Stopping alcohol use cold turkey refers to abruptly quitting alcohol consumption without any professional assistance or tapering. For some drinkers, this may seem like an appealing option to quickly curb alcohol intake. However, quitting alcohol cold turkey can be dangerous and life-threatening for many. This article provides an overview of alcohol withdrawal dangers, safer medical detox options, and tips for getting help.
Dangers of Stopping Drinking Cold Turkey
Alcohol acts on the same receptors in the brain as anti-anxiety medications. With prolonged alcohol use, the brain starts to depend on alcohol to function normally. When alcohol use suddenly stops the brain goes into overdrive, causing withdrawal symptoms.
Withdrawal symptoms occur because the brain is reacting to the sudden lack of alcohol. Symptoms can begin as early as two hours after the last drink. They tend to peak around 24 to 72 hours later. Some level of withdrawal is common in most regular heavy drinkers. However a subset of drinkers experience severe dangerous symptoms.
Common Alcohol Withdrawal Symptoms
Mild to moderate withdrawal symptoms include:
- Anxiety
- Shakiness
- Sweating
- Nausea and vomiting
- Insomnia
- Depression
- Irritability
- Fatigue
These symptoms may feel like a bad hangover. For people who experience mild to moderate withdrawal, quitting alcohol cold turkey can be uncomfortable but manageable. However, for others, withdrawal can quickly become dangerous or life-threatening.
Dangerous Withdrawal Symptoms
Up to 20% of heavy drinkers experience severe alcohol withdrawal syndrome. Symptoms may include:
- High blood pressure
- Rapid heart rate
- High body temperature
- Seizures
- Hallucinations
- Delirium tremens (“DTs”)
DTs occur in about 5% of people experiencing alcohol withdrawal. This disturbed mental state results in extreme confusion, agitation, vivid hallucinations, and delirium. People with DTs often do not realize they are unwell. The mortality rate of DTs is estimated to be 1-5% without treatment.
Factors That Increase Risk of Severe Withdrawal
Certain factors can place a person at higher risk for dangerous alcohol withdrawal, including:
- History of withdrawal seizures or DTs
- Other health conditions like infections, heart disease, diabetes, or liver problems
- Long history of heavy drinking
- Prior head injury
- Older age
- Drinking large amounts right before quitting
Due to the unpredictability of withdrawal seizures and DTs, many substance use experts warn against attempting to quit alcohol cold turkey.
Medical Detox for Alcohol Withdrawal
Because alcohol withdrawal can be unpredictable and dangerous, professional detox is recommended for most people quitting alcohol. There are several medications that can be given to help control withdrawal symptoms:
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Benzodiazepines: These anti-anxiety medications can significantly reduce the risk of severe withdrawal complications like seizures or DTs. They help calm the overexcited brain and nervous system. The most frequently used benzo is chlordiazepoxide (Librium).
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Anticonvulsants: Medications like carbamazepine help prevent withdrawal seizures. They are often used alongside benzos for added protection.
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Beta blockers: These medications help control high blood pressure and rapid heart rate during detox. Propranolol and atenolol are commonly used.
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Clonidine: This blood pressure medication reduces anxiety, sweating, restlessness and other sympathetic nervous system symptoms during withdrawal.
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B vitamins: Alcohol depletes vital B vitamins. Replenishing thiamine, folate, and other B vitamins can help minimize withdrawal symptoms and prevent brain damage.
Detox providers use a combination of monitoring and medications to keep the person safe and comfortable as alcohol leaves their system. After detox, ongoing treatment with counseling helps prevent alcohol relapse.
Getting Help for Alcohol Addiction
Quitting alcohol completely often requires a combination of detox, behavioral therapies, support groups, and/or medications. Treatment should also address any co-occurring mental health or medical conditions. Options may include:
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Inpatient alcohol rehab: 24/7 care and support for 1-3 months of intensive programming. Detox is provided on-site.
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Outpatient rehab: Attend day or evening treatment 1-5 days per week while living at home. Includes skills training, therapy, and peer support groups.
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Individual counseling: Work one-on-one with a substance abuse counselor on motivation, managing triggers, building a sober network, etc.
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Group counseling: Gain peer support and learn from others experiencing alcohol recovery.
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12-step programs: Free peer support groups like Alcoholics Anonymous use a 12-step model to achieve sobriety.
