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The Dangers of Quitting Alcohol “Cold Turkey”

June 17, 2022

Table of Contents

Everyone’s body reacts differently to alcohol. Some individuals can drink heavily for years and have very mild to even no withdrawal symptoms. Other individuals may drink less and yet have very complicated or dangerous withdrawal symptoms. 

Unfortunately, the amount of alcohol alone does not necessarily correlate well or be very predictive of a person’s risk of having complicated withdrawal. Instead, other factors like genetics may play a larger role. 

Doctors call significant alcohol withdrawal syndrome delirium tremens or DTs. [1] Up to 2% of people with DTs die due to the condition.[2] Rather than quitting cold turkey, work with skilled detox professionals. Medications and monitoring can ensure you get sober safely. 

Alcohol Withdrawal Symptoms & Timeline

Alcohol withdrawal can start as soon as a few hours after a last drink and usually lasts no longer than 3-5 days after a last drink. 

People with a mild or moderate alcohol use disorder may feel subtle symptoms like anxiety, nausea, and insomnia when they quit cold turkey for the first 24 to 72 hours.[3] Heavy or long-term drinkers can experience more severe symptoms, including hallucinations, confusion, seizures, and even delirium tremens which is defined as changes in blood pressure or heart rate that can be life threatening. [4] While only a small percentage of people who withdraw from alcohol will have more serious complications like seizures or delirium tremens, these symptoms can be dangerous and even life threatening, and therefore anyone with a history of these symptoms should speak to their doctor and be carefully monitored if they are attempting to “detox cold turkey”.  

Benzodiazepine Pharmacotherapy for Alcohol Withdrawal

If you are going through detox in a medically supervised setting, you can be given medications that help ameliorate the unpleasant symptoms of alcohol withdrawal and prevent the more serious and life threatening side effects. Generally, benzodiazepine medications are used as first line treatment for alcohol withdrawal symptoms. Benzodiazepine medications can calm your overactive brain cells. Researchers say no benzo drug is proven superior to all others in helping people recover from alcoholism.[5] But long-acting forms of the drug - Diazepam or clonazepam - offer the best control of symptoms and are the most commonly used. 

Benzodiazepines can be given in two ways in the hospital or detox center: [6]

  • Fixed schedule: You take your medications on a routine that's set by your doctor.
  • Symptom triggered: Your medical team assesses your withdrawal symptoms and offers treatment accordingly. 

If you have a history of “complicated” alcohol withdrawal - withdrawal with worrisome features such as seizures, hallucinations, or changes in blood pressure or heart rate - talk to your doctor about medically supervised withdrawal and use of benzodiazepines to aid in your safety during detoxification. 

Quitting Alcohol Cold Turkey: FAQs 

Can your body go into “shock” when you stop drinking?

Yes. Long-term drinking can suppress electrical impulses in your brain. When you suddenly quit, your brain cells can overreact and trigger symptoms, such as hallucinations, heart rate changes, and seizures. These can, in rare instances, be life threatening. Shock is defined as changes in your vital signs - heart rate, or blood pressure. In rare instances, individuals can go into shock and even die from alcohol withdrawal. 

What happens to your body when you stop drinking suddenly?

It really depends on the individual - your drinking habits and your genetics. Some individuals can quit drinking “cold turkey” without any withdrawal symptoms, while others may have very severe or even life threatening symptoms such as hallucinations, seizures, or shock that requires intubation and intensive care. The greatest risk for developing these more serious symptoms are having a history of these symptoms in the past. Everyone’s body is different when it comes to dependence on alcohol, and the amount of alcohol alone does not necessarily predict how severe withdrawal symptoms will be. 

Will my body recover if I stop drinking?

Yes, the acute symptoms of withdrawal usually last somewhere between one to five days. Once five days are over, generally the symptoms of acute withdrawal subside and the risk of any life threatening withdrawal symptoms is minimal. However, you still may have cravings to drink that can continue to last for weeks, months or even years after stopping drinking. In addition, there can be lasting health effects of drinking that are irreversible even after stopping drinking, particularly liver damage. 

What is the safe way to stop drinking?

If you’ve been drinking heavily for a long time, you should not stop drinking suddenly without medical supervision. A medical professional can design and supervise a detox process for you. Medications may be used to support your body during this time, so you feel more comfortable and the process is safe.

Elena Hill, MD, MPH

Elena Hill, MD; MPH received her MD and Masters of Public Health degrees at Tufts Medical School and completed her family medicine residency at Boston Medical Center. She is currently an attending physician at Bronxcare Health Systems in the Bronx, NY where she works as a primary care physician as well as part time in pain management and integrated health. Her clinical interests include underserved health care, chronic pain and integrated/alternative health.

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Citations

  1. Delirium Tremens. National Library of Medicine. https://medlineplus.gov/ency/article/000766.htm. January 2021. Accessed May 2022. 
  2. Risk Factors for Lethal Outcome in Patients with Delirium Tremens: Psychiatrist's Perspective. A Nested Case-Control Study. Annals of General Psychiatry. https://annals-general-psychiatry.biomedcentral.com/articles/10.1186/1744-859X-12-39. 2013. Accessed May 2022. 
  3. Delirium Tremens (DTs). Medscape. https://emedicine.medscape.com/article/166032-overview. Accessed May 2022. 
  4. Dealing With the DTs. The Hospitalist. https://www.the-hospitalist.org/hospitalist/article/123281/dealing-dts. February 2007. Accessed May 2022. 
  5. Treatment of Alcohol Withdrawal Syndrome. U.S. Pharmacist. https://www.uspharmacist.com/article/treatment-of-alcohol-withdrawal-syndrome. November 2014. Accessed May 2022. 
  6. Caring for Hospitalized Patients with Alcohol Withdrawal Syndrome. Nursing Critical Care. https://journals.lww.com/nursingcriticalcare/fulltext/2019/09000/caring_for_hospitalized_patients_with_alcohol.3.aspx. September 2019. Accessed May 2022. 
  7. Advances in the Science and Treatment of Alcohol Use Disorder. Science Advances. https://www.science.org/doi/10.1126/sciadv.aax4043. September 2019. Accessed May 2022. 

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