Can You Die From Alcohol Withdrawals?

To say this is a loaded question would be the understatement of the year, or perhaps the decade, but in simple terms, the answer is a “yes.” A sudden cessation of alcohol consumption can be dangerous to one’s health, as seen by the tragic death of actor Nelsan Ellis, who died from cardiac complications (heart failure) following the sudden withdrawal from alcohol in 2017. Healthcare providers agree that alcohol is one of the most toxic substances to detox from, especially when done cold turkey and without medical care.

According to the National Center for Drug Abuse Statistics (NCDAS), alcohol abuse and alcohol use disorders (AUD) kill three million people annually, accounting for up to 6% of global deaths. Alcohol use disorder is a clinical diagnosis of alcoholism or alcohol addiction, which affects around 10.2% of Americans aged 12 and older. AUD or alcohol dependence is the underlying cause of alcohol withdrawal symptoms. As such, treatment for alcohol withdrawal should be followed by addiction treatment to reduce the risk of relapse and maintain long-term recovery.

What Is Alcohol Withdrawal?

The onset of alcohol withdrawal occurs when an individual reduces or stops drinking abruptly after a long period of heavy consumption and constant exposure. These symptoms can range from mild to severe depending on individual factors such as the duration of alcohol abuse, the severity of physical dependence, the amounts of alcohol consumed, age, weight, and gender. 

Alcohol-dependent patients may experience mild withdrawal symptoms as quickly as six hours after their last drink and moderate to severe manifestations within twelve to seventy-two hours after the last drink. Among the most severe withdrawal symptoms are delirium tremens, hallucinations, and seizures. These manifestations are the result of alcohol-induced chemical imbalances in the brain, which lead to an increase in nerve cell activity when alcohol is withheld. 

Due to the complexity of alcohol withdrawal symptoms, patients who wish to stop drinking should receive treatment in an inpatient setting to avoid life-threatening complications.

Stages of Alcohol Withdrawal

Clinical evidence from the American Academy of Family Physicians (AAFP) highlights three stages of alcohol withdrawal syndrome: 

Stage 1 – Mild symptoms may appear within six to 12 hours after the last drink. Mild symptoms of withdrawal include the following:

• Headache
• Insomnia
• Anxiety
• Tremors
• Loss of appetite
•  Nausea
• Profuse sweating
• Gastrointestinal issues 
• Heart palpitations (cardiac complications)
• Tachycardia
• Hypertension

Stage 2 -. Minor withdrawal symptoms, like anxiety and cravings for alcohol, can worsen over the next 12 to 24 hours. Moderate symptoms may arise within 12 to 48 hours after the last drink. This stage of withdrawal may include the following symptoms:

• Elevated blood pressure or rapid heart rate (related to heart attacks)
• Foggy and dazed state
• Mild hyperthermia
• Breathing difficulties

Patients are at a greater risk of experiencing alcoholic hallucinosis (visual, auditory, or tactile hallucinations) during 12 to 24 hours and alcohol withdrawal seizures around 24 to 48 hours in the withdrawal timeline.

Stage 3 – Severe symptoms may manifest around 48 to 72 hours after the last drink. Patients are at risk of developing symptoms of delirium tremens (DTs) during this stage. Symptoms of alcohol withdrawal delirium include the following:

• Hallucinations (predominately visual)
• Disorientation
• Agitation
• Paranoia
• Seizures or convulsions
• Severe autonomic hyperactivity (tachycardia, fever, sweating, and hypertension)

Acute-alcohol withdrawal symptoms generally subside within five to 10 days. Clinical management of alcohol withdrawal is imperative to reduce the risk of life-threatening complications. 

Some patients may experience symptoms beyond the above-mentioned alcohol withdrawal timeline. These prolonged symptoms are referred to as post-acute withdrawal syndrome (PAWS), which could last for months, if not years.

