Monday October 20th 2014

When you should not stop drinking cold turkey

You should not stop drinking cold turkey if you’ve been drinking heavily for a period of weeks or months. This is because your body has adapted to the presence of alcohol and will go through withdrawal when the alcohol is taken away.

Instead of gritting your teeth and jumping on the wagon “cold turkey”, it’s really best that you have medical supervision during alcohol withdrawal, perhaps at a certified detox clinic or alcoholism rehabilitation centers. We outline the reasons below, and provide a list of risk factors for avoiding cold turkey alcohol cessation.

Alcohol withdrawal is possibly fatal

What happens when you stop drinking alcohol?  First, the body tries to seek homeostasis without alcohol.  During this period, withdrawal symptoms can be uncomfortable, scary and possible complications can arise.  This is why doctors do not recommend cold turkey withdrawal from alcohol, especially without medication or medical supervision. And even in cases of young healthy people, doctors medically supervise the detox.

The outcome of “cold turkey” treatments have not been established through scientific studies or evidence-based methods. Additionally, there are medications available for alcohol withdrawal which help ease symptoms and make the experience more bearable. Plus, alcohol withdrawal is unpredictable and life threatening complications are always possible. These complications are made more risky and you should not try to stop drinking cold turkey when you:

  • are in general bad health
  • are of increasing age
  • have been diagnosed with co-occurring medical, surgical, and/or psychiatric disorders
  • have consumed high amounts of alcohol in the weeks prior to treatment
  • have poor nutritional status
  • use medications (prescription, over-the-counter, or herbal)

Each of these factors can increase the severity of alcohol withdrawal symptoms. Proper medical management of alcohol withdrawal reduces the probability of withdrawal complications and can save your life.

Cases which require medical supervision during detox

Additionally, there are other even more specific cases when you should definitely NEVER stop drinking cold turkey without medical assistance. Specifically, you should not stop drinking cold turkey if:

1. You are extremely intoxicated

When you are in the middle of alcohol intoxication, doctors need to monitor you in order preserve respiration and cardiovascular function until alcohol levels fall into a safe range. In other words, during a severe cass of intoxication, you can stop breathing or your heart can stop beating. Likewise, doctors need to monitor vital functions, protect breathing, and observe potential accidental sucking in of food particles or fluids into the lungs (aspiration), hypoglycemia, and thiamin deficiency.

2. You have been through withdrawal 3-4 times in the past

Doctors have noticed the appearance of severe withdrawal reactions in people who have experienced 3-4 previous alcohol withdrawals. In these cases, unless adequate medical care is provided, it is possible that you experience Complicated or severe medical withdrawal including: delirium, hallucinations, delusions, seizures, and/or disturbances of body temperature, pulse, and blood pressure.

3. You have a previous history of seizures or delirium tremens (DTs) during withdrawal

You should not stop drinking cold turkey if you have had seizures or DTs in the past. Instead, doctors can administer medications like benzodiazepine to help you avoid seizures and DTs. Why? Because untreated DTs or seizures may result in death and disability.

4. You have been diagnosed with co-occurring unstable medical and psychiatric conditions

Only young people in good health, with no history of previous withdrawal reactions, are considered for alcohol withdrawal without medication. Still, you need not go through detox without aid. Medications are available to help your body normalize to functioning without alcohol again.

The reasons why people drink beer, wine, and spirits are usually harmless at first.  But once your body builds an immunity (tolerance) to alcohol, and becomes dependent on alcohol … you have to address both medical and mental problems which compel you to drink.  Once your body is free from alcohol, the work of looking inside begins.  Got questions? Please leave them here. We’ll be happy to answer them.

Reference sources: Protocol for Alcohol Intoxication and Withdrawal

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3 Responses to “When you should not stop drinking cold turkey
Sheila Sunderland
9:31 pm March 10th, 2014

Hello! I am 35 years old. I have been drinking for many years on a daily basis. Sometimes consuming up to 20 Coors lights in one day. I had back surgery in October of 2013 and have been taking hydrocodone, as prescribed along with and anti-depressant that I am weaning myself off of. I am a nurse and would definitely classify myself as a functioning alcoholic. I have decided that I either need to slow way down on consumption or quit completely. I quit for two days last week and was miserable. Moody, I had a headache, insomnia, shakes. So, the third day, I went and bought some wine and felt better immediately. I Haven’t had a drink today but my decision to not consume and the thought of not having any beer or wine in the house is killing me! I can’t stop wanting to go buy…something. I guess I need to know how long theses withdrawal symptoms are going to last and should I quit cold turkey or still consume 1-2 per evening so I don’t feel like crap? Let me know what you think please. Thank you for your time.

Sincerely,
Sheila S.

12:44 pm March 11th, 2014

Hello Sheila. Sometimes, tapering down from alcohol can help minimize symptoms. In your case, you may need an assessment to determine possible level of alcohol dependence and to schedule a detox plan. Additionally, there are medications which can help during withdrawal.

I know that coming off alcohol is difficult. Especially when psychological craving is present. Have you considered attacking this as a medical problem and seeking help through rehab? Inpatient or outpatient treatment could benefit you. I wish you ALL THE BEST.

Steven
6:09 am July 20th, 2014

Hello, I’m hoping to find some advice for my father, who is 62 years old, and has been alcohol dependant right from my earliest memories (I’m 32 yrs old so dependant for at-least 25 years).
Very long story short: in recent years he has gone from being a reasonably functional alcoholic who would drink in moderation from the moment he woke in the morning and saving his binges till later in the evenings, to being 100% dysfunctional and constantly binging whenever he is awake. He sleeps for an average of 18 hours a day, and the remaining 4 hours he drinks until he falls asleep. He has always been prone to (what I perceive to be) stages of psychosis, but in my opinion he has been in a constant state if psychosis for around a year now. He is apparently unable to walk, he has liver cirrhosis, and he lives on the couch. He forces my step mum to provide him with alcohol, and is very aggressive towards her if she dares to deny it to him, despite his weaknesses she is still very scared of him, and totally under his control. Due to his lack of mobility, she apparently also has to deal with his bodily functions – from the couch.

I am considering spending 3 to 4 days with him, and taking control of his alcohol consumption. In other words, I will be the one denying him of alcohol, because he cannot manipulate me the same way as he does my step mum.. Effectively forcing him into cold turkey.

Having read your article, it seems that this would probably not be advisable, probably causing lethal consequences. Would you advise another way that I may be able to achieve a solution? I have tried to have him admitted to mental health hospitals, tried to have doctors interviene, tried to get the police involved.. But none of the relevant authorities will do anything unless he admits himself, or does harm to himself or someone else. I’m not sure if you are based in the UK, but that’s how the system seems to work here.

If you have any advice at all, I will be so greatul for your input. Thanks for reading,

Regards,

Steven.