Can you die from alcohol detox?

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Can you die from alcohol detox?

It is possible to die from alcohol detox. When you quit drinking, the central nervous system becomes overexcited. This leads to alcohol withdrawal symptoms, and the symptoms can vary from mild to severe. People who are at risk of developing severe withdrawal symptoms are the ones who are at risk of death from the detox process.

People at risk of experiencing severe alcohol withdrawal symptoms are: 

  1. Those who meet the diagnostic and statistical manual (DSM-5) criteria for alcohol use disorder [1].  
  2. People with a history of heavy alcohol use.  
  3. People with a history of delirium tremens and withdrawal seizures.  
  4. People who have another acute illness combined with the alcohol addiction.  
  5. Those with a history of head injuries.  
  6. Those with poor health and nutrition.  
  7. People who have been taking alcohol for more than 2 decades.  

The national institute on alcohol abuse and alcoholism (NIAAA) defines alcohol use disorder as a medical condition characterized by an impaired ability to stop or control alcohol use despite its negative effects on your health, social or occupation life [2].  

This definition encompasses other conditions such as alcohol dependence, alcohol abuse, alcohol addiction, and alcoholism.  

NIAAA identifies alcohol use disorder as a brain disorder. This disorder can range from mild, moderate to severe. 

The factors that increase the risk of developing alcohol use disorder are: 

  1. Starting to drink from an early age.  
  2. Genetics and family history of alcohol abuse.  
  3. Mental conditions and a history of trauma.  
  4. Alcohol misuse e.g., binge drinking and heavy alcohol use.  

Those who suffer from alcohol use disorder should enrol at a treatment facility for alcohol detox. That's because the withdrawal symptoms can become life-threatening.  

In the UK and Ireland, alcohol is responsible for more deaths than any other substance abuse [3]. In 2019, there were 7,544 alcohol-specific deaths in the UK.

77% of those deaths were due to alcoholic liver disease. Also, 13% of the deaths were due to alcohol-related mental and behavioural disorders.  

There are no exact figures as to the number of deaths resulting from alcohol withdrawal. But experts agree that you could die from alcohol withdrawal because of the severity of the symptoms.

These symptoms include: 

  • Hallucinations (visual, auditory, tactile hallucinations) 
  • Seizures  
  • Faster heart rate  
  • Insomnia  
  • Nausea and/or vomiting  
  • High blood pressure  
  • Extreme agitation 
  • Confusion  
  • Sweating  
  • Headaches 

Even mild withdrawal symptoms such as vomiting can end up being fatal [3]. The risk of developing complications of alcohol withdrawal can cause significant illness and death [4].  

Some studies state that up to 20% of withdrawal symptoms end up in complications such as delirium tremens or seizures [5].  

Other factors that may increase your chances of dying from alcohol withdrawal are: 

  • Older age  
  • Delirium tremens  
  • History of medical problems  
  • Presence of liver cirrhosis  
  • Presence of other conditions such as pneumonia  

That's why it is recommended that you go detox at a medical facility or an alcohol rehab.

The medical professionals understand the withdrawal process and have the right tools in place to decrease the risk of complications. 

Addiction treatment also helps make the process as comfortable as possible.  

Why is alcohol detox so dangerous?

Alcohol detox is so dangerous because of the effects of alcohol in the body. You need to understand that alcohol affects various parts of the body, including the brain.

Prolonged alcohol use suppresses the functioning of the central nervous system.  

Excessive drinking leads to physical dependence as the brain builds a tolerance to alcohol.

The body adapts to the loss of motor coordination from the alcohol by altering the functions of major neurotransmitters (the GAMA and glutamate neurotransmitters).  

When the brain builds tolerance to the alcohol, you'll find that you need to drink greater amounts than before to feel the same effects that you used to with fewer drinks.

This tolerance is a warning of more problems from alcohol use.  

When you stop drinking or greatly reduce your alcohol intake, the brain responds by working to regain its equilibrium before the alcohol.

