Getting into a drinking or drug problem can be insidiously easy: just one drink to celebrate a happy occasion, or a puff of a joint or a line of coke at a party, and a few months later you’ve lost everything.
Getting out of a drinking or drug problem isn’t often easy, but that doesn’t stop some people from trying to quit cold turkey, without any help or control. The dangers of cold turkey detox are real, and they are life-threatening.
The phrase “cold turkey” simply means suddenly stopping consumption of the vice of choice: drinking, smoking, drugs, problem gambling, compulsive eating, etc. The phrase originates from an old American idiom meaning “to speak clearly or plainly”, and it was adapted to mean leaving behind a bad habit without any help (i.e., similarly clearly or plainly).
Detox (or detoxification) refers to giving the body a period of time to purge its physical craving for an addictive substance. When detox is properly done, a patient is given a safe, controlled environment in which they can go through the painful and difficult changes of the body breaking free of the substance dependence.
How painful and difficult? HBO’s Addiction Project lists some of the physical effects of a patient withdrawing from drug or alcohol consumption:
Together, these are part of an extreme case of alcohol withdrawal known as delirium tremens (literally meaning “shaking frenzy”). It occurs in up to 10 percent of all alcoholics who attempt detox, and kills 35 percent of them if they do not seek treatment. It is caused by an alcohol-addled brain unable to regulate its biochemistry in the sudden absence of the alcohol upon which it had come to depend for years.
WebMD lists more effects of suddenly stopping alcohol consumption:
If you detox in a treatment center or a hospital, you’ll have doctors and nurses who can talk you through each of these effects. They can administer anti-anxiety medication to help calm you down and make you less of a danger to yourself. The Journal of Clinical Pharmacy and Therapeutics published a 2010 study that concluded that drugs in the benzodiazepine family are the primary choice of prescription medication to treat alcohol withdrawal symptoms. Examples of such benzodiazepines are:
These drugs can help patients control their trembling, disorientation, and fear as their bodies disengage from the habit of substance abuse. In cases of seizures and convulsions, doctors may prescribe carbamazepine (sold as Tegretol).
But imagine going through these symptoms at home, alone, or with people who have no medical training, who can’t prescribe benzodiazepines, who don’t know what to do when your withdrawal symptoms drive you to the point of pleading and begging for a drink, anything to make the pain and depression and physical and mental agony go away. Imagine facing the possibility of actually dying as a result of the withdrawal symptoms shutting your body down.
That is widely suspected to be the cause of death of British singer Amy Winehouse (who famously sang about her refusal to go to a rehabilitation center). When she died in July 2011, the physician director for the Betty Ford Center told The New York Times that people are generally unaware that unsupervised alcohol withdrawal can be dangerous, and said that self-detox, without any medical help, is “one of the most fatal complications” of substance abuse.
This is why the Director of the National Institute of Drug Abuse, Dr. Nora Volkow, says that detox is “the beginning of the road” of treatment. Take counseling out of the equation, and the treatment will go nowhere. In fact, it may even be harmful in the long run, because a patient will not have the skills and tools to cope with the temptation to relapse, that they otherwise would have learned in a therapeutic setting.
Of course, alcohol is not the only drug whereby quitting cold turkey poses a danger to the patient. People who addicted to opiates (heroin, methadone, morphine, Suboxone, and even prescription benzodiazepines) are at immense risk if they try to stop their drug intake without a plan. Psychology Today lists three substances from which withdrawal if attempted without medical supervision can lead to death: alcohol, benzodiazepines and opiates.
Although benzodiazepines are prescribed to help calm patients down when their alcohol withdrawal symptoms become too difficult to bear, the truth is that benzodiazepines themselves are very addictive. That is why they are only dispensed by licensed practitioners, and why the U.S. Drug Enforcement Administration has classified benzodiazepines as Schedule IV depressants. These drugs have a low potential for abuse (compared to the drugs in the preceding three Schedules) but enough potential to warrant caution and careful prescription.
For this reason, Psychology Today warns that attempting to stop taking benzodiazepines after a period of prolonged exposure can be fatal. Benzodiazepines should not be consumed without a prescription and without a health care provider’s knowledge and consent. Trying to get off benzodiazepines can take as long as 18 months, depending on how much benzodiazepine has been consumed and for how long.
Similarly, other forms of opioid addiction are incredibly difficult (if not actually impossible) to overcome. People who abuse heroin do not realize how completely their nervous system adapts to long-term exposure to heroin, which results in the typical withdrawal symptoms of nausea, diarrhea, vomiting, abdominal pain, insomnia and mood disorders.
However, heroin is so deadly that even medical attempts to detoxify can still lead to fatalities. ScienceBlog.com reports on the practice of rapid detox, whereby heroin users are anesthetized and given infusions of opioid blockers. In theory, this should turn the patient’s brain off their opioid dependence as they sleep, a process that can be over in as little as eight hours. In the words of a USA Today report on the practice, the claim is that users can “sleep through their withdrawal.”
But as ScienceBlog.com reports, a study by psychiatrists at Columbia University Medical Center and the New York State Psychiatric Institute at Columbia (and published in the Journal of the American Medical Association) found that such methods are “ineffective and unsafe,” and they can result in increased stress, psychosis and even death.
All of these factors point to the importance and necessity of detoxing in a professional setting. Without the supervision of medical personnel, a patient is exposed to the possibility of relapsing, injuring themselves or the people around them, and dying from their bodies becoming vulnerable to any kind of infection or complication as a result of the sudden termination of the substance of abuse.
With medical care, on the other hand, doctors and treatment staff are on hand to ensure that even when the withdrawal symptoms are at their most severe, the patient is always safe. There is no chance of abandoning the detox, because alcohol, heroin and other harmful substances will be kept out of reach. There is no chance of the patient’s body completely shutting down in the face of the excruciating detox effects, because the doctors will be on-hand to administer Suboxone, benzodiazepines, or whatever other medications are necessary to alleviate the distress. There is no chance of a concerned friend or family member supplying the patient with drugs or alcohol because they cannot stand to see their loved one in the throes of withdrawal.
Instead, for as difficult as the detox stage naturally is, the patient will be monitored and supervised to ensure that the process reaches its natural conclusion. Once the addict is completely over his physical need for drugs or alcohol, he is ready to embark on a course of psychotherapy to help him correct his thought and behavior patterns, to learn how he can live again without the need to self-medicate his problems away.
This is why Dr. Nora Volkow of the National Institute of Drug Abuse called detoxification “the beginning of the road.” Patients who attempt to detox on their own are often too focused on starting the process, not realizing that if they really want to go clean and leave their days of substance abuse behind them, cold turkey is not the answer. Cold turkey addresses an immediate need, that of getting over the physical compulsion to drink or use drugs, but it does nothing to identify and eliminate the deep reasons behind why that substance abuse took hold in the first place. Psychotherapy does, and that’s why cold turkey detox is not the best choice.
Every year in the United States, there are around 500,000 cases of alcohol withdrawal so serious that medical attention is required. While people who attempt home detox may have the right idea – there’s never anything wrong with wanting to stop drinking – trying to go it alone is incredibly dangerous and short-sighted.
Instead, call us. Working together, we can come up with a treatment plan for you that does not require you to risk your health or your life, and we can guide you through the ups and downs and twists and turns of leaving behind a lifestyle of addiction and excess. Please call us today, and find out that you don’t have to be alone.
Integrated Treatment of Substance Abuse & Mental Illness