When you quit drinking, can alcohol withdrawal kill you?
Alcohol addiction is an insidious condition that sneaks up on you. Many people drink alcohol on the weekends and on special occasions for many years without any serious problems.
For some people, they will eventually cross one line after another, bringing them gradually to a state where they are psychologically and physically dependent on alcohol. First, they may realize that a drink or two at night during the week helps the to feel better or sleep better. Then, when they start to drink too much and get a hangover in the morning, a drink or two in the morning takes away the headache.
Eventually, you may find that you are drinking every day of the week, and consuming more alcohol than most people would be able to handle while still functioning with respect to everyday life. Along with daily drinking, you will likely have other problems, such as blackouts and legal issues, such as DUI or DWI charges.
If your drinking has reached the level where there is no doubt that you are suffering from advanced alcohol use disorder, you may be aware of the dangers of quitting cold-turkey. Quitting alcohol suddenly can lead to a dangerous withdrawal syndrome that can certainly be life threatening.
Do not use the dangers of withdrawal as an excuse not to quit.
While there is danger in quitting, you should not use this as an excuse to continue drinking at a dangerous level. While there have been deaths from alcohol withdrawal, there have been many more deaths from excessive, ongoing alcohol overuse.
It is possible to detox safely off of alcohol with medical assistance. When it comes to a safe, medical detox from alcohol, you have several options.
First, there is the traditional detox and residential rehab pathway to getting sober comfortably and safely. If you check in to detox, you will be in a hospital-like setting for a week or two.
During that time, your health status will be monitored around the clock by nurses or other healthcare professionals. During your stay, you will also visit with an internist or family doctor as well as a psychiatrist or psychologist.
The primary purpose of inpatient detox is to prevent deaths from alcohol withdrawal.
The detox process involves two major components. The most important of all is time. It takes time for the alcohol in your system to be processed by your liver, broken down, and excreted. There is no way to speed up this process. As your body eliminates the alcohol remaining in your system, your autonomic nervous system will kick into overdrive.
The second major part of detox is protecting your brain and body from the effects of acute alcohol withdrawal. This involves sedative medication to calm down your overexcited nervous system as well as important nutritional support to prevent permanent consequences, including brain damage. Detox facilities administer medical treatment to make the detox process tolerable and to prevent serious events, such as seizures, irregular heartbeat, and agitation, and confusion.
Following your detox unit stay, you will likely be transferred to a residential rehab facility.
While still a healthcare facility, the medical management will be stepped down in intensity from what you experienced in detox. Staff will more likely consist of addiction counselors and non-medical staff as opposed to doctors and nurses.
In rehab, you will engage in group therapy as well as some individual therapy. Many rehabs employ an evidence-based process known as 12-step facilitation. The 12-step facilitator will meet with you and other residents and introduce the basics of 12-step programs, such as Alcoholics Anonymous and Narcotics Anonymous.
When you have completed your rehab stay, which will likely last for up to four weeks or more, you will then step down to an outpatient rehab program. Outpatient treatment involves your going to group and individual therapy during the day four several hours at a time. In the evening, you will live at home or in a sober living home.
A sober home is a place where you and other people recovering from addiction or alcoholism live together. There are strict rules in place to ensure that no one is using drugs during their stay in the sober living facility. Sober living also involves an atmosphere of recovery in which residents travel together to 12-step meetings or the meetings are brought to their facility.
Is the traditional detox and rehab path the only way to overcome alcohol addiction?
There are some major downsides to the traditional rehab method of recovering from alcoholism. Yet, it may seem like detox and rehab are the only solution, since alcohol withdrawal is so dangerous.
Often, the detox and rehab components are combined at a single facility. Residents are considered to either be engaged in the detox or rehab phase of treatment, but all services are provided under one roof. So, when a family member investigates where to send their loved one for help, checking them into a rehab for a month or more seems like the only safe and effective way get them safely off of alcohol.
Rehab is very costly. You may think that the cost reflects intensive twenty-four hour medical monitoring, with doctors and nurses checking the status of their patients, day and night.
In reality, rehab consists mostly of activities such as meeting in groups, learning about the 12-steps, interacting with other residents, and generally being in a safe space away from family and life stress and easy access to alcohol or drugs.
Even with minimal medical care involved, residential rehab typically costs around $30,000 for a 30-day stay. Some rehabs can cost more than double this amount. And, some rehabs have programs that require a minimal stay of 3-5 months, making the cost that much greater.
If you have good health insurance coverage, the cost of rehab may not seem so bad. You, or your family, simply pay the deductible, and your insurance company picks up the rest of the bill. Insurance will often cover multiple rehab stays, so if you do not succeed the first time, you can go back and check in again. There are people who have gone through rehab many times, over and over, as long as their insurance will continue to cover the bill.
However, if your insurance does not cover rehab, or if you are uninsured, a $30,000 stay is not easily affordable. You may be able to save some money by going to an outpatient rehab, but the price will still be high.
Another major downside is being cut off from the world for a 30-day stay in rehab. While some people have lost everything in their lives before going to rehab, many people are still working at their job and taking care of their family when it becomes necessary to stop drinking alcohol.
It may not seem practical for people who have been functional in their lives to suddenly drop everything and disappear for a month. Who will take care of the family? Who will pay the bills?
This brings up an interesting idea. What if many people who drink too much were ready to get help early on, but they didn’t because they couldn’t afford the time or money for a month or more of rehab? What if they waited it out until they hit rock bottom, losing their health, family, money, career, and possibly freedom, before they were willing to accept whatever help is available?
What alternatives are there to going to detox and rehab to quit drinking safely?