This adjustment leads to alcohol withdrawal symptoms. The withdrawal symptoms occur within hours after your last drink.  

Alcohol interferes with the dopamine levels in the brain. Dopamine is also known as a "feel good" hormone as this is the hormone that brings about pleasurable feelings when one takes alcohol.  

This effect of alcohol reinforces the behaviour to take more alcohol. Consequentially, alcohol detox results in a reduction in dopamine levels.

This change, combined with alcohols effect on other neurotransmitters, leads to mental disorders such as depression, anxiety, and psychosis.  

The alcohol withdrawal timeline varies from one person to another. Typically, the timeline is as follows:  

Stage 1(first 6-12 hours): Patient experiences mild withdrawal symptoms such as headache, insomnia, stomach pains, anxiety, loss of appetite, mood swings, nausea.  

Stage 2 (next 12-48 hours): The symptoms escalate to include severe withdrawal symptoms such as hallucinations, tremors of "shakes," abdominal cramps, 

Stage 3 (remaining 48-72 hours): Withdrawal symptoms include sweating, confusion, racing heartbeat, high blood pressure, delirium tremens (DTs) with hallucinations, and even death.  

Stage three symptoms can be dangerous if left untreated. However, they are less common and mostly associated with people who are long-term, heavy drinkers.

DTs may accompany other dangerous withdrawal symptoms such as hallucinations, severe mental confusion, fever, and seizures.  

These symptoms usually show up three days after the last drink. There are instances where they show up 10 days later.  

In most cases the DTs are a progression of the initial alcohol withdrawal syndrome.

They can occur suddenly and without warning which makes it dangerous for the person. For instance, a seizure while at the workplace could lead to a medical emergency.  

Some patients may experience a severe form of the alcohol related seizures. This severe form is known as status epilepticus. This condition can lead to brain damage of even death.

Out of those who experience seizures, only 3% are likely to develop status epilepticus [6].  

The severity of these withdrawal symptoms makes alcohol detox a dangerous process.

If you or your loved one try to detox by yourself and experience any of the stage 3 symptoms, you should reach out to a medical provider immediately.  

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Why is alcohol withdrawal life-threatening? 

Alcohol withdrawal can be life threatening if you experience the dangerous symptoms.

Symptoms such as seizures, DTs, high blood pressure, and heart failure can be fatal if left unchecked. The alcohol withdrawal seizures can happen at any time leading to injuries or even death.  

A study by Newman RK, Stobart Gallagher MA, and Gomez AE showed that 50% of patients who experienced seizures progressed into delirium tremens [6].

While only 2 to 3 people out of 100 will experience these seizures, the risks increase if: 

a. You have a history of 3 or more previous withdrawals.  

b. You have a history of head injuries e.g., brain trauma.  

c. You are a long-term alcohol drinker (more than 20 years).  

d. You have poor health and nutrition.  

The right care and treatment will help you or your loved one manage the withdrawal symptoms. When a chronic drinker goes cold turkey (self-detox) they will experience withdrawal symptoms that put their life at risk.  

The withdrawal process can lead to other life-threatening conditions such as respiratory failure, heart problems, Rhabdomyolysis and other complications that can be fatal.  

Proper medication and care can prevent or reduce the dangerous withdrawal symptoms. 

Can alcohol withdrawal symptoms kill? 

Yes, if you are a long-term alcohol drinker, quitting alcohol cold turkey or without medical supervision can kill you.

It is possible to die from alcohol withdrawal. But most of the cases that can lead to death are manageable and preventable.  

The treatment options that you can choose from are either outpatient or inpatient treatment.

When you consult a qualified healthcare provider, they will help you determine which treatment approach is suitable for you.  

Most recovering alcoholics experience mild to moderate symptoms. Generally, it is the severe withdrawal symptoms that can be fatal.  

During the addiction treatment process, you will be provided with medications such as: 

a). Benzodiazepines.  

b). Antiseizure medications such as carbamazepine .  

c). Antipsychotic medicines.  

d). Adrenergic medications.  

