attention and management, the risk of death from alcohol withdrawal can be reduced.
| Characteristics | Values |
|---|---|
| Number of deaths per year in the US | Hundreds |
| Number of deaths per year worldwide | 85,000+ |
| Percentage of patients admitted to hospitals or detox centers who die | 6.6% |
| Percentage of people who go through alcohol withdrawal and experience delirium tremens | 5% |
| Percentage of patients with alcohol use disorder in ICUs, EDs, and CCUs who progress to delirium tremens | 33% |
| Chances of death with medical supervision | Extremely rare |
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What You'll Learn
Alcohol withdrawal symptoms
Mild symptoms of alcohol withdrawal include headache, anxiety, nervousness, insomnia, upset stomach, and increased blood pressure and heart rate. These initial symptoms usually worsen before improving over the next few days. People with milder levels of alcohol dependence may only experience these mild symptoms.
More severe symptoms of alcohol withdrawal include hallucinations, body temperature fluctuations, irritability, seizures, and delirium tremens (DTs). DTs are a combination of physical tremors and serious mental symptoms, including rapid onset of mental confusion and hallucinations. While DTs are rare, occurring in only about 1-5% of people with alcohol withdrawal, they can be fatal.
The risk of severe alcohol withdrawal symptoms, such as DTs, can be mitigated by undergoing detox under medical supervision. Medical detox programs provide professional treatment and supportive care to reduce the risk of complications and make the process as comfortable as possible. Medications such as acamprosate, disulfiram, and naltrexone are also used to treat alcohol dependence and ease withdrawal symptoms.
It is important to seek medical attention and support when dealing with alcohol withdrawal, as the symptoms can become worse with each successive detox, increasing the chance of medical complications or even death. Relapse is common, and individuals with alcohol use disorder should not hesitate to seek professional help and treatment to safely manage their withdrawal symptoms and achieve long-term recovery.
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Delirium tremens
Alcohol withdrawal can be deadly, and close to 178,000 people die each year from alcohol-related deaths. Delirium tremens (DTs), or 'mental disturbance with shaking', is a severe form of alcohol withdrawal that can be life-threatening. It involves sudden and severe nervous system changes and is characterised by a rapid onset of confusion, typically occurring three days into the withdrawal symptoms and lasting for two to three days. The symptoms are typically worse at night and include shaking, shivering, irregular heart rate, sweating, and hallucinations. In some cases, a very high body temperature or seizures (colloquially known as "rum fits") may result in death.
The symptoms of delirium tremens can be mitigated and treated with aggressive treatment in a quiet intensive care unit with sufficient light. Benzodiazepines are commonly used as the medication of choice, and antipsychotics may also be administered to combat overactivity and possible excitotoxicity caused by withdrawal. Thiamine (vitamin B1) is also recommended to address nutritional deficits caused by long-term high alcohol intake.
While delirium tremens is a rare condition, affecting only about 5% of people undergoing alcohol withdrawal, it can have fatal consequences. However, with proper medical supervision and treatment, the risks can be significantly reduced.
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Seizures
Alcohol withdrawal seizures are a potentially fatal symptom of severe or complicated alcohol withdrawal. They are caused by a sudden cessation or reduction of alcohol intake in individuals who have developed physical alcohol dependence. When someone regularly consumes large amounts of alcohol, their brain chemistry adapts to the depressant effects of alcohol, including changes in neurotransmitter levels, particularly gamma-aminobutyric acid (GABA) and glutamate, which help regulate brain activity.
When alcohol consumption is abruptly stopped, the brain’s chemistry is thrown off balance, and the absence of alcohol’s depressant effects leads to an overexcitation of the nervous system, as the brain continues to produce higher levels of excitatory neurotransmitters like glutamate. This hyperactivity can result in alcohol withdrawal seizures, which are sudden, uncontrolled electrical disturbances in the brain.
The most typical and severe type of seizure that occurs during alcohol withdrawal is called a tonic-clonic seizure, also known as a convulsion. Tonic-clonic seizures involve a combination of tonic (stiffening) and clonic (rhythmical jerking) movements. These seizures generally occur within 48 hours of the last drink but can happen at any time during the first week of withdrawal. They usually begin on both sides of the brain but can start on one side and spread to the whole brain. During a tonic-clonic seizure, all muscles become stiff, and air is forced through the vocal cords, causing a cry or groaning sound. The individual loses consciousness and falls, and they might bite their tongue or the inside of their cheeks, causing bloody saliva. The arms and legs then start to jerk rapidly and rhythmically, bending at the hips, knees, and elbows. The jerking slows and stops after a few minutes, but if the seizure goes on too long, the person's face may turn blue or dark due to trouble breathing.