As an alternative to the traditional detox and rehab route, there are outpatient detox programs available. You may be able to find a detox program in your area where you can come in during the day to check in and get meds if you need them.
An outpatient detox will allow for you to continue with your regular home life and you may be able to continue with work, though you will need time to attend the detox program during the day. For some people, outpatient detox may be a good solution.
Another possible solution is a full home detox, managed by a concierge doctor or a VIP doctor. With home detox, the doctor makes a house call and evaluates you in your own home. The doctor then prescribes needed medications and monitors you personally or arranges for monitoring to be done by a home health nurse, or even experienced family members.
In today’s world of the COVID-19 pandemic, more people are turning to telemedicine and telehealth services. It is possible to perform an alcohol detox program by telemedicine, though there are some limitations.
To effectively provide alcohol detox safely via telemedicine, it will be important to have willing and supportive loved ones available to help observe the patient and administer medications and supplements.
Can a sober coach or sober companion help with a home detox?
For people who want to detox off of alcohol and skip the entire rehab process, they may opt for home detox via telemedicine or a house call doctor. An excellent additional service to make this type of treatment more effective is a sober companion service. An experienced sober companion is similar to having an alcoholics anonymous sponsor who is available onsite or by phone at all times to provide support.
If you are familiar with the AA program, then you are aware that you can work with a sponsor at no cost. You are expected to check in with your sponsor regularly and to work on the 12 steps together. The program teaches that the sponsor/sponsee relationship benefits both sponsor and sponsee, hence, there is no need for payment either way.
The difference with a sober coach or sober companion is that it is a paid, professional service. Your sober coach will call you and visit you, even if you do not reach out. Where an AA sponsor expects you to do your part of the work to get support, the sober companion will be there for you either way, as long as the service contract lasts.
Is there another way to detox that is not as dangerous and that does not require the use of controlled medications, such as Valium or Librium?
Part of the treatment for alcohol withdrawal is administering benzodiazepine sedatives to calm the patient and to help prevent seizures. Wouldn’t it be great to avoid the harrowing experience of detox altogether and still quit dangerous alcohol use? What if you don’t want to get so sick that a doctor has to give you potent sedatives to keep you from seizing?
Can alcohol withdrawal cause death if you reduce alcohol intake gradually? The Sinclair Method is a treatment protocol that is gaining popularity in the US, and is already being used in other countries around the world. Interestingly, The Sinclair Method, or TSM, uses a prescription medication, that is non-controlled and relatively safe for most people. That medication is naltrexone, an opioid receptor blocker.
Naltrexone is already approved by the FDA to treat alcohol use disorder. It is available as a monthly injection, Vivitrol, or as a daily tablet.
The difference in the typical use of naltrexone for alcoholism and use with The Sinclair Method is how the naltrexone is taken. With TSM, the Vivitrol injection does not work with the protocol, the reason being that the patient must have control over when they take the medication.
Can you die from alcohol withdrawal if your doctor prescribes medication-assisted treatment?
The patient also cannot take Antibuse, another common medication prescribed for alcoholism. The problem with Antibuse is that it makes the patient sick when they take it and drink alcohol. The Success of TSM depends on the patient being able to continue drinking in moderation for a period of time.
The way TSM works is that the patient takes a naltrexone tablet an hour before drinking. When they do drink, they only consume a small amount of alcohol, for example, a beer or a glass of wine. The naltrexone blocks activity in the reward center of the brain, blocking the pleasure response of endorphin release that occurs with drinking alcohol.
Over time, a process called pharmacological extinction occurs in the brain, diminishing alcohol cravings gradually. With each drinking session, the naltrexone effects help the patient to limit alcohol intake to one drink or less. Patients who follow the TSM protocol are able to completely stop drinking or keep alcohol intake to a minimum.
A major advantage of TSM is that, because alcohol intake is reduced gradually, there is less concern of having a dangerous alcohol withdrawal syndrome.
There is no need to check in to detox and take sedatives to prevent deadly seizures. TSM is very effective, with an efficacy rate that is similar to other medication-assisted treatment protocols used for opioid addiction.
Medication-assisted treatment in general has a far higher success rate than rehab, therapy, or support meetings alone. Whichever protocol is followed, naltrexone is an excellent tool for doctors to provide to patients who can tolerate it.
One other benefit to a tapering protocol, such as TSM, is that patients can avoid the alcohol deprivation effect. When a person quits alcohol, or other addictive drugs, they may feel great at first, but after a period of time, cravings set in and can get increasingly worse.
The alcohol deprivation effect is a major reason why so many people relapse within the first year of sobriety. By using naltrexone to help reduce alcohol intake gradually, this dangerous effect is reduced or absent.
Are there any good alcoholic podcasts to listen to for more information?
Alcohol addiction and alcohol recovery has been a topic of many episodes on The Rehab Podcast on the Mental Health News Radio Network. If you are looking for a good alcohol recovery podcast, you have come to the right place. We cover topics ranging from traditional treatment and recovery programs to the leading edge of scientific research and upcoming treatment options.
In fact, we even have an interview with Claudia Christian, film and television actress and proponent for The Sinclair Method for treating alcohol addiction. If you check the Claudia Christian IMDB page, you will see that in addition to well over 100 credits as actress, including multiple major motion pictures and popular television series, she has produced and starred in a documentary on the topic of TSM, “One Little Pill.”
Alcohol withdrawal is a serious topic. There have been many deaths from alcohol withdrawal that could have been prevented with proper medical care. So, in addition to reading articles and books, and listening to podcasts, it is important to see your doctor as soon as possible if you are concerned that you might have an issue with alcohol overuse. Your doctor will be able to assess you for alcohol use disorder and help you to formulate a plan to quit or reduce alcohol use.