Medication is crucial to manage symptoms. Bear in mind that much of the danger from withdrawal has to do with the body's response to the chemical alterations going on in the brain and the rest of the body.  

Alcohol and other drugs such as opiates affect the GABA system. Withdrawing from these drugs is uncomfortable and painful.

Going through symptoms of alcohol withdrawal on your own is potentially dangerous and not advisable.  

How death can occur during withdrawal 

Death from alcohol withdrawal occurs when you detox without medical attention. It is not common for people to die from alcohol withdrawal.  

However, people who engage in excessive alcohol consumption are at risk of getting life threatening symptoms that can be fatal. Furthermore, a person trying cold turkey may develop dangerous complications.  

When you stop drinking, the alcohol withdrawal syndrome sets in within hours after your last drink. Common symptoms include headache, rapid heart rate, sweating, insomnia, irritability, the shakes, nausea or vomiting.  

Long term drinking results in complications. For instance, alcohol damages the cardiovascular system resulting in weakened heart muscles and irregular heartbeats [7].

These symptoms increase the risk of an alcohol-related heart attack and stroke.  

It is best to treat alcohol withdrawal with the assistance of medical professionals.

In a study by Elliott Dolores, the researcher observed that a significant number of patients who enter treatment have been using multiple substances aside from alcohol [8].  

The presence of mental health disorders combined with alcohol and other substances makes the symptoms of alcohol withdrawal more fatal. Patients who drink heavily may not realize that they have a problem.  

They may shy away from reducing their alcohol intake not realizing that alcohol withdrawal can be fatal.  

How to detox from alcohol safely?  

The best way to detox from alcohol safely is to enrol into a treatment facility. This could be an inpatient or an outpatient treatment facility.

 Both approaches offer similar treatment programmes, and the only difference is that with inpatient, you get to live in the facility for a period of time.  

It's important to note that there are various studies that associate inpatient treatment with long-term recovery.

People who are physically dependent on alcohol can benefit from inpatient care. This option provides them with a safe and supportive alcohol-free environment.  

Professional medical detox programmes help make the withdrawal process less painful.  

When you seek addiction treatment at an alcohol rehab, you get access to licensed medical professionals.

These professionals will provide you with the necessary medical treatment and medications to help you detox safely.  

Detox is only the first phase of treatment. This process takes about three to seven days.

Once you successfully detox, your treatment provider will help you find support groups that will offer you support in your recovery journey.  

You also get to attend various therapies that will impart you with coping skills to help you avoid relapse.  

To conclude: 

People who are heavy drinkers are at a higher risk of experiencing severe withdrawal symptoms.

At the onset, the symptoms may not appear severe, but as the days progress, the person may experience delirium tremens or other life-threatening symptoms.  

Stopping drinking is a painful process with negative consequences on the brain and body.

However, there are prescribed medications that can help manage the symptoms and make the detox process more manageable.  

There's more to treatment than just detox. When you or your loved one enter an alcohol rehab, you will get counselling to help you uncover the underlying factors contributing to the addiction.

Therapy also helps you develop coping skills to prevent relapse.  

Remember that if you have a history of withdrawals and relapsed, the next time you detox, you are likely to get more serious symptoms.  

Most people find it hard to accept that they struggle with alcohol dependence. Yet, one way to identify this issue is when you discover that you've been taking more than you used to.  

There are a variety of treatment options available with flexible payment options. So take the first step, and go for detox at a treatment facility to increase your chances for success at recovery.  

Abbeycare Pricing Bot

Last Updated: November 8, 2021

About the author

Peter Szczepanski

Peter has been on the GPhC register for 29 years. He holds a Clinical Diploma in Advanced Clinical Practice and he is a Clinical Lead in Alcohol and Substance Misuse for Abbeycare Gloucester and works as the Clinical Lead in Alcohol and Substance Use in Worcestershire. Find Peter on Respiratory Academy, Aston University graduates, University of Birmingham, Q, Pharmaceutical Journal, the Dudley Pharmaceutical Committee, Dudley Council, Twitter, and LinkedIn.