“My hands shake uncontrollably. I am unable to write with a pen. Fever. Chills. Nausea. No appetite. I am getting 300-500 calories a day from food I force myself to eat. I am confused and have random thoughts running through my head. The other day I kept thinking I was dead and this was my afterlife. Stuttering Speech. Insomnia. Pain and soreness throughout my entire body. within 2-3 days of not drinking I cave because drinking is the only thing that alleviates my symptoms.” - Anonymous
Alcohol is one of the most widely abused substances in the United States. In a recent study published by the Journal of the American Medical Association, researchers found that alcohol use rose from 65% to 73% of the adult population between 2002 and 2013, with the sharpest increases occurring for women and minorities. Today, more than 86% of people aged 18 or older report having drank at least once. Although this legal intoxicant may seem less dangerous than substances such as heroin and methamphetamine, the truth is that alcohol can be even more deadly. It is estimated that 88,000 people die from alcohol-related causes annually, making it the third leading preventable cause of death in the United States.
Alcohol can prove deadly for many reasons. For one, consuming too much at one time can easily lead to unconsciousness, poor decision making, and possible liver poisoning. Its legality and ubiquity also make it easier to acquire and consume, increasing its lethal capabilities. Death from asphyxiation is also possible, as anyone who passes out from drinking could possibly vomit and choke to death. Alcohol depresses the nerves associated with involuntary actions such as breathing and the gag reflex, so death from asphyxiation can occur for anyone who is not conscious because of intoxication. One of the lesser known causes of death from alcohol occurs due to withdrawals.
Can You Die From Alcohol Withdrawal?
Experts say that while it’s not common, death from alcohol withdrawal is very much possible. The family of Amy Winehouse reported that the singer died from fatal seizures induced from alcohol withdrawal in her last days. While her toxicology report provided evidence to the contrary, healthcare professionals all agree that alcohol withdrawal may lead to life threatening side effects. Complications such as convulsions, where the body goes into epileptic seizures, and cardiac arrhythmia, where the heart goes into spasms, are two possibly fatal outcomes for heavy drinkers who go cold turkey. This is why hospitals and treatment centers will sometimes advise individuals to continue drinking before checking in for treatment.
What Happens During Alcohol Withdrawal?
Alcohol withdrawal occurs when an individual who has consumed excessive alcohol for a prolonged period of time suddenly stops using. Alcohol is a sedative, so generally speaking it will relax the body and induce calmness. Over time, the brain must work in overdrive to overcome the effects of the sedation and achieve a normal functional level. When the body suddenly stops intaking alcohol, the neurotransmitters continue to fire as though they were being subdued, only this time there is nothing to block them. The neurotransmitters firing in overdrive will lead to all sorts of complications.
Another way to think of the process is your brain is a car and alcohol is the brakes. Imagine driving around with one foot on the brakes. If you suddenly take your foot off the brake but continue with the same pedal pressure on the gas, you will be going much faster. It’s also like if two equally balanced people were playing tug of war and one person suddenly dropped the rope, sending the other person flying backward. The most common side effects of alcohol withdrawal are:
- Loss of appetite
- Depression and irritability
The side effects are painful but are not necessarily lethal. The more serious side effects usually only occur in severe alcoholics who have years of continual heavy drinking under their belt. The appearance of any of these withdrawal symptoms should be followed by immediate hospital or treatment admittance.
- Heart Palpitations
- Delirium Tremens (DT)
The most common withdrawal symptoms are usually treatable with a mixture of rest, fluid intake, and careful monitoring. Generally speaking, a hangover is akin to a mild form of withdrawal. Severe alcohol withdrawal however, can be deadly and should be medically monitored. In 2010 study published by the Oxford University Press Journal Alcohol and Alcoholism, 6.6% of patients who were admitted to hospitals with alcohol withdrawal symptoms died due to various effects of their symptoms. All participants in the study were severe drinkers who had gone cold turkey.
According to the Institute for Heart & Vascular Health, there are many reasons why alcohol withdrawal can lead to heart palpitations. Known as alcohol-induced arrhythmias, these palpitations can be caused by electrolyte abnormalities, rebound and adrenergic hypersensitivity, QT interval prolongation, decreased heart rate variability and atrial effective refractory period, and more.
Neurotransmitters in the brain are always firing, but during withdrawal they are firing without any sort of cap. Hallucinations tend to occur in withdrawal around 12 to 24 hours after a person stops drinking and are experienced by more than a quarter of alcoholics admitted into hospitals for withdrawal. These hallucinations are typically acoustic verbal and are accompanied by delusions and mood disturbances, similar to schizophrenia.