Complications of Alcohol Withdrawal

Heavy alcohol consumption over a lengthy period, followed by an abrupt break, can result in a more aggressive expression of withdrawals, which could lead to various complications. The disease processes and events that follow abrupt alcohol withdrawal can result in serious illness and death. Some patients develop seizures, the severity of which may worsen after future withdrawal episodes. Another potential complication is cognitive impairment and delirium, which may progress to Wernicke-Korsakoff syndrome, a chronic memory disorder. In addition, changes in physiology, mood, and behavior may persist even after acute withdrawal has faded, increasing the risk of relapse.

Delirium tremens – According to the U.S. National Library of Medicine, only 3% to 5% of patients with AUD exhibit dangerous withdrawal symptoms like DTs. This condition has anticipated mortality of up to 37% without proper medical attention. Medical conditions, including cardiac arrhythmia, respiratory arrest, oversedation, and aspiration pneumonitis, have been linked to delirium tremens. All of these conditions carry a high risk of serious infections or death.

Alcohol withdrawal seizures – The chances of having withdrawal seizures, and their intensity, grow higher with the number of past withdrawals. The correlation between the number of alcohol detoxifications and the development of alcohol withdrawal complications, including seizures, has been linked to long-term changes in excitatory neurotransmission (how your brain is stimulated). Alcohol withdrawal seizures affect around 5% of patients undergoing detox.

Other long-term health complications of alcohol withdrawal are: 

• Cardiac and blood pressure issues
• Being more susceptible to strokes and liver disease 
• Digestive tract problems 
• Significantly weaker immune system (increases your chances of falling sick)
• Higher risk of developing various forms of cancer 
• Poor memory recall with the onset of dementia in some cases
• Prolonged mental health issues relating to anxiety and depression 

Who Is at Risk for Alcohol Withdrawal Syndrome?

Chronic alcohol exposure over an extended period increases the risk of experiencing symptoms of alcohol withdrawal. Patients with a history of alcohol abuse or alcoholism or who previously required medical supervision for severe alcohol withdrawal syndrome are at an even greater risk.

Preventing Alcohol Withdrawal Syndrome

A surefire way to prevent the adverse effects of withdrawals is to avoid heavy drinking in all its forms, especially over a long period. If you are struggling with an alcohol use disorder, it’s important to seek medical, pharmacological and/or holistic interventions as soon as possible. The main goal of treatment is to safely and slowly reduce your dependence on alcohol so you can return to the best version of yourself.

Treatment for Alcohol Withdrawal 

Medical detox is the initial stage of treatment and recovery. No one should ever attempt alcohol detox on their own, as the severity of symptoms can change rather swiftly. With the assistance of medical professionals, alcohol withdrawal symptoms should be managed in inpatient or outpatient settings. It is widely agreed that alcohol detoxification at an inpatient treatment facility is the most secure and comfortable option.

After a successful detox from alcohol, patients must continue with professional treatment to address the underlying conditions that contribute to alcohol dependence. This can help reduce the risk of relapse and maintain prolonged sobriety.

Finding the Right Supportive Care

Nearly two million Americans suffer from alcohol withdrawal syndrome annually. Therefore, selecting a treatment facility that meets your requirements and recovery goals is crucial when embarking on your road to recovery. If you want to get the most out of your treatment and get the best results, you need a program that can adapt to your needs and provide you with multiple viable options. 

Futures Recover Healthcare is committed to walking the challenging path to recovery with you. We provide:

• Qualified & accredited staff
• Family-inclusive recovery
• Customized treatment options
• Aftercare planning
• Flexible treatment plans to account for progress
• Evidence-based therapeutic interventions

The course of alcohol withdrawal is highly variable and somewhat unpredictable. It’s heartbreaking to watch someone you love struggle with alcohol addiction and withdrawal symptoms. This is where Futures Recovery Healthcare makes a real difference. At Futures, patients are part of an exclusive treatment community with state-of-the-art facilities, amenities, and cutting-edge wellness techniques. At the heart of our program, we offer alcohol-dependent adults a variety of rehabilitative pathways focusing on chronic disease management, battles with addiction, and co-occurring mental health disorders.