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Can You Die During Alcohol Detox?

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You can die during the alcohol detox process. The most severe complications typically result from grand mal seizures or withdrawal delirium.

Alcoholism, or alcohol use disorder, is associated with numerous problems, such as health issues, financial strain, relationship distress, and legal consequences, all of which can severely impact a person’s quality of life.

With an estimated 14.4 million Americans struggling with problematic drinking learning about appropriate interventions, safe detoxification programs, and sustainable treatment options is essential for those struggling.1
Glass of whiskey, alcohol addiction
Acute alcohol withdrawal is a serious, sometimes-complicated process with significant health risks. Because of the potential dangers that present during withdrawal, it’s crucial to understand the importance of medical supervision and monitored care when detoxing from alcohol.

What is Detox?

Detoxification refers to the set of interventions designed to manage acute intoxication and withdrawal symptoms. Detox programs promote the safe elimination of toxins from the body, including alcohol. For many, detox represents the first “point of contact” with a treatment system, as it often marks the initial step to recovery or on the continuum of addiction care.8 While detox alone is no substitute for comprehensive substance abuse treatment, it provides the individual with assessment and stabilization needed to prepare both the body and mind for sobriety.

Without professional intervention, detoxification will occur naturally, in a process commonly referred to as “quitting cold turkey.” The cold turkey method involves abstaining from drinking alcohol on their own after chronic consumption.

In general, medical professionals advise against cold turkey detox methods, as complications from alcohol withdrawal can be fatal. Serious withdrawal symptoms, such as grand mal seizures and withdrawal delirium, may occur, as well as associated complications, including Wernicke-Korsakoff Syndrome (a brain disorder caused by thiamine deficiency), heart complications, and disturbances in mood and thought.3

Detox can be more safely managed in a formal inpatient or outpatient setting, such as a hospital or freestanding detox center, where patients receive physical and mental health evaluations, interventions to help achieve stabilization, and support for the physical and emotional discomfort often associated with early withdrawal.8

Why is Alcohol Withdrawal Dangerous?

Abusing alcohol can lead to the development of alcohol dependence. Physiological dependence develops as the body naturally adapts to the presence of alcohol. People who develop significant levels of alcohol dependence will experience withdrawal symptoms when they abruptly stop or slow their alcohol intake.4 Due to the emergence of these unpleasant symptoms, people may continue to drink to avoid or prevent them—a cycle that could contribute to the development of an alcohol addiction. Once addicted, a person will drink compulsively despite the negative impact on their life.

The cluster of symptoms referred to as acute alcohol withdrawal can range from relatively mild to fatal. Though there is no surefire way to predict the exact nature of a pending withdrawal, the likelihood of experiencing a more complicated or prolonged course of alcohol withdrawal is increased by the presence of the following factors:3
Man with horrible stomach pain sitting on a couch

  • Lifetime or long duration of alcohol consumption.
  • Prior detox attempts.
  • Prior seizures.
  • Prior history of delirium tremens.
  • Intense cravings for alcohol.
  • Specific alterations of blood chemistry.
  • Nervous System Disturbances.
  • Elevated Liver Enzymes.
  • Co-occurring mental health disorders.

In severe alcohol addiction, withdrawal can be risky and lead to death without appropriate monitoring and support. For instance, about 3 to 5% of people with alcohol use disorders experience grand mal seizures while withdrawing from alcohol.6 Without professional detox care, these seizures can be fatal.

Delirium tremens (DT’s) refers to a state of autonomic nervous system hyperactivity and hallucinations and/or disorientation that sometimes develops in association with alcohol withdrawal. Although these mental disturbances are not life-threatening in and of themselves, they can lead to bizarre, violent, and erratic behavior, which can increase the risk of accident, injury, or death. DT’s typically develop within 24-72 hours after last alcohol consumption, and symptoms tend to subside within 1-7 days.5

For this reason, it is best that you seek the evaluation of a medical professional before deciding to quit drinking, especially if you’ve been drinking large amounts of alcohol over an extended period of time. Your doctor can assess your risk of experiencing complicated or life-threatening withdrawal and will refer you to the appropriate level of detox care.