Tonic-clonic seizures are the most dangerous and dramatic element of alcohol withdrawal syndrome (AWS), and up to one-third of people with significant alcohol withdrawal may experience them. Alcohol withdrawal seizures typically occur within 8 to 24 hours after heavy drinking is stopped, and they may happen as a single seizure or in clusters over several hours. The risk of seizures from alcohol withdrawal is increased by the sudden cessation of alcohol, especially after prolonged use. Older adults may be more vulnerable to alcohol withdrawal seizures due to age-related physiological changes.
It is crucial to seek professional treatment for alcohol withdrawal through medical detox programs, supporting therapies, counseling, and education. Detoxifying from alcohol without professional supervision poses a significant threat to an individual’s safety, and seizures from alcohol withdrawal can be life-threatening. With proper medical attention and management, alcohol withdrawal symptoms, including seizures, can be controlled or mostly eliminated.
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Medical detox programs
Alcohol withdrawal can be deadly, and severe withdrawal can include symptoms such as hallucinations, body temperature fluctuations, and delirium tremens (DTs). DTs, a combination of physical tremors and mental confusion, can be fatal. However, medical detox programs can reduce the risk of death and provide a safe and effective way to eliminate alcohol from the body. Medical detox is especially important for those with physical and psychological signs of substance dependence.
Inpatient medical detox, where individuals live at a hospital, detox clinic, or rehab center, offers around-the-clock care and is suitable for those with serious medical or mental health issues or a long history of problem drinking. Outpatient detox, on the other hand, involves visiting a healthcare professional during the day while living at home. This option is generally safe and effective for people with mild to moderate alcohol withdrawal and good physical and mental health, provided they have a stable home environment and a strong support network.
Medical detox addresses the physical consequences of addiction and is often a critical first step toward recovery. It can be combined with other therapies, counseling, and education to address the underlying emotional, spiritual, and behavioral causes of addiction. This comprehensive approach helps to promote lasting change and build a foundation for new, healthy habits.
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Alcohol withdrawal syndrome
The symptoms of AWS can range from mild to severe. Initial symptoms can appear as early as several hours after the last drink and may include tremors, insomnia, mild anxiety, headache, gastrointestinal discomfort, and night sweats. Tremors, or "the shakes", can be scary but are not usually deadly. However, they can progress to delirium tremens (DTs), a more severe symptom combining physical tremors with mental confusion and possible hallucinations, which can be fatal. Other serious symptoms include body temperature fluctuations, extreme irritability, and seizures.
The risk of developing DTs is higher for certain individuals, including older people. Overall, only about 5% of people experiencing alcohol withdrawal will develop DTs. However, research indicates that up to 33% of patients with AUD being treated in intensive care units, emergency departments, or critical care units progress to DTs. Furthermore, according to the National Institute on Alcohol Abuse and Alcoholism, 6.6% of patients admitted to hospitals or alcohol detox centres for AWS die due to complications arising from their symptoms.
Treatment for AWS involves supportive care and medications. The Food and Drug Administration (FDA) has approved three medications to treat alcohol dependence: Acamprosate, which helps reduce or prevent symptoms caused by alcohol cessation; Disulfiram, which causes unpleasant symptoms when the patient drinks alcohol; and Naltrexone, which blocks certain brain receptors to stop cravings for alcohol. Detoxification under medical supervision can help mitigate the risk of dangerous or lethal outcomes from AWS.
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Frequently asked questions
Yes, alcohol withdrawal can be deadly, especially if attempted without medical supervision. However, deaths linked to alcohol withdrawal are rare and almost completely preventable with the right medical care.
Symptoms can range from mild to severe and include anxiety, shaky hands, headache, nausea, vomiting, insomnia, sweating, tremors, rapid onset of mental confusion, hallucinations, seizures, and delirium tremens (DTs).
Alcohol is the most commonly used substance in the United States, with over 75% of individuals aged 12 and older reporting lifetime consumption. Alcohol withdrawal syndrome is a prevalent condition affecting a substantial portion of the US population.
While there is no exact number, hundreds of people in the United States alone die each year from alcohol withdrawal. Alcohol is also linked to over 85,000 deaths per year, with close to 178,000 people dying annually from alcohol-related causes.