Abrupt cessation of alcohol after prolonged usage is known to induce seizures, even in people with no previous diagnosis of epilepsy. Both alcohol toxicity and metabolic changes are responsible for causing seizures, with the central nervous system firing off on all cylinders after being suppressed by alcohol for so long. According to the National Institute on Alcohol Abuse and Alcoholism, more than 90% of alcohol withdrawal seizures occur within 48 hours after the patient stops drinking, and that the likelihood of having withdrawal seizures as well as the severity increases with the number of past withdrawals.
Delirium Tremens (DT) is the rapid onset of confusion and physical symptoms that encapsulate severe alcohol withdrawals. Also known as the “The Shakes”, DT’s usually occur in individuals with more than a year of heavy alcohol intake and manifest within 2 - 3 days of their last drink. Symptoms include body tremors, confusion, deep sleep, delirium, mood changes, hallucinations, and restlessness when awake. Although it is manageable with the proper care, Delirium Tremens is fatal in 5-15% of patients.
Stories of Alcohol Withdrawal
To give readers a better picture of what Delirium Tremens and other symptoms of alcohol are like, we’ve compiled first hand testimonials from the online forum Reddit. These views are not endorsed or associated with Landmark Recovery.
“Shaking. Sweating. Diarrhea. Extreme Anxiety. Racing Heart. Hearing Voices. The first night in the hospital I sweat so much my bed had to be changed. I was put on a drip as I couldn’t keep fluids down. My anxiety was so high I couldn’t sleep for days.”
“When I stopped drinking I was fantastically anxious. My ears were ringing and it felt like I was surrounded by static. In fact I felt like the world was closing in on me. I went to lunch at a regular place and I was sweating. I could not hear my lunch companion but I could see her lips moving and her eating, but the guy across the restaurant, 5 tables away, I imagined I could hear his conversation as clear as a bell. I returned to my office and I had a panic attack believing irrationally that if I continued standing or walking around I would be sucked out of my office window and that I would fall to my death. I laid down on my carpet and sunk my fingers into the pile of the carpet for safety. My heart was racing. Everything I looked at was washed out of colors or looked as if it had been burned out. I had intrusive thoughts and I could not sleep. The panic, the sweats, the crazy thoughts, the audio hallucinations, and the panic and racing thoughts continued for a few days but never as bad as this meltdown moment around the first day or two.”
I was convinced that the entire universe was dissipating and there was nothing I could do. I remember vividly hearing children laughing and crying outside my window (it was the middle of the night) and then robotic alarms blaring. At one point, I looked down at my hand and saw that it was completely covered in blood... it took several inspections, but the blood eventually disappeared and I realized it hadn't been real. I saw faces in the texture of objects (bathmat, ceiling stippling, etc) and every time I closed my eyes I saw absolutely horrible things (that often made no sense) that made me jolt. My vision steadily narrowed in to a pinprick and all I could hear was a rushing in my ears. The worst of this lasted for about 36-48 hours
Other Side Effects of Long Term Alcohol Abuse
A person who experiences any of the above withdrawal symptoms is also likelier to encounter one or several of the following side effects associated with their health. Chronic drinkers and addicts tend to suffer from similar medical conditions as a result of their drinking. These include:
This is caused by long term damage to the liver as a result of excessive alcohol abuse. When the liver tissue begins to scar, it begins to function less and less well, eventually losing the ability to produce proteins and filter toxins out of the blood like it is supposed to. Symptoms include jaundice, portal hypertension, and skin itching along with anemia, high blood sugar, and hypertension. In advanced cases of Cirrhosis, only a liver transplant is possible for a person to heal.
Long term alcohol abuse also results in heart problems. Cardiomyopathy is sometimes referred to alcohol heart disease and occurs when the heart has been weakened and thinned by long term alcohol abuse, affecting its ability pump blood efficiently. This can lead to heart failure and other life threatening health problems. Treatment includes prescribing beta-blockers, reducing sodium, and taking ACE inhibitors.
Also known as peripheral neuropathy, this disorder arises due to excessive alcohol consumption causing nerve damage to the peripheral nerves in the human body. Excessive alcohol consumption over a prolonged period depletes the body of vital nutrients and disrupts the way nerves acquire these nutrients. The resulting damage of alcohol induced neuropathy can severely limit the function and capabilities of the peripheral nerves, and in some cases lead to permanent loss of function in the hands and feet of victims. It is estimated that somewhere around 65% of people in the United States who have been diagnosed with alcohol use disorder also have alcoholic neuropathy.
Withdrawing from alcohol can be a dangerous and even deadly prospect. If you are concerned about a drinking problem and wish to help yourself or a loved one get sober, it is recommended that you consult with a medical professional or enlist the assistance of a certified detox and rehabilitation center. Alcohol withdrawal is a telltale sign of a serious issue. At Landmark Recovery, we pride ourselves on offering leading, evidence-based treatment for those suffering from any kind of substance use disorder. Visit our website to learn more about drug and alcohol rehab options such as residential treatment and intensive outpatient.