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Medications for alcoholism: FDA-approved medications like naltrexone, acamprosate, or disulfiram help reduce cravings and promote abstinence.
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Sober living homes: Live in a structured, alcohol-free home with peer support during early recovery.
Finding Help for Alcohol Addiction
If you or a loved one wants to quit drinking, the safest approach is to seek professional medical advice first. Many options for alcohol addiction treatment are available, including:
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Talk to your doctor about getting a referral to addiction treatment providers in your community.
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Contact the SAMHSA National Helpline at 1-800-662-HELP for free confidential information about alcoholism treatment and recovery support services in your area.
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Search the SAMHSA Treatment & Recovery Locator online directory for alcohol rehab programs, detox centers, and support groups.
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Check whether your state or local health department has resources to assist people with alcohol use disorder.
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Reach out to a local hospital or addiction treatment center to learn about their detox and treatment options.
With help, safe alcohol detox, and ongoing treatment, long-term recovery is absolutely possible. Quitting alcohol abruptly and without support can be extremely dangerous, even fatal in some cases. If you are dependent on alcohol, get medical advice and consider entering a professional detox program to start your recovery journey. Over time, you can reclaim your health, relationships and quality of life in recovery.
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Other Dangerous Side Effects of Alcohol Withdrawal
Other common issues seen in those experiencing alcohol withdrawal include dehydration, electrolyte imbalances, and malnutrition—all of which could lead to serious medical complications.5 Electrolyte imbalances, for instance, can cause an irregular heartbeat. Malnutrition, which is common in those with alcohol use disorder, can result in significant thiamine deficiency, which could result in Wernicke-Korsakoff syndrome (WKS).5 WKS is actually two separate syndromes: One is a temporary but severe condition known as Wernicke’s encephalopathy, marked by confusion, optic nerve paralysis, and muscle coordination problems. The second condition is the persistent and disabling Korsakoff’s psychosis, which results in long-term memory and learning problems.7
What Happens When You Stop Drinking Cold Turkey?
More than 28 million people aged 12 and older had an alcohol use disorder in 2020, a medical condition defined by the uncontrollable use of alcohol despite the negative impact on an individual’s physical and mental health and their relationships with family, friends, and others.1,2 Excessive, regular alcohol consumption can result in structural and functional changes within brain circuits involved in reward, stress, and self-control, which can lead to the compulsive patterns of use characteristic to addiction.2
Research indicates that about half of individuals with an alcohol use disorder who suddenly stop drinking or drastically reduce their alcohol intake experience a set of symptoms known as alcohol withdrawal syndrome.3
The signs and symptoms of alcohol withdrawal may include:3-5
- Sweating.
- Rapid heart rate.
- Heart palpitations.
- High blood pressure.
- Headache.
- Insomnia.
- Nausea and vomiting.
- Hallucinations.
- Anxiety.
- Agitation.
- Tremors or shakes.
More rarely, if left untreated or inadequately managed, withdrawal can progress to violent seizures, delirium tremens (DTs), and death.3
What specifically happens in your body when you abruptly cease drinking depends on a variety of factors. How much, how often, and how long alcohol was consumed affect the severity of the withdrawal symptoms.4 Additionally, older adults, those with a past history of alcohol withdrawal seizures, and individuals with comorbid physical or mental health conditions may be at risk of experiencing more severe alcohol withdrawal symptoms.6
While exact timing differs from person to person, alcohol withdrawal syndrome typically begins within 6 to 24 hours after the last drink of alcohol and can last for days:5
- During hours 6-12, relatively milder withdrawal symptoms set in. These may include insomnia, tremors, mild anxiety, stomachache, headache, excessive sweating (diaphoresis), heart palpitations, and loss of appetite.
- During hours 12-24, hallucinations may occur.
- During hours 24-48, the risk for seizures is at its highest, should they develop.
- During hours 48-72, the risk for developing alcohol withdrawal delirium (or DTs) continues into the third day, with symptoms such as psychomotor agitation, hallucinations, disorientation, rapid heart rate, high blood pressure, fever, and sweating.
For those with alcohol dependence, quitting is not without risks. Acute alcohol withdrawal may be associated with certain medical complications. At American Addiction Centers (AAC), we offer the 24-hour supervision and care during medical detox. We can help you get through the withdrawal process safely and with the aid of medical professionals. Call one of our admissions navigators at .
Should I Quit Drinking “Cold Turkey” If I’m A Heavy Drinker?
FAQ
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