How Many People Die During Alcohol Detox?

Research estimates that 1 to 4% of hospitalized patients who experience withdrawal delirium die. Most commonly, these deaths are due to:6

  • Complications from grand mal seizures.
  • Hyperthermia (dangerously high body temperature).
  • Cardiac arrhythmias (irregular heart beat).

In some cases, medical issues that develop in association with chronic alcohol abuse can present life-threatening risks even after the acute withdrawal period has passed. Such co-occurring conditions may include:3,9

  • Gastrointestinal bleeding.
  • Cirrhosis or other liver disease.
  • Pneumonia.
  • Wernicke-Korsakoff syndrome.

Wernicke-Korsakoff syndrome is a nervous system disorder caused by a vitamin B1, or thiamine, deficiency that sometimes develops in severe alcoholics. Characteristics of this serious condition include ataxia, paralysis of eye muscles, severe amnesia, significant cognitive impairment, disorientation, and delirium. If inadequately treated, this syndrome can progress to stupor, coma, and eventually death.3

While the numbers of deaths associated with alcohol detox are difficult to pinpoint, the risks of life-threatening complications are very real and need to be considered anytime an attempt to quit drinking is made. Alcohol withdrawal deaths can be prevented or reduced with proper medical attention and care. Professional medical detox programs accomplish this through close symptom monitoring and management of potentially fatal withdrawal complications.

How to Reduce the Risk

If you or someone you know is addicted to alcohol and is thinking about quitting, the safest course of action is seeking 24-hour medical support. Detox services can occur in several settings, including hospitals and inpatient detox and treatment programs.8

Medical care helps mitigate the risks associated with alcohol withdrawal. Trained staff members can provide essential withdrawal medication, such as benzodiazepines and antipsychotics, if needed. These medications can help prevent or manage seizures, tremors, and symptoms of delirium or hallucinations. 24-hour care also provides a thorough evaluation and ongoing assessment of symptoms, treatment for co-occurring issues, and emotional/psychological support.8

In fact, research suggests that 24-hour medical care is the preferred setting for alcohol detox, based on principles of safety and humanitarian concerns.8

If you or a loved one is struggling with alcohol addiction, you are not alone, and help is always available. To find support, schedule an appointment with your primary care physician or a mental health therapist and receive a comprehensive evaluation. They can provide you with referrals to detox and substance abuse treatment programs they think will be most beneficial for you.

Sources

  1. Substance Abuse and Mental Health Services Administration. (2017). Mental and Substance Use Disorders.
  2. U.S National Library of Science. (2017). Alcohol Withdrawal.
  3.  Trevisan, L., Boutras, N., Petrakis, I., Krystal, J. (1998). Complications of Alcohol Withdrawal. Alcohol Health & Research World, V. 22 (N) 1.
  4. American Psychiatric Association. (2013). Diagnostic and statistical manual of mental disorders (5th ed.). Washington, DC.
  5. Mainerova, B., Prasko, J., Latalova, K., Axmann, K., Cerna, M., Horacek, R., Bradacova, R. (2015). Alcohol withdrawal delirium- diagnosis, course, and treatment., Biomed Papers Medical Facility University Palacky Olomouc Czech Republic, 159(1): 44-52.
  6. Schuckit, M. (2014). Recognition and Management of Withdrawal Delirium (Delirium Tremens). The New England Journal of Medicine.
  7. Verelst, S., Moonen, P., Desruelles, D., Gillet, J. (2012). Emergency Department Visits Due to Alcohol Intoxication: Characteristics of Patients and Impact on the Emergency Room. Alcohol and Alcoholism, V. 47(4, 1).
  8. Substance Abuse and Mental Health Services Administration. (2013). Detoxification and Substance Abuse Treatment.
  9. Monte, R., Rabunal, R., Casariego, E., Lopez-Agreda, H., Mateos, A., & Pertega, S. (2010). Analysis of the Factors Determining Survival of Alcoholic Withdrawal Syndrome Patients in a General Hospital. Alcohol and Alcoholism, 45 (2), 151-158